# Admin & Compliance
Source: https://help.elationhealth.com/admin-compliance
Manage user accounts, practice configuration, compliance requirements, integrations, data exchange, and reporting in Elation EHR.
Explore guides for administration, compliance, and practice management, or use the search bar to find a specific topic.
Multi-factor authentication, account security, user management, and practice configuration.
21st Century Cures Act, MIPS quality measures, Promoting Interoperability, and regulatory compliance.
Connect with Dock Health, Fullscript, IntakeQ, Zocdoc, Tebra, and other third-party tools.
Data migration, EHI exports, QRDA, hosted database, and Elation Analyst.
Practice Home, daily to-do lists, CQM dashboards, custom reports, and action item queues.
# API Reference
Source: https://help.elationhealth.com/api-reference
Connect your tools and systems to Elation EHR using the REST API or FHIR API.
Connect your tools and systems to Elation programmatically. Choose the REST API for full-featured integrations, the FHIR API for standards-based data exchange, or HL7 for lab and imaging result delivery.
Build custom integrations with Elation — authentication guides, endpoint reference, and request/response schemas.
Access standardized patient data using FHIR R4 for interoperability and certified health IT use cases.
Send lab results, radiology reports, and lab orders to Elation using HL7 ORM and ORU message specifications.
# 12 Diagnosis Code Support
Source: https://help.elationhealth.com/articles/12-diagnosis-code-support
Learn about 12 diagnosis code support per claim in Elation Billing
This article provides an overview of the 12 diagnosis code support feature in Elation Billing.
## Overview
### What is 12 Diagnosis Code Support?
Elation Billing now supports up to 12 Diagnosis Codes per claim, even with only one charge line. This feature aligns with CMS-1500 form requirements and supports value-based and quality programs that require more reporting on patient conditions.
### Why is 12 Diagnosis Code Support important?
More value-based and quality programs require comprehensive reporting on patient conditions. Having support for 12 diagnosis codes ensures you can capture all relevant diagnoses for accurate claims and program compliance.
## How it works
Elation Billing automatically selects a maximum of 12 diagnosis codes when submitting a claim. You do not need to manually remove diagnosis codes from the superbill before submission — the system handles this for you based on the CMS-1500 form limit.
### What you need to know
* You can enter more than 12 diagnosis codes on a bill in the EHR.
* When the claim is submitted, Elation Billing automatically selects up to 12 diagnosis codes for transmission.
* Manual trimming of diagnosis codes is **not** required as part of your standard workflow.
Changes made to the superbill for billing purposes do **not** affect the patient's medical record in the EHR system. Comprehensive patient diagnosis history remains intact in the EHR.
### Troubleshooting
If you receive a claim rejection related to an invalid diagnosis pointer or more than 12 diagnosis codes being transmitted, reach out to Elation Support using **Help** → **Contact Elation Support**.
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Using the Worklist](/articles/using-the-worklist)
# 21st Century Cures Act Introduction
Source: https://help.elationhealth.com/articles/21st-Century-Cures-Act-and-Elation-EHR
The 21st Century Cures Act (“Cures Act”) is a set of healthcare-related regulations.
## What is the 21st Century Cures Act?
The 21st Century Cures Act (**Cures Act**) is a set of healthcare-related regulations signed into law effective December 13, 2016, with provisions spanning multiple healthcare sectors. The Cures Act created six ongoing Conditions and Maintenance of Certification:
* **Application Programming Interfaces (APIs)**: Health IT (such as Elation) must transparently make API available and continue to meet ongoing updated API requirements.
* **Assurances**: Health IT must report that it does not block the exchange of electronic health information (EHI).
* **Attestations**: Health IT must attest to complying with Conditions and Maintenance of Certification every six months, starting in April 2021.
* **Communications**: Health IT cannot block communications about the usability, interoperability, security, user’s experiences, business practices, or manner of use of health IT.
* **Information Blocking**: Health IT must not take any action that blocks patient information. Information Blocking is defined as "a practice that is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information" ([§ 171.103](https://www.healthit.gov/condition-ccg/information-blocking)).
This provision is very important for the 21st Century Cures act and has a direct impact on how you use your EHR. [Read more about how Elation will help you stay compliant with Information Blocking Provision requirements](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions) .
* **Real-World Testing**: Health IT must develop and implement a plan to fully test the real-world use of the EHR yearly. The first plan must be completed by the end of 2021 and implemented in 2022.
[Learn more about the Conditions & Maintenance of Certification](https://www.federalregister.gov/documents/2020/05/01/2020-07419/21st-century-cures-act-interoperability-information-blocking-and-the-onc-health-it-certification).
## Who is impacted by the 21st Century Cures Act?
* Patients
* Clinicians
* All healthcare actors, including providers, health IT developers, and health information networks/health information exchanges (HINs/HIEs) must comply with the Cures Act, including information blocking provisions. "Healthcare providers" includes all physicians and practitioners regardless of the practice model.
* Health IT developers (such as Elation Health, Inc.)
* an individual or entity, other than a health care provider that self-develops health IT for its own use, that develops or offers health information technology (as that term is defined in [42 U.S.C. 300jj(5)](https://www.govinfo.gov/link/uscode/42/300jj)) and which has, at the time it engages in a practice that is the subject of an information blocking claim, one or more Health IT Modules certified under a program for the voluntary certification of health information technology that is kept or recognized by the National Coordinator pursuant to [42 U.S.C. 300jj-11(c)(5)](https://www.govinfo.gov/link/uscode/42/300jj-11) (ONC Health IT Certification Program).
## How Elation will help you stay compliant
Elation will continue to meet all 2015 CEHRT requirements as provisions of the 21st Cures Act take effect.
* For more information, please see [Staying compliant with Information Blocking Provisions](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions).
## Definitions you should know
* **Actor**: a health care provider, health IT developer of certified health IT, health information network or health information exchange.
* **Access**: the ability or means necessary to make electronic health information (EHI) available for exchange or use.
* **Covered entity**:
1. A health plan.
2. A health care clearinghouse.
3. A health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter.
* **Designated record set**:
1. A group of records maintained by or for a covered entity that is:
2. The medical records and billing records about individuals maintained by or for a covered health care provider;
3. The enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or
4. Used, in whole or in part, by or for the covered entity to make decisions about individuals.
5. For purposes of this paragraph, the term record means any item, collection, or grouping of information that includes protected health information and is maintained, collected, used, or disseminated by or for a covered entity.
* **Electronic Health Information (EHI)**: individually identifiable information that is transmitted in any electronic media or maintained in electronic media to the extent that it would be included in a designated record set regardless of whether the group of records are used or maintained by or for the covered entity
1. **From April 5, 2021 to October 6, 2022**, EHI is defined as data identified by data elements in the [United States Core Data for Interoperability (USCDI) v1 standard](/articles/Cures-Act-Patient-Data-and-USCDI)
2. **After to October 6, 2022**, EHI is defined as all electronic protected health information (ePHI)
* **Health IT**: the area of IT involving the design, development, creation, use and maintenance of information systems for the healthcare industry
* **Health IT developer of certified health IT**: an individual or entity, other than a health care provider that self-develops health IT for its own use, that develops or offers health information technology (as that term is defined in [42 U.S.C. 300jj(5)](https://www.govinfo.gov/link/uscode/42/300jj)) and which has, at the time it engages in a practice that is the subject of an information blocking claim, one or more Health IT Modules certified under a program for the voluntary certification of health information technology that is kept or recognized by the National Coordinator pursuant to [42 U.S.C. 300jj-11(c)(5)](https://www.govinfo.gov/link/uscode/42/300jj-11) (ONC Health IT Certification Program).
* **Interfere with or interference**: to prevent, materially discourage, or otherwise inhibit.
* **Practice**: *(v.)* an act or omission by an actor
For more definitions, please [click here](https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-D/part-171#p-171.102\(Actor\)).
## Additional Resources
* [21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program Final Rule in the Federal Register](https://www.federalregister.gov/documents/2020/05/01/2020-07419/21st-century-cures-act-interoperability-information-blocking-and-the-onc-health-it-certification)
* [Information Blocking Exceptions info sheet](https://www.healthit.gov/cures/sites/default/files/cures/2020-03/InformationBlockingExceptions.pdf)
* [ONC Information Blocking FAQs](https://www.healthit.gov/curesrule/resources/information-blocking-faqs)
* [United States Core Data for Interoperability Information Sheet](https://www.healthit.gov/cures/sites/default/files/cures/2020-03/USCDI.pdf)
## Related Articles
* [21st Century Cures Act Guide- Patient CCDAs and U.S. Core Data for Interoperability (USCDI)](/articles/Cures-Act-Patient-Data-and-USCDI)
* [21st Century Cures Act Guide- Staying compliant with Information Blocking Provisions](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions)
* [Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
# AI Billing Guide - Generating billing codes automatically in the EHR
Source: https://help.elationhealth.com/articles/AI-Billing-Guide-Coding
## Overview
### What is AI Coding?
When triggered, AI Coding automatically adds the following types of codes to the Billing Section of your visit note based on the information listed:
* **CPT Codes** - Evaluation & Management CPT codes are auto-populated based information included in the patient’s chart.
* **Diagnosis Codes** - Suggests and populates supporting ICD‑10 diagnosis codes per CPT line based on the visit note snapshot and the patient’s problem list.
* **NDC Codes** - Identifies drug codes and auto-populates NDC code, dosage, measure, and units using the patient’s chart and historical claims.
* **Lab & Vaccination Codes** - Reads recent lab measurements (including point-of-care labs) and documented vaccinations from the patient’s chart and uses them as context when generating codes, which can result in the corresponding lab or vaccination codes. For example, an A1c result captured from point-of-care labs can be used to code the corresponding measure.
* **Modifiers** - AI Coding can add modifier 25 when the visit note documents a significant, separately identifiable Evaluation & Management (E/M) service alongside a procedure on the same day, and modifier 59 when the documentation supports billing a procedure as a distinct service.
* **Place of Service & Modifiers (Telehealth)** - For telehealth visits, AI Coding automatically applies the correct Place of Service (POS) and telehealth modifier. It adds modifier 95 to the Evaluation & Management (E/M) line and sets POS 10 (telehealth in the patient’s home) for Medicare, or POS 02 for commercial payers. Modifier 95 is added only to the E/M line (not to wellness, Annual Wellness Visit, or preventive lines), and it is not applied to audio-only (telephone) visits, since modifier 95 is for audiovisual telehealth.
AI Coding adds to the codes already on the bill rather than replacing them. It may update supporting detail on an existing service line, such as a modifier or NDC value.
If your practice has created custom billing rules, AI Coding applies them while it generates codes. See [AI Billing Guide - Creating billing rules](/articles/AI-Billing-Guide-Creating-billing-rules).
### What are the benefits of AI Coding?
AI Coding expedites coding and improves coding accuracy and completeness.
### Automated quality coding (MIPS)
When enabled, **Quality Coding** lets AI Coding automatically add QPP (MIPS) quality measure codes to bills during coding automation. This helps your practice meet the CMS reporting minimum of at least six quality measures, reducing the risk of MIPS penalties.
Quality Coding identifies measures only when they are **clearly documented in the visit note**. AI Coding currently supports the following quality measures:
* **Diabetes care** - blood sugar control (such as A1C results) and diabetic eye/retina evaluations.
* **Depression screening** - a documented screening and any follow-up plan when one is indicated.
* **Blood pressure control** - blood pressure values recorded during the visit.
* **Weight / BMI** - a documented BMI and, when required, a related follow-up plan.
* **Advance care planning** - a documented discussion or recorded plan.
* **Falls risk** - a fall-risk assessment and documented plan of care when applicable.
* **Tobacco use** - tobacco-use screening and any documented cessation counseling or support.
The exact code AI Coding applies depends on the measure logic and what was documented — including whether the measure was **met, not met, or qualifies for an allowed exception**.
By default, Quality Coding is scoped to Medicare payers and Annual Wellness Visits (AWVs). You can configure which payers and visit types are eligible in the settings described below.
In the **Quality Coding** section of AI Billing settings, click the information (i) icon next to the heading to see the full list of supported quality measures.
## Setup
AI Coding must be enabled by an Admin Level User by following these steps:
| **1** | Click **Settings** -> **Billing** . |
| ----- | -------------------------------------------------------------------------------------------- |
| **2** | Go to the **AI Billing** section and set the **Billing Analysis** toggle to **green (ON)** . |
### Enabling Quality Coding (MIPS)
Quality Coding (MIPS quality measures) is enabled separately from the main Billing Analysis toggle. An Admin Level User can turn it on by following these steps:
| | |
| ----- | --------------------------------------------------------------------------------------------------------------------------- |
| **1** | In the **AI Billing** settings card, find the **Quality Coding** section. |
| **2** | Turn on the **Enable Quality Coding** toggle. |
| **3** | Use the **Payer Scope** and **Visit Scope** settings below the toggle to control which payers and visit types are eligible. |
By default, Quality Coding applies to Medicare payers and Annual Wellness Visits (AWVs).
## Workflow Instructions
### Using AI Coding
To use AI Coding:
| | |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **1** | Ensure your visit note documentation is complete. |
| **2** | Open the **Billing Section** of the visit note. Either click **+ Add Billing Information** or **Edit Bill**. |
| **3** | Click **Generate Codes** or **Apply Codes**. If a medication or injection CPT code is applied, AI Coding will look for NDC information in historical claims with the same CPT code and include the NDC information with the bill. |
| **4** | Review all codes and modifiers added by AI Coding for accuracy. Click the information (i) icon next to any added code or modifier to open its citation dialog and review the supporting evidence. |
| **5** | Click **Save & Close** to save the bill. |
### Reverting automatically generated codes
To revert the bill to what it was before using AI Coding, click the **Revert to previous bill** button at the top of the codes section.
### Providing feedback about the automatically generated codes
Click one of the feedback buttons to provide Elation feedback about AI Coding. This will assist Elation with improving on the tool.
* Mark as helpful
* Mark as unhelpful
### Reviewing AI Coding citations and providing feedback
Each AI-suggested CPT line, diagnosis (DX) row, and modifier displays an information (i) icon when supporting evidence is available. Click it to open the citation dialog, which shows:
* a plain-language rationale explaining why the code was suggested;
* the suggested code and its standard description;
* an inline preview of the visit note with the exact supporting text highlighted.
Modifiers that AI Coding added use the same citation dialog. For example, when AI Coding applies the telehealth modifier to a telehealth visit, the dialog shows the documentation it based that modifier on.
Within the citation dialog you can give per-code feedback using the thumbs up or thumbs down buttons and a free-text comment box. Elation uses this feedback to improve AI Coding recommendations and evidence display.
## Frequently Asked Questions
### Why can’t I see the Generate Codes or Apply Codes button on the bill?
You must enable Billing Analysis Settings in order for the **Generate Codes**/**Apply Codes** button to appear. Follow the [Setup](#setup) instructions above to enable the Setting.
### Can anyone click the Generate Codes or Apply Codes button?
Yes, both Provider Level Users and Staff Level Users can click the **Generate Codes**/**Apply Codes** button.
### Can I click the Generate Codes or Apply Codes button multiple times?
Yes, you can click the **Generate Codes**/**Apply Codes** button multiple times.
### Can AI Coding overwrite codes I’ve already entered?
AI Coding adds to the codes already on the bill rather than replacing them. It may update supporting detail on an existing service line, such as a modifier or NDC value. To return the bill to the state it was in before you ran AI Coding, click **Revert to previous bill** at the top of the codes section.
## Related Articles
* [AI Billing Introduction](/articles/AI-Billing-Introduction)
* [AI Billing Guide - Scrubbing claims](/articles/AI-Billing-Guide-Scrubbing-claims)
* [AI Billing Guide - Creating billing rules](/articles/AI-Billing-Guide-Creating-billing-rules)
* [AI Billing Guide - Queueing claims automatically](/articles/AI-Billing-Guide-auto-queue-claims)
# AI Billing Guide - Creating billing rules
Source: https://help.elationhealth.com/articles/AI-Billing-Guide-Creating-billing-rules
Create and manage custom rules that AI Billing applies when it generates codes and scrubs claims.
## Overview
### What are AI Billing rules?
AI Billing rules are instructions your practice writes for how it wants bills handled. AI Billing applies them alongside its own checks, so a rule can affect both the codes [AI Coding](/articles/AI-Billing-Guide-Coding) generates and the results of [claim scrubbing](/articles/AI-Billing-Guide-Scrubbing-claims).
These rules are also called custom rules or payer rules. In your EHR settings they appear as **AI Billing Rules**, or as **Custom Rules** with a **+ Add Validation** button. They are separate from the **Billing Rules** settings page in Elation Billing, which controls which fields appear on the Superbill.
A rule does one of two things, and Elation determines which one fits from the rule you describe:
* **Changes the bill** — for example, adding a modifier, adjusting a code, or setting a provider field.
* **Flags the bill for review** — the flag appears in the **Billing Analysis** section of the bill. A flag never changes codes and never prevents you from saving the bill, signing the visit note, or submitting the claim.
### What can a rule check?
Rules work from the bill, the claim, and the visit note context available to billing analysis. This includes service and diagnosis codes, modifiers, units, National Drug Code (NDC) information, service location, and the payer, provider, and patient details on the bill. A rule can apply to every payer or be limited to specific payers and providers.
Currently, rules cannot check information outside billing analysis, such as scheduling or an external payer portal, and cannot read images, scanned documents, or attachments. Rules also do not change clinical documentation or make a clinical judgment on a clinician's behalf.
To review what rules can and cannot check in Elation, click the information (i) icon in the **AI Billing Rules** section of your EHR settings.
## Setup
Creating rules requires AI Billing. An Admin Level User can turn it on by clicking **Settings > Billing**, going to the **AI Billing** section, and setting the **Billing Analysis** toggle to green (ON).
Your practice's **AI Billing** settings include one of two ways to create rules. Check which one appears before you start:
* **AI Billing Rules** — describe the rule you want in a chat box, and Elation drafts it for you.
* **Custom Rules** — build the rule yourself using the **+ Add Validation** button.
## Describing a rule in AI Billing Rules
1. Click **Settings → Billing**.
2. Go to the **AI Billing** section and find **AI Billing Rules**.
3. Describe the billing behavior you want in plain language, then send your message. Be as detailed and as specific as you can.
4. Read the response. Elation drafts a rule, explains whether it can enforce that rule today, and identifies any data the rule would need.
5. Review the drafted title and wording under **Rule to create**. Use **Applies to** to limit the rule to specific payers, or leave it empty to apply the rule to all payers. You can only select Payers that are in your **Insurance Carriers** list in the EHR.
6. Click **Save rule**.
Saved rules appear under **Your Practice's Rules**, along with a count of how many are active.
## Adding a rule with Add Validation
1. Click **Settings → Billing**.
2. Go to the **AI Billing** section and click **+ Add Validation**.
3. Select the **Claim Scrub Agent** you want to create a rule for:
* **Payer** — create a rule for specific Payers listed.
* **Eligibility** — create a rule based on the patient's insurance eligibility.
* **NCCI validation** — create a rule based on NCCI rules.
* **Clearinghouse validation** — create a rule based on Clearinghouse rules.
4. Select **Payers** that are tied to this rule, if applicable. You can only select Payers that are in your **Insurance Carriers** list in the EHR.
5. Specify the **Condition** you want the rule to look for. Be as detailed and as specific as you can.
## Sample rule
Cigna will administratively deny claims when ICD-10-CM Z diagnosis codes Z02.0-Z02.6, Z02.71, Z02.79, Z02.82-Z02.83, Z02.89-Z02.9, Z13.9, Z56.1, Z62.21, or Z63.6 are the **only codes** on the claim. Knowing this, you can create a rule to flag any claim that matches these conditions before it gets denied.
In **AI Billing Rules**, describe the rule in the chat box:
*For patients with Cigna as their insurance, alert me if diagnosis codes Z02.0-Z02.6, Z02.71, Z02.79, Z02.82-Z02.83, Z02.89-Z02.9, Z13.9, Z56.1, Z62.21, or Z63.6 are the only codes on the claim.*
Select your Cigna payers under **Applies to**, then click **Save rule**.
In **Custom Rules**, click **+ Add Validation**, select **Payer** under **Claim Scrub Agent**, select all Cigna **Payers** that are tied to the rule, and enter the same instructions in the **Condition** field.
## Managing your practice's rules
Each rule listed under **Your Practice's Rules** has the following controls:
* The **Enabled** switch turns the rule on or off. A rule that is off stays in your list and is not applied to bills.
* The edit (pencil) icon changes the rule's title and the payers it applies to.
* The remove (trash) icon deletes the rule.
To change a rule's wording, describe the change you want in the chat box. Elation proposes an updated version and shows you what changed. Review it, then click **Update this billing rule**.
## Creating a rule while reviewing a bill
The same chat box appears in the **Billing Analysis** section of the bill, so you can describe a rule based on the bill in front of you.
1. Click **+ Add Billing Information** or **Edit Bill** to open the bill.
2. Describe the rule you want in the chat box in the **Billing Analysis** section.
3. Review the drafted rule and click **Save rule**.
Rules you create here are added to **Your Practice's Rules** in **Settings > Billing**.
## Frequently Asked Questions
### Why can't I change the wording of a rule I created?
The rule text is the instruction Elation sends to the billing AI, so it stays as it was written when the rule was saved. You can change a rule's title and the payers it applies to with the edit (pencil) icon. To change the wording, describe the change in the chat box and Elation proposes an updated version for you to review.
### Why can't I turn on a rule?
A rule that changes the **Billing Provider** or **Supervising Provider** field can only be turned on while that field is visible in the bill. Turn the field on first — see [Collaborative Billing Fields](/articles/collaborative-billing-fields) — then turn on the rule. If Elation reports that the rule's enforcement details are missing, describe the rule again in the chat box to create a version it can apply.
### Can everyone at my practice create rules?
If your practice restricts billing settings to Admin Level Users, non-Admin users can see your practice's rules but cannot create, change, or remove them.
## Related Articles
* [AI Billing Introduction](/articles/AI-Billing-Introduction)
* [AI Billing Guide - Generating billing codes automatically in the EHR](/articles/AI-Billing-Guide-Coding)
* [AI Billing Guide - Scrubbing claims](/articles/AI-Billing-Guide-Scrubbing-claims)
* [Collaborative Billing Fields](/articles/collaborative-billing-fields)
# AI Billing Guide - Scrubbing claims
Source: https://help.elationhealth.com/articles/AI-Billing-Guide-Scrubbing-claims
## Overview
### What tools are available for scrubbing claims in the EHR?
Elation’s AI Billing solution also provides claim-scrubber-style feedback on the bill before submission, including support for the following areas:
* insurance eligibility issues
* Quality reporting requirements
* NCCI rules
* missing drug codes
* Clearinghouse validations
* custom payer-specific rules
### Why are the benefits of scrubbing claims?
Scrubbing claims identifies potential rejection or denial issues upfront so you don’t spend time fixing claims later.
### What will the claim scrubber look for automatically?
| **Agent** | **Scrubs for…** |
| --------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Insurance Eligibility | Verifies patient has insurance information on file. • Verifies active primary insurance coverage at the claim level. • Identifies any potential secondary insurance indicated in the eligibility response. |
| NCCI Rules | Flags when the units/quantity for a CPT code on a single Date of Service exceeds CMS limits for that code. • Flags invalid or mutually exclusive CPT code combinations on the same claim and when a modifier is required to bill those CPT Codes together. |
| Clearinghouse Rules | Verifies patient has an address on file. • Verifies there are no duplicate service lines. • Verifies there are no \$0 charge lines. • Verifies diagnosis codes exist on all charge lines. • Flags if modifier 95 is associated with the wrong place of service. |
## Setup
### Enabling the claim scrubber
The claim scrubber must be enabled by an Admin Level User by following these steps:
1. Click **Settings > Billing**.
2. Go to the **AI Billing** section and set the **Billing Analysis** toggle to **green (ON)**.
### Creating custom rules for claim scrubbing
Custom rules, also called payer rules, let you tell AI Billing how your practice wants bills handled, including what the claim scrubber should flag. Because a rule can also affect the codes AI Coding generates, rules are covered in their own article — see [AI Billing Guide - Creating billing rules](/articles/AI-Billing-Guide-Creating-billing-rules).
## Workflow Instructions
### Scrubbing a claim
1. Click **+ Add Billing Information** or **Edit Bill** to open the bill.
2. Click the **Generate Codes**/**Apply Codes** button to run [AI Coding](/articles/AI-Billing-Guide-Coding) and scrub the claim.
3. Review the results in the **Billing Analysis** section of the bill. Each check appears as a card labeled with its outcome, such as **Warning**, **Failed**, or **Error**.
4. Expand a card to read the individual checks behind that outcome.
5. Adjust what is needed based on the described errors.
6. Run the checks again to confirm your adjustments passed. If the **Billing Analysis** section includes a chat box, click **Generate Codes**/**Apply Codes** again. Otherwise, click **Reanalyze with latest changes** at the top of the section.
7. Repeat steps 3-6 until all errors are corrected.
When a rule flags a bill for review instead of changing it, the flag appears under **Advisories** in the **Billing Analysis** section, and a marker appears on the service line or diagnosis the flag relates to. Click **Acknowledge** or **Dismiss** to record your decision. A flag never changes codes and never prevents you from saving the bill, signing the visit note, or submitting the claim.
You don't need to resolve all errors before signing the visit note or bill — you can sign and come back to make corrections later, as long as the bill remains in the EHR. Any errors associated with a bill can be viewed from the [Billing Home](/articles/Billing-Home) .
## Frequently Asked Questions
### Why can’t I see the Billing Analysis section in the bill?
You must enable Billing Analysis Settings in order for the Billing Analysis section to appear in the bill. Follow the [Setup](#setup) instructions above to enable the Setting.
### How long does it take for the claim scrubber to detect corrected errors?
The claim scrubber detects corrected errors the next time you run it. If the **Billing Analysis** section of the bill includes a chat box, click **Generate Codes**/**Apply Codes**. Otherwise, click **Reanalyze with latest changes** at the top of the section.
## Related Articles
* [AI Billing Introduction](/articles/AI-Billing-Introduction)
* [AI Billing Guide - Generating billing codes automatically in the EHR](/articles/AI-Billing-Guide-Coding)
* [AI Billing Guide - Creating billing rules](/articles/AI-Billing-Guide-Creating-billing-rules)
* [AI Billing Guide - Queueing claims automatically](/articles/AI-Billing-Guide-auto-queue-claims)
* [Collaborative Billing Fields](/articles/collaborative-billing-fields)
# AI Billing Guide - Queueing claims automatically
Source: https://help.elationhealth.com/articles/AI-Billing-Guide-auto-queue-claims
## Overview
### What are auto-queued claims?
Auto-queued claims are specific claims that are sent from the EHR directly to the [Elation Billing Claims Queue](https://help.billing.elationemr.com/en/articles/6868793-claims-queue) and bypass the Worklist. Claims that meet auto-queue criteria are:
* Single charge line claims that passed all [scrubbing checks](/articles/AI-Billing-Guide-Scrubbing-claims) in the EHR.
* Multi-charge line claims that have a confidence score of 90% or higher.
* Each claim in Elation Billing is automatically assigned an invisible confidence score based on your practice’s history with similar claims. Afterwards:
* claims with a confidence score greater than or equal to 90% will go straight to the Claims Queue.
* claims with a confidence score less than 90% will go to a Worklist.
Since auto-queue uses your historical claim data to calculate confidence scores, you may notice a lower volume of auto-queued claims at first — this will increase over time as you build up more claim history.
### What are the benefits of auto-queuing claims?
Auto-queueing claims speeds up your workflow by sending “clean” claims directly to the Claims Queue, so you don’t need to review them again in Elation Billing before sending them to the Clearinghouse.
## Setup
| **1** | Click **Settings** -> **Billing** . |
| ----- | -------------------------------------------------------------------------------------------- |
| **2** | Go to the **AI Billing** section and set the **Billing Analysis** toggle to **green (ON)** . |
## Workflow Instructions
### Auto-queuing claims
| **1** | Add all necessary claim details to the [billing information section](/articles/billing#entering_billing_details) of your visit note in the EHR. Use [AI Coding](/articles/AI-Billing-Guide-Coding) as needed. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Use [the claim scrubber](/articles/AI-Billing-Guide-Scrubbing-claims) in the EHR to identify and correct any errors. |
| **3** | Push the bill to Elation Billing once you are ready. |
| **4** | Claims that meet the auto-queue criteria will be automatically sent to the **Claims Queue** . Look for the **Queued by A** I\*\* tag to quickly identify these claims. |
## Frequently Asked Questions
### Will any claims be billed automatically without my review?
No, claims will never be billed automatically. You must click **Bill Now** from the **Claims Queue** to send the claim to the Clearinghouse.
### How do I release claims from the Claims Queue?
To send claims from the [Claims Queue](https://help.billing.elationemr.com/en/articles/6868793-claims-queue)to the Clearinghouse:
| **1** | Click **Claims Queue** in Elation Billing to open it. |
| ----- | ----------------------------------------------------------------------- |
| **2** | Make sure all the claims in the queue can be sent to the Clearinghouse. |
| **3** | Click **Bill Now** . |
| **4** | Click **Bill Now** again. |
## Related Articles
* [AI Billing Introduction](/articles/AI-Billing-Introduction)
* [AI Billing Guide - Generating billing codes automatically in the EHR](/articles/AI-Billing-Guide-Coding)
* [AI Billing Guide - Scrubbing claims](/articles/AI-Billing-Guide-Scrubbing-claims)
* [Claims Queue](https://help.billing.elationemr.com/en/articles/6868793-claims-queue)
# AI Billing Introduction
Source: https://help.elationhealth.com/articles/AI-Billing-Introduction
## Overview
### What is AI Billing?
AI Billing is Elation’s native AI technology designed to expedite the revenue cycle management process for Elation Billing users. This technology is built to learn from the information it receives and will keep getting better.
It currently uses native AI technology to speed up the claims generation, review and submission by
* Generating appropriate CPT and Diagnosis codes based on demographics and visit note documentation.
* Scrubbing claims to check
* for insurance eligibility issues
* for Quality reporting requirements
* against NCCI rules
* for missing National Drug Codes (NDC)
* Clearinghouse validations
* against [custom rules your practice creates](/articles/AI-Billing-Guide-Creating-billing-rules)
* Auto-queuing specific claims
AI Billing will keep evolving as Elation introduces new AI-driven tools to optimize your payment workflows.
### What are the benefits of AI Billing?
AI Billing:
* Reduces administrative burden by
* handling the clear, simple claims to reduce the number of manual touches required to get paid.
* using information from your patient’s chart and note to fill in billing details on your behalf.
* Prioritizes your practice first by continuously optimizing your accounts receivable by learning from your data over time.
## Setup
All Elation Billing users automatically have access to AI Billing features.
### Enabling the AI Billing features
| **1** | Click **Settings** -> **Billing** . |
| ----- | -------------------------------------------------------------------------------------------- |
| **2** | Go to the **AI Billing** section and set the **Billing Analysis** toggle to **green (ON)** . |
## Workflows
AI Billing works alongside the documentation you already do. When you open the billing details on a visit note:
1. **AI Coding** suggests and populates diagnosis, procedure, and drug codes based on the visit note and the patient's chart.
2. **Billing Analysis** scrubs the bill for insurance eligibility issues, Quality reporting requirements, NCCI rules, missing drug codes, Clearinghouse validations, and any [custom rules your practice has created](/articles/AI-Billing-Guide-Creating-billing-rules).
3. Claims that pass scrubbing and meet the auto-queue criteria go directly to the **Claims Queue** in Elation Billing, where a user reviews them and submits them to the Clearinghouse.
Click on the corresponding link below for more details about the various AI Billing features:
* [AI Coding](/articles/AI-Billing-Guide-Coding)
* [Billing Analysis - Claim Scrubber](/articles/AI-Billing-Guide-Scrubbing-claims)
* [Auto-Queue Claims](/articles/AI-Billing-Guide-auto-queue-claims)
## Frequently Asked Questions
### How do I turn AI Billing on or off?
The **Billing Analysis** toggle in **Settings > Billing > AI Billing** controls the AI Billing features. An Admin Level User can turn it on or off at any time.
When the toggle is off, the AI Coding and Billing Analysis sections do not appear on the bill, and claims are not auto-queued. Your bills and claims behave exactly as they do without AI Billing.
Any [custom rules your practice created](/articles/AI-Billing-Guide-Creating-billing-rules) are saved. They are not applied to bills while the setting is off, and they apply again when you turn it back on.
### Does AI Billing learn from other practices' data?
No. AI Billing uses your own practice's historical claims data — what your practice billed, what was paid, and how — to refine its coding suggestions, NDC population, and the confidence scores behind auto-queued claims. Another practice's claims history does not influence the suggestions you see.
Elation and its third-party AI providers do not use your patient data, including de-identified data, to train AI models. See [Elation AI — Frequently Asked Questions](/articles/elation-ai-faq) for more about how Elation's AI features handle your data.
### Do I stay in control of my billing?
Yes. AI Billing supports your billing process rather than replacing your review:
* AI Coding adds to your codes rather than replacing them, and you can undo its changes with **Revert to previous bill**.
* Claim scrubbing surfaces errors for you to resolve. You decide what to correct and when.
* Claims are never billed automatically. A user always clicks **Bill Now** from the **Claims Queue** to send a claim to the Clearinghouse.
* You define what Billing Analysis enforces. An Admin Level User can create [custom rules](/articles/AI-Billing-Guide-Creating-billing-rules) so the scrubber flags the issues your practice cares about.
### How do I give feedback or report a problem with AI Billing?
Use the feedback buttons in the bill to react to the codes AI Coding generated. Each AI-suggested code also has an information (i) icon that opens its citation dialog, where you can leave a thumbs up or thumbs down and a comment about that specific code. Elation uses this feedback to improve AI Billing.
For a technical problem that needs investigation, [contact Elation Support](https://app.elationemr.com/support/). To share a feature request, reach out to your Customer Success Manager.
## Related Articles
* [Elation AI — Frequently Asked Questions](/articles/elation-ai-faq)
# Alternative Payment Model (APM) / Accountable Care Organization (ACO) Participation Guide
Source: https://help.elationhealth.com/articles/APM-ACO-Participation
This article describes Elation's role in supporting providers in ACO participation.
## Overview
### What is an APM?
An Alternative Payment Model (APM) is a way to participate in Center for Medicare Medicaid Services (CMS) programs alternatively to the traditional Fee For Service (FFS) method of participation in CMS.
### What types of APM are most common among PCPs?
There are several types of APMs across provider types. The most common APMs that Elation Health providers participate in are the Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO), and ACO Realizing Equity, Access, and Community Health (REACH). An ACO is a type of an APM and may sometimes be used interchangeably. Note that there are different types of APMs, and different types of ACOs, understanding which program you are in is very important.
### How can I report quality as an ACO participant?
As an ACO participant, quality reporting often differs from traditional MIPS. Many ACOs have their own specific quality measures and reporting requirements, often tied to the overall performance of the ACO entity. These measures frequently emphasize patient outcomes and population health, rather than individual encounter-based metrics. Check with your ACO administrator for their specific reporting guidelines and data submission processes, as they often leverage electronic health record (EHR) data in different ways.
### How does ACO participation and MIPS overlap?
ACO participation can significantly impact MIPS. Qualifying APM Participants (QPs) may be exempt from traditional MIPS reporting. However, some ACOs, particularly non risk bearing MSSP ACOs, may still require quality reporting that aligns with MIPS measures. Furthermore, APCO participation can earn providers MIPS Alternative Payment Model (APM) scoring standards, which can positively affect their overall MIPS score. It's essential to understand how your specific ACO interacts with MIPS to optimize your performance. This is why understanding your ACO contract and working with your ACO administrator on reporting requirements, scoring standards, and reimbursement expectations.
### What should I know about participating in an ACO as a provider or practice?
Participating in an ACO requires a commitment to collaborative care and data-driven decision-making. Providers must be prepared to share data, coordinate care across different settings, and focus on population health management. Understanding the specific financial risk and reward structure of your ACO is vital. Additionally, effective communication and engagement with patients are crucial for achieving positive outcomes. Be prepared to adapt your workflows and practice management to meet the requirements of the ACO. Some things a provider should know about participating in an ACO include:
* What type of ACO are you participating in?
* What are the terms of the contract?
* Who is the ACO administrator?
* What data are you as a provider responsible for and to whom?
### How can Elation Health help me participate in an ACO?
Elation Health offers a comprehensive EHR platform designed to support providers in ACO participation. Our platform facilitates seamless data sharing, quality measure tracking, and population health management. Elation's robust reporting capabilities enable you to monitor performance, identify areas for improvement, and demonstrate value to your ACO entity. Features that aid in this include robust API capabilities, detailed reporting tools, and customizable workflows. By leveraging Elation Health, you can streamline your ACO participation and enhance your ability to deliver high-quality, coordinated care.
## Navigating the 2025 MSSP ACO Landscape: A Provider's Guide to Quality Reporting
The Medicare Shared Savings Program (MSSP) continues to evolve, bringing both opportunities and challenges for participating providers. In 2025, significant changes in quality reporting reshaped the landscape, demanding a deeper understanding of electronic Clinical Quality Measures (eCQMs), Clinical Quality Measures (CQMs), and the role of Qualified Clinical Data Registries (QCDRs).
### MSSP ACOs: A Distinctive Landscape
Unlike other ACO models like REACH, MSSP ACOs are directly regulated through CMS rulemaking, impacting Physician Fee Schedule and Quality Payment Program (QPP) updates. This direct connection means changes to outpatient Part B billing, MIPS, and MSSP ACOs are often intertwined.
### The 2025 Reporting Shift: eCQMs, CQMs, and the End of Web Interface
MSSP ACOs are incentivized to adopt eCQM reporting, though CQMs remain an option. Web Interface reporting is sunsetting, a sampling-based method that requires extensive chart abstraction. This shift necessitates a move from Medicare-only reporting to all-payer, all-patient reporting that aligns with MIPS eCQM standards.
### Technical Complexities and the Role of QCDRs
The move to eCQMs and CQMs introduces significant technical complexities. ACO administrators must grapple with data aggregation, deduplication, and reporting, often requiring the deployment of a QCDR. These QCDRs act as central hubs, collecting data from various practices within the ACO. This necessitates a strong understanding of technical feasibility and data exchange.
### Varied Reporting Pathways: A Challenge for Providers
The reporting landscape is far from uniform. Practices face diverse reporting requirements depending on their ACO. This variability arises from the ACO's choice of reporting mechanisms, quality measures, and data sources. This means that a one-size-fits-all approach is impossible, and providers must work closely with their ACO administrators.
### Workflow Partners and Communication Pathways
Effective communication and collaboration are essential for successful reporting. Here's a breakdown of the key players and their roles:
* **Practice → ACO Administrator**- The practice enters a contractual agreement with the ACO administrator, outlining reporting obligations.
* **ACO Administrator → QCDR/Technical Solution** - The administrator contracts with a QCDR or deploys their own technical solution to aggregate and report data.
* **ACO Administrator → Practice**- The administrator communicates contractual obligations, including specific reporting requirements (e.g., 5 eCQMs, QRDA1 submissions, integrations). It is crucial to note that these requirements vary significantly between ACOs.
* **ACO Administrator → Elation Health** - Ideally, the practice should communicate their reporting needs to Elation. However, sometimes the ACO administrator communicates on the practice's behalf. Elation directs the ACO to the practice, and then the practice to Elation, to ensure the practice understands their requirements.
* **QCDR → Elation Health**- The QCDR may directly contact Elation to establish technical requirements, integrations, and workflows. For instance, QCDRs like MD Interactive may establish FHIR integrations and provide guidance on QRDA1 file generation.
* **QCDR → Practice/Provider** - The QCDR explains the technical solution and required workflows to the practice.
### Key Takeaways for Providers
* Understand your specific ACO's reporting requirements.
* Embrace data sharing and collaboration with your ACO and QCDR.
* Familiarize yourself with eCQMs and CQMs.
* Leverage technology to streamline data aggregation and reporting.
* Recognize the importance of clear communication with all stakeholders.
## Related Articles
* [Qualified Clinical Data Registry (QCDR) Guide](/articles/Qualified-Clinical-Data-Registry-Guide)
# Fax Inbox Guide - Actioning on documents within the Fax Inbox
Source: https://help.elationhealth.com/articles/Actioning-on-documents-within-the-Fax-Inbox
This article describes the various actions you can take on documents within the Fax Inbox.
This article describes the various actions you can take on documents within the Fax Inbox.
📖
**RECOMMENDED READING**
[Click here for an introduction to the Fax Inbox feature in the EHR](/articles/Fax-Inbox-Introduction)
.
## Overview
### What type of actions can I take on documents within the Fax Inbox?
You can take the following actions on documents within the Fax Inbox:
* If there are any pages within a document that you do not want to store in the patient’s chart (i.e. fax cover sheets, blank pages), you can delete those pages from the Fax Inbox before filing the remainder of the document to the patient’s chart.
* If any pages are not oriented properly, you can rotate those pages before filing the document to the patient’s chart.
* If there are any faxes that are not associated to any patients (ie. supply order forms, medical newsletters), you can print those pages out for external use and then delete those documents from the Fax Inbox afterwards.
* If there are any faxes you do not need (ie. advertisements), you can delete those documents from the Fax Inbox.
* If the documents need to be stored in the patient’s chart, you can file them to the matching patient.
### What are the benefits of actioning on documents within the Fax Inbox?
The Fax Inbox gives you the flexibility to **clean up** patient documents before they are filed into the patient’s chart for permanent storage.
## Workflow Instructions
### Viewing documents in the Fax Inbox
Each document is grouped into a listing if the document is from a single fax transmission or a single uploaded document file. To view documents in the listing, click on the document title to expand the listing
* You will see the images of the first 5 pages of the document in the expanded view (this is the default).
* To see additional pages of the document, if the document is more than 5 pages, click the **More** button at the end of the listing. Each time you click **More** you will see the next 5 pages.
* To zoom in on an image, double click on the page. A large version of the image, with a higher resolution, will appear on your screen.
To zoom in on the image incrementally within your web browser, press the **Ctrl** key and then **+** key on your keyboard (for Mac users, press the **Command** key and then the **+** key) until the image reaches the desired resolution.
To reset the image to the original image size, press the **Ctrl** key and then the **0** key (for Mac users, press the **Command** key and then the **0** key).
### Deleting document pages
To delete pages within a document:
1. Select the document page(s) you want to delete using one of the following methods:
* To select specific pages within a document listing, click on each page individually.
* To select all pages within a document list, click the **Select All** button at the top of the document listing.
2. Click the **Delete** button to delete the selected pages.
3. Click **Yes** to confirm deletion.
[Click here for instructions on how to restore documents deleted from the Fax Inbox](/articles/Restoring-documents-deleted-from-the-Fax-Inbox)
.
### Rotating document pages
To rotate pages within a document:
1. Select the document page(s) you want to delete using one of the following methods:
* To select specific pages within a document listing, click on each page individually.
* To select all pages within a document list, click the **Select All** button at the top of the document listing.
2. Click one of the rotate buttons at the top of the document listing to rotate selected pages towards the desired direction.
* **Rotate Left**
* **Rotate 180**
* **Rotate Right**
### Filing documents
[Click here for detailed instructions on how to file documents from the Fax Inbox to a patient’s chart](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
.
## Related Articles
* [Fax Inbox Introduction](/articles/Fax-Inbox-Introduction)
* [Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox)
* [Fax Inbox Guide - Uploading documents to the Fax Inbox](/articles/Uploading-documents-to-the-Fax-Inbox)
* [Fax Inbox Guide - Restoring documents deleted from the Fax Inbox](/articles/Restoring-documents-deleted-from-the-Fax-Inbox)
* [Fax Inbox Guide - Filing documents from the Fax Inbox into a patient's chart](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
* [Fax Inbox Guide - Managing fax settings & fax usage](/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage)
# Best Practice- Administering Injectables
Source: https://help.elationhealth.com/articles/Administering-Injectables
This article will guide you through the best practices for documenting administered injectables in Elation.
## What does it mean to administer injectables?
Injectables are medications that must be administered through a syringe and require qualified medical personnel to administer the medication. Some common examples of injectables are vitamins, antibiotics, and hormones.
Vaccines are not considered an injectable medication. For more information on documenting vaccines in Elation, please reference the [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide) .
## Why is it useful to document administered injectables in Elation?
Documenting administered injectables in Elation is useful because it enables your practice to have a comprehensive and accurate medical record for the patient.
## How to document administered injectables in Elation
Elation recommends two workflows for administering injectables:
* Documenting injectables through the vaccine form
* Documenting injectables in visit notes
* Documenting injectables through the Prescription Form
### Documenting injectables through the vaccine form
We recommend documenting injectables using the vaccine form in Elation because there are structured fields where you can enter necessary information such as manufacturer, lot number, expiration date, and more. Below are instructions for how you can enter injectable information through the vaccine form.
1. Start in a patient's chart and scroll down the Clinical Profile (left hand column of the chart) to the **Other Info** vaccine section
2. Click **+ Add Vaccination** to open the Document Vaccination window
3. Type the name of the injectable into the Vaccine field. You can free text the name of the injectable into the Vaccine field and click into the free space in the Document Vaccination window to save the text you have written.
![Document Vaccination form with "Vitamin B12" free-typed in the Vaccine field, showing a yellow warning that it is not a known vaccine in the database. A "Click here" callout points to the open form area where clicking saves the free-text entry.]()
1. Enter additional necessary information such as manufacturer, lot number, expiration date, and more
*
The injectable will be saved as an option for future documentation for your practice after the first time it has been entered for a patient. The manufacturer, lot number, expiration date, and dose will save and auto-populate next time the injectable is chosen.
2. Once the injectable information is completely documented in the form, click one of the **Save** options. The injectable will be documented in the Clinical Profile in the vaccine section.
If your practice is connected to any state immunization registries, you must choose the option to **not send the record** of the injectable to an immunization registry. ![Document Vaccination form with "Send to an Immunization Registry?" dropdown set to "No, a record should not be sent to an Immunization Registry," highlighted with a red arrow and border.]()
If you have a visit note open as you are documenting the injectable in the vaccination form, the injectable will be added automatically to the visit note.
You can export a documented injectable from the Clinical Profile at any time to a visit note by clicking **Actions** >> **Export to Note** ![Actions dropdown menu open on a Vitamin B12 vaccine entry in the Clinical Profile, with "Export to Note" option highlighted and an arrow pointing to "Vitamin B12" in the visit note Assessment/Plan section.]()
### Documenting injectables in visit notes
Documenting injectables in visit notes is a great option for practices who prefer to keep vaccines and injectables documentation separate.
1. Start in a patient's chart with an open visit note
2. Document the injectable information into the body of the note
*
Creating [visit note templates](/articles/elation-visit-note-templates) for injectable administration will streamline this process for your practice. [We recommend creating a template](#template_faq) that will auto-populate the fields that need to be documented for each vaccine, as well as billing codes that are consistently used with injections.
3. Complete the visit note with any additional information pertaining to the visit and sign the note
We recommend using [Document Tags](/articles/tag-reports-and-notes-with-document-tags) to track injections with specific identifiers in case of a recall or other situation where you need a list of patients who received the injection. When the visit notes are tagged with Document Tags, it enables your practice to search in a [Patient List](/articles/find-patients-with-elations-patient-list) for patients with the specific Document Tag.
### Documenting injectables through the Prescription Form
[Click here for instructions on how to document injectables through the Prescription Form](/articles/Documenting-Clinic-Administered-Medications)
.
## Frequently Asked Questions
### What if the injectable I am administering is not available in the vaccine form?
You can free text information into the vaccine form, such as the name of the injectable. Type the name of the injectable into the
**Vaccine**
field and click into the free space in the Document Vaccination window to save the text you have written.
*
The injectable name and additional information will be saved as an option for future documentation for your practice after the first time it has been entered for a patient. The manufacturer, lot number, expiration date, and dose will save and auto-populate next time the injectable is chosen.
### How can I search for patients who have received a specific injectable?
You can tag patient records, such as visit notes, with
[Document Tags](/articles/tag-reports-and-notes-with-document-tags)
that enable your practice to search in a
[Patient List](/articles/find-patients-with-elations-patient-list)
for patients with the specific Document Tag. We recommend including the name of the injectable and the lot number in the tag so that you can pull a list of patients that received that injectable in case of a recall or other similar situations.
### What information is recommended to be included in a visit note template for injectables?
We recommend saving standard injection documentation fields and common CPT codes for billing in visit note templates. The information you can save in a visit note template is very customizable and can save your practice time documenting the information.
The CPT Code,
**96372**
: Injection of drug or substance under skin or into muscle, is commonly used for coding patient encounters that involve injectables. Feel free to
[save this CPT Code to your practice settings](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?)
.
Clinical Information for templates:
![Visit Note Template dialog named "Injection Template" with the Objective Data field highlighted, showing pre-filled labels: Injection, Manufacturer, NDC #, Lot #, Expiration Date, Dose, Method, Site, and VIS.]()
Billing Information section for templates:
![Billing Information section of a visit note template with CPT code 96372 entered, highlighted with a red border to indicate this section for template setup.]()
## Related Articles
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
* [Prescriptions Guide- Frequently Asked Questions](/articles/Prescriptions-Guide-Frequently-Asked-Questions)
* [Document Tags for Visit Notes & Reports Guide](/articles/tag-reports-and-notes-with-document-tags)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Billing Guide- Navigating Billing Settings](/articles/billing-settings---service-locations--procedure-codes)
# Administering the COVID-19 Vaccine Workflow Guide
Source: https://help.elationhealth.com/articles/Administering-the-COVID-19-Vaccine-Workflow-Guide
This article will provide a comprehensive guide on the best workflow to follow in Elation when administering the COVID-19 vaccine.
If your practice has been approved to administer the COVID-19 vaccine, please use this step-by-step guide for recommendations of how to use Elation to recall patients, document vaccines, and report administration to your IIS.
If your practice has not been approved to administer the vaccine, but you have other questions about your COVIID-19 vaccination workflows, such as referring eligible patients or documenting vaccines administered elsewhere, please read our
[COVID-19 Vaccination Recommendations](/articles/COVID-19-Vaccination-Recommendations)
article.
## In the article we will cover:
1. Configuring your settings to allow you to perform the COVID-19 vaccination workflows covered in this article
2. Identifying patients who are eligible for the vaccine
3. Scheduling patients who should be vaccinated
4. Documenting the first dose of the vaccination
5. Reporting the vaccines you have administered to the IIS
6. Tracking and Recalling patients for the second dose of vaccine
7. Documenting the second dose of the vaccination
## 1.) Configuring your settings to allow you to perform the COVID-19 vaccination workflows covered in this article
### Calendar:
We recommend creating a [dedicated appointment type](/articles/calendar-and-booking-settings) in Elation to track your “COVID-19 Vaccine” visits. You can also consider making this appointment type available on your [Booking Site](/articles/Patient-Booking-Site) for patient self-scheduling.
### Patient Tags:
We recommend creating the following patient tags to allow you to track patients and their vaccination status for reporting and for recalling patients for second doses.
1. Create the following patient tag so that you can track vaccines that need to be reported to your IIS: \***C-19 IIS Pending**
2. Create the following patient tags for the start of each upcoming week to allow you to easily track and recall patients who are due their second vaccine dose:\*\*\*C-19 Due Wk month/day (ex. \*C-19 Due Wk 2/1, *C-19 Due Wk 2/8, *C-19 Due Wk 2/15)**
Patient Tags appear in alphabetical order in the patient's chart. Any tag that begins with a punctuation mark will appear first, so adding the asterisks symbol will help draw attention to these COVID tags.
## 2.) Identifying patients who are eligible for the vaccine
Please remember to check and follow your local jurisdiction’s latest guidelines to determine which patients are eligible to receive the vaccine.
Use Elation’s [Patient List](/articles/find-patients-with-elations-patient-list) to identify who in your panel qualifies for their first dose of the vaccine.
1. Click **Reports >> Patient List** at the top of Elation.
2. On the left side, confirm which provider(s) you’re running the report for. Then apply the filters that you would like to use. For example:
3. Check **Age** and specify patients older than 64.
4. Check **Active Problems in Clinical Profile** and specify patients with certain high-risk diagnoses in their problem list.
5. Check **Vaccinations in Clinical Profile** and exclude patients who already have a COVID-19 vaccine documented in their chart.
6. Click **Generate List** to generate the patient results. The patients will appear on the right side of the page.
## 3.) Scheduling patients who should be vaccinated
After drawing up your patient list, refer to the **Next Appointment** column to check if the patient has an upcoming appointment in the near future. If not, use the **Contact** column and call the patient to make an appointment.
You can also send a **Bulk Letter** to these patients to share that they can make an appointment for their vaccine via Patient Passport or a mailer.
1. From the Patient List results, decide who you want to send the bulk letter to. To **select all**, click on the checkbox at the top of the page; to select specific patients, click the checkboxes next to each patient’s name.
2. Click **Send Bulk Letter**. Give the bulk letter a name and type in what you’d like the message to say.
3. Bulk letters will be delivered via Patient Passport to all patients who already have an account. If a patient doesn’t have an account yet but has their email and cell phone number recorded in Elation, you can choose to invite them to Patient Passport with the bulk letter. After they register, they’ll be able to see your message. For all other patients, you can choose to print a PDF along with their address cover page to mail the message.
4. After sending your Bulk Letter, you can check the Bulk Letter dashboard to check who has opened the message in their Patient Passport account.
If your staff are calling to schedule the patient’s initial appointment, consider also booking the follow-up appointment for Dose 2 before ending the call to increase the likelihood of recall.
## 4.) Documenting the first dose of the vaccination
When you administer the vaccine, document all fields [required by the CDC](https://www.cdc.gov/coronavirus/2019-ncov/lab/reporting-lab-data.html#what-to-report) to meet reporting requirements. These include:
| Patient Demographics | Vaccine Details |
| ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Recipient name • Recipient ID • Recipient date of birth • Recipient sex • Recipient address | Administration date • CVX (product) • Dose number • Lot number • MVX (manufacturer) • Vaccine administration site (on the body) • Vaccine expiration date • Vaccine route of administration • Vaccine administering provider’s name and suffix |
| The following practice-level Information also needs to be reported, but doesn’t need to be documented in each patient’s chart: Administration address (including Company) • Administering provider’s address, if different than the administration address | |
1. Update patient demographics by clicking the patient’s name in their chart.
2. Document the vaccine by scrolling to the Immunization section of the Clinical Profile. Click **+ Add Vaccination Details**
3. Start typing the name of the vaccine and select the vaccine from the dropdown results. This will ensure that the CVX number is documented and pulls in any pre-saved vaccine details (for your convenience, Elation pre-fills the dose, lot number, manufacturer, and expiration date after the first time you document them).
4. Enter the required vaccine details in the corresponding fields.
5. Click **Save**.
![Document Vaccination dialog with "covid" typed in the Vaccine field, showing a dropdown of COVID-19 vaccine options including Moderna CVX 207 highlighted, and a yellow warning that it is not a known vaccine in the database.]()
Apply the following patient tags (by clicking on "+ Tags" to the right of the patient's name) to the patient’s chart.
1. \***C-19 IIS Pending** (to identify that this vaccination needs to be reported to the IIS)
2. \***C-19 Due Wk month/day** (use the tag that corresponds with the week the patient should return for Dose 2)
Check the appointment summary in the Clinical Profile to see if the patient has an upcoming appointment for Dose 2 by the recommended deadline. If they do not, make sure that someone in the practice schedules the patient before they leave.
## 5.) Reporting the vaccines you have administered to the IIS
Reporting deadlines vary by state, but it needs to be completed within 72 hours at the latest. Please follow the steps below at the end of each day, or every 2-3 days depending on your state’s requirements.
1. Use the patient list to identify vaccines that have been administered.
2. Click **Reports >> Patient List** at the top of Elation.
3. On the left side, confirm which provider(s) you’re running the report for. Click the checkbox for the **Patient Tag** filter. Search for the \***C-19 Pending IIS** tag and select it.
4. Click **Generate Report**. At the top of the results, click **Download >> Download CSV** to save a copy of the results. Open the CSV spreadsheet and also keep the Elation patient list results open.
5. Log into your state IIS and report the vaccination details according to their requirements.
6. For patient demographics: Open the spreadsheet that you downloaded from the Patient list results. Each patient’s name, ID, date of birth, sex, and address will be documented here. Transfer this information to your IIS using the workflows advised by the IIS entity.
7. For vaccine details: Click the patient’s name from the Patient List results to open their chart. Scroll to the Immunization section of the Clinical Profile. Click the vaccine name to view the administration details. Transfer this information to your IIS using the workflows advised by the entity. Once the information has been transferred, click on the \***C-19 Pending IIS** tag. Click **x** to remove it from the patient’s chart to indicate that the reporting is complete.
## 6.) Tracking and Recalling patients for the second dose of vaccine
1. Click **Reports >> Patient List** at the top of Elation.
2. On the left side, confirm which provider(s) you’re running the report for. Click the checkbox for the **Patient Tag** filter. Type in the \***C-19 Due Wk month/day** tag that you want to filter for.
3. Pick the tag that matches the current week if you want to find patients who are due this week.
4. Pick tags in the future if you want to find patients who are due back soon.
5. Pick tags from the past if you want to find patients who are past due for Dose 2.
6. Click **Generate Report**. Check to see if patients have upcoming appointment dates in the report results and reach out to schedule any patients who do not.
## 7.) Documenting the second dose of the vaccination
Use the [documentation instructions for Dose 1](#four) to document the second dose of the vaccine for the patient.
Update the Patient tags:
* Click on the \***C-19 Due Wk month/day** tag, and click the **x** button to remove it from the chart because the second dose is complete.
* Add the tag for \***C-19 IIS Pending**
# Alabama State- ImmPRINT- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Alabama-State-ImmPRINT-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Alabama State Immunization Registry [ImmPRINT] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Alabama State Immunization Registry called Immunization Provider Registry with Internet Technology (ImmPRINT).
## What is the ImmPRINT Immunization Registry Interface?
The ImmPRINT Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to ImmPRINT, the Alabama State Immunization Registry. Practices can also query ImmPRINT for vaccination history or forecast.
## Why is the ImmPRINT Immunization Registry Interface valuable?
With the ImmPRINT Immunization Registry Interface, practices no longer need to separately log in to ImmPRINT to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to ImmPRINT. You can also pull vaccination history for specific patients from ImmPRINT to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & ImmPRINT
The Elation Team will assist you with initiating interface with ImmPRINT. To begin:
1. Confirm you have an ImmPRINT account. [Click here to register for an ImmPRINT account](https://siis.state.al.us/ImmPrint/user/providerenrollmentagreement.aspx) if you do not have one.
2. [Click here to sign up for an account with the Alabama Department of Public Health Security Portal](https://dph.state.al.us/adphsec/new_user_request.aspx).
3. Click **Create an account**.
4. Check off the **Meaningful Use / Promoting Interoperability** box in the **Select Applications to Request Access** section.
5. Fill out all the required fields to create your account.
6. [Click here to notify Elation of your interest in initiating an interface with ImmPRINT](https://help.elationemr.com/s/contactsupport).
7. Select **Immunization Registry** as the \*\*Request Type \*\* and provide Elation with the following information:
* What county is your practice in?
* Who will be the point of contact at your practice for this interface project
ImmPRINT requires the following actions prior to turning on the interface for your practice: A 30-minute call between Elation, your practice and a representative at ImmPRINT during the interface testing phase to test sending vaccination data from Elation EHR to ImmPRINT.
Registration on the ImmPRINT Pilot server. ImmPRINT will provide you with instructions about registration once you pass the testing phase.
## How to submit vaccination data to ImmPRINT using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to ImmPRINT. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ImmPRINT
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Alaska State- VacTrAK- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Alaska-State-VactrAK-Immunization-Registry-Interface-Guide
This article will describe how you can submit vaccination data to the Alaska State Immunization Registry [VacTrAK] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Alaska State Immunization Registry (VacTrAK).
## What is the VacTrAK Immunization Registry Interface?
The VacTrAK Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to VacTrAK, the Alaska State Immunization Registry. Practices can also query VacTrAK for vaccination history or forecast.
## Why is the VacTrAK Immunization Registry Interface valuable?
With the VacTrAK Immunization Registry Interface, practices no longer need to separately log in to VacTrAK to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to VacTrAK. You can also pull vaccination history for specific patients from VacTrAK to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & VacTrAK
The Elation Team will assist you with initiating an interface with VacTrAK. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry would you like to connect to?
* Does your practice participate in Meaningful Use Programs? (e.g MIPS)
* Does your practice administer or report vaccinations to VacTrAK?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
VacTrAK requires real patient data for testing the interface connection and will only consider the interface as fully **live** after successfully receiving sufficient patient data. Once the interface is **live** you will be able to query for immunization history.
## How to submit vaccination data to VacTrAK using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to VacTrAK. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using VacTrAK
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Arizona State- ASIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Arizona-State-ASIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Arizona State Immunization Registry [ASIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Arizona State Immunization Information System (ASIIS).
## What is the ASIIS Immunization Registry Interface?
The ASIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to ASIIS; the Arizona State Immunization Information System. Practices can also query ASIIS for vaccination history or forecast.
## Why is the ASIIS Immunization Registry Interface valuable?
With the ASIIS Immunization Registry Interface, practices no longer need to separately log in to ASIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to ASIIS. You can also pull vaccination history for specific patients from ASIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & ASIIS
The Elation Team will assist you with initiating interface with ASIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. What is your ASIIS IRMS ID?
2. What is your ASIIS PIN (VFC/Pandemic)?
Testing is required before the interface can go live. Elation will coordinate the testing process with you after receiving your request, and you should continue reporting vaccinations to ASIIS through your existing process until testing is complete.
## How to submit vaccination data to ASIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to ASIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ASIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Arkansas- AR WebIZ- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Arkansas-AR-WebIZ-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Arkansas State Immunization Registry [AR WebIZ] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Arkansas State Immunization Information System (AR WebIZ).
## What is the AR WebIZ Immunization Registry Interface?
The AR WebIZ Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to AR WebIZ, the Arkansas State Immunization Information System. Practices can also query AR WebIZ for vaccination history or forecast.
## Why is the AR WebIZ Immunization Registry Interface valuable?
With the AR WebIZ Immunization Registry Interface, practices no longer need to separately log in to AR WebIZ to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to AR WebIZ. You can also pull vaccination history for specific patients from AR WebIZ to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & AR WebIZ
The Elation Team will assist you with initiating interface with AR WebIZ. To notify us of your interest, please
1. Register with Arkansas' Department of Health (AR MURCS) [here](https://adhmurcs.arkansas.gov/MeaningfulUse/RegistrationContent/ShowRegistrationContentHome.aspx)
2. Afterwards, [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the Request Type, and send the following information to Elation:
3. Does your practice currently administer vaccinations?
4. Is your practice currently registered with AR WebIZ?
## How to submit vaccination data to AR WebIZ using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to AR WebIZ. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using AR WebIZ
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Letter & Referral Guide - Auto-drafting letters and referrals with Wordsmith
Source: https://help.elationhealth.com/articles/Auto-drafting-letters-and-referrals-with-Wordsmith
## Overview
### What does Wordsmith do?
Wordsmith is a generative AI tool that helps you draft Referrals, Provider Letters, and Patient Letters.
This feature pulls in clinical details from the patient chart, such as medications, problems, and recent visit notes, to create an initial letter draft that the user can edit. Users can also use Wordsmith in tandem with existing letter templates by first applying templates and then prompting Wordsmith to make refinements.
### Which chart details are used by Wordsmith?
To draft a letter or referral, Wordsmith takes the following details into account:
* Patient name, date of birth, pronouns
* Medications
* Problem List
* Clinical Profile History sections (e.g. past medical history, social history, diet)
* Last three visit notes
* Last three lab reports with structured lab values
Please note that:
* Content from the following are **not** used by Wordsmith to generate drafts.
* Faxed or imported Reports
* Confidential notes and labs - unless they are explicitly attached to the letter or referral.
* Generated drafts require clinical review and editing before being sent—Wordsmith is designed to accelerate, not fully automate, communication.
### What are the benefits of using Wordsmith?
Leveraging Wordsmith helps:
* Increase the efficiency of drafting a letter, allowing providers to focus more on patient care.
* Reduces the risk of excluding relevant details from the patient’s chart
* Increases timeliness of outbound clinical communication
## Setup
While using Wordsmith doesn’t require personalization, you have the option to tailor its tone and formatting to better match your own documentation style.
| **1** | Click on your **email address** in the upper right corner of Elation. |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Settings** . |
| **3** | In the left-hand menu, click **AI Personalization** . |
| **4** | Under the Wordsmith section, click\*\*+ Add New Instruction\*\* to type a custom rule or select one of our **sample instructions** from the provided list. Click on the Patient Letters, Provider Letters, or Referral Letters buttons to specify when you’d like the rule to be applied. • Click the **trash can** icon if you’d like to delete a rule. |
| **5** | Changes are automatically saved. |
![AI Personalization settings page showing a custom instruction "Use 'Hello' as a complimentary opening" entered in the text field, with an arrow pointing to the input area and "Provider Letters" selected as the apply-to option.]()
## Workflow Instructions
### Using Wordsmith to draft or refine a letter
| **1** | Open the patient’s chart. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | At the top of the chart, click **Referral**, **Letter**->**To Provider**, or **Letter**->**To Patient**. A new draft letter will open on the right-hand side of the chart. |
| **3** | Locate Wordsmith towards the bottom of the letter body. When there is no content in the letter body, type a description of the letter you’d like to create and click **Create**. • When there is already content in the body (i.e. you’ve applied a template or started a draft), type the edits you’d like Wordsmith to make and click **Edit**. |
| **4** | The drafted content will appear in the letter body. You can give Wordsmith additional prompts as needed to continue refining the letter. |
![Referral draft for Misty Swanson showing AI-generated referral body text, with the thumbs up, thumbs down, and undo icons highlighted in the upper right of the letter body, and the Wordsmith prompt bar at the bottom.]()
* If you like the drafted communication, let us know using the **thumbs up** icon.
* If the drafted communication is inaccurate, send us the feedback using the **thumbs down** icon so that we can continue improving on the feature.
* Click the **undo** icon when you want to revert to a previous draft.
## Glossary
### Example prompts
| Write a referral to a cardiologist and include relevant lab results. |
| -------------------------------------------------------------------- |
| Draft follow up instructions to the patient for today's visit. |
| Summarize the care plan for today's visit. |
## Frequently Asked Questions
### How can I troubleshoot if Wordsmith fails to generate content?
If draft generation fails or errors occur, refresh the patient chart and within the letter draft, clear and resubmit Wordsmith instructions. If an error persists, contact support for further escalation.
### What happens if Wordsmith is wrong?
If the drafted communication is inaccurate, send us the feedback using the **thumbs down** icon so that we can continue improving on the feature. You can also click the **undo** button to revert to a previous draft.
### Can I save a prompt for future use?
Saving reusable prompts is not possible at this time. However, you can use a letter template as a starting point for Wordsmith and then prompt it to make edits or populate it with its patient context.
## Related Articles
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
* [Decision Support Interventions Regulatory Documentation](/articles/Decision-Support-Interventions-Regulatory-Documentation)
* [Elation Health - Building Clinical-First AI](/articles/Building-Clinical-First-AI)
* [Letter & Referral Guide - Sending correspondences to other Elation EHR Users](/articles/share-documents-between-other-elationemr-users)
* [Letter & Referral Guide - Sending and receiving Direct messages](/articles/how-to-use-direct-messaging)
* [Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax)
* [Letter & Referral Guide - Sending correspondences via a secure Provider Portal](/articles/secure-Provider-Portal)
# Automatic Coding Guide- Advanced coding automations (Premium)
Source: https://help.elationhealth.com/articles/Automatic-Coding-Guide-Advanced-Coding-Automations
This article describes the advanced coding automations available to Premium EHR users.
## What is the automatic coding feature?
Elation's automatic coding feature is designed to help you get credit in quality programs for the documentation already present in your visit note by automatically adding CPT and/or ICD-10 codes to the billing information section of your visit notes based on certain information you store in your visit notes.
## What are the benefits of automatic coding?
When automatic coding is enabled, Elation uses the documentation already present in your visit note to automatically input relevant CPT or ICD-10 codes into the Billing Information section of the visit note. Your practice no longer need to (1) remember to code, or (2) remember which code needs to be added to the bill, based on the resulting vitals, screening results or Clinical Profile documentation. This will reduce time spent on double documentation on your practice, allowing you to focus more time on patient care.
## Which coding automations are available in Elation?
### Standard EHR
All EHR users have access to the following coding automations. [Click here for more information about the Standard EHR coding automations](/articles/elation-coding-automation).
### Premium EHR
Premium EHR users have access to the Standard EHR set plus the following:
* Place [Body Mass Index](#BMI_ordering) diagnosis codes at the bottom of the bill.
* Export diagnosis codes for hypertensive and/or diabetic patients into the bill after inputing [blood pressure](#BP_export_dx_code) procedure codes into the bill.
* Input the depression screening diagnosis code in the bill after inputting a the [PHQ-9](#PHQ9_screening) screening result procedure code into the bill.
* Input the procedure code for [pain](#pain) or no pain into the bill based on the pain scale value recorded for a patient in their vitals.
* Input the 1107F procedure code into the bill after an **Activities of Daily Living (ADL) Index** [functional status assessment](#functional_status_assessment) is completed and referenced in the visit note.
* Place diagnosis codes starting with [W (W00 to W99)](#w_diagnosis_code_ordering) at the bottom of the bill.
The coding automations listed are part of Elation's Premium EHR offering. If you are already a Premium EHR user and you are interested in using these coding automations, click the **I need help** button to notify Elation and a member of the Elation Team will activate the feature for you.
If you are interested in upgrading to Premium EHR to use these coding automations, click the **I need help** -> **Contract Elation Support** button and a member of the Elation team will assist you.
## Using the automatic coding feature
### Enabling automatic coding
Admin Level Users within your practice can turn the automatic coding features on or off by using the toggle in the Settings section.
To adjust your automatic coding preferences:
1. Click on your email at the top of your Elation account and then click **Settings** --> **Billing**
2. Use the toggles next to turn the corresponding coding automations ON (green) or OFF (grey) for any of the listed workflows. Once enabled, the coding automation will work for all users in your practice.
*
Certain coding automations have a primary automation and then a secondary automation. You must first enable the primary automation in order to enable the secondary automation. For example, you must first enable the *Body Mass Index* coding automation in order to enable the **BMI Diagnosis Code Ordering** coding automation.
When the **Admin only** toggle at the top right of the page is turned on, only Admin Level Users will be able to turn the feature on or off. For more information on Admin privileges, please reference the [User Accounts Guide- Administrative privilege](/articles/administrative-privileges) .
### Applying coding automation in visit notes
When automatic coding is turned on, taking certain actions in the visit note, such as entering blood pressure information or importing a PHQ-9 result from the Clinical Profile, will result in associated CPT or ICD-10 codes being automatically inputted in the Billing Information section of associated visit note. Certain coding automations may also reorder certain ICD-10 codes. Reference the information below to understand how each coding automation works.
## Using the Body Mass Index - BMI Diagnosis Code Ordering coding automation
For the **BMI Diagnosis Code Ordering** coding automation, any BMI related diagnosis code that is automatically inputted in the bill as a result of the [BMI coding automation](/articles/elation-coding-automation#BMI) will automatically be place at the bottom of the bill. This ensures that BMI diagnosis codes are not listed as the primary diagnosis code on the bill. If you manually reorder the BMI diagnosis code, this automation will override your action and return the code to the bottom of the bill upon saving the bill.
*
You must first enable the [Body Mass Index coding automation](/articles/elation-coding-automation#BMI) in order to enable the **BMI Diagnosis Code Ordering** coding automation.
## Using the Blood Pressure - Export Dx Code coding automation
For the blood pressure **Export Dx Code** coding automation, any hypertensive or diabetic diagnostic codes from the Clinical Profile or visit note will automatically be inputted in the bill along with any procedure codes that were inputted as a result of the [Blood Pressure coding automation](/articles/elation-coding-automation#BP).
*
You must first enable the [Blood Pressure coding automation](/articles/elation-coding-automation#BP) in order to enable the **Export Dx Code** coding automation for Blood Pressure.
## Using the PHQ-9 depression screening coding automation
For the
*PHQ-9*
coding automation, complete the **Depression (PHQ-9 Questionnaire)** in the
*Pysch*
(Psychological) section of the patient's Clinical Profile. Afterwards, when you export the completed PHQ-9 screening into a visit note, Elation will automatically input
* the G8510 CPT code in the billing section of the visit note if the screening results are negative or minimal (the PHQ-9 score is between 0-4).
* the G8431 CPT code in the billing section of the visit note if the screening results are positive (the PHQ-9 score is greater than 4).
### Using the PHQ-9 - Export Dx Code coding automation
For the PHQ-9 **Export Dx Code** coding automation, the depression screening diagnosis code, Z13.13, will automatically be inputted in the bill when the G8510 or G8431 CPT codes are inputted in the bill as a result of the PHQ-9 depression screening coding automation.
*
You must first enable the [PHQ-9 coding automation](/articles/elation-coding-automation#PHQ9) in order to enable the **Export Dx Code** coding automation for PHQ-9.
[Click here for more information about the PHQ-9 clinical questionnaire in the Clinical Profile](/articles/structured-questionnaires).
## Using the Pain assessment coding automation
For the **Pain** assessment coding automation, when you enter a patient’s perception of pain intensity on a scale of 0-10 in the **Pain** field of the **Vitals** section of a visit note, Elation will automatically input the appropriate associated CPT® Category II Code in the billing section:
* 1126F for a pain intensity of 0 (no pain present)
* 1125F for pain intensities between 1-10 (pain present)
[Click here to learn more about the Pain field](/articles/Pain-Scale)
.
## Using the Functional Status Assessment coding automation
For the
*Functional Status Assessment*
coding automation, complete the **Activities of Daily Living (ADL) Index** assessment in the
*Func*
(Functional)
* \*
section of the patient's Clinical Profile. Afterwards, when you export the results into a visit note, Elation will automatically input the 1170F CPT® Category II Code in the billing section.
[Click here for more information about the 'Activities of Daily Living (ADL) Index' clinical questionnaire in the Clinical Profile](/articles/structured-questionnaires)
.
## Using the W Diagnosis Code Ordering coding automation
For the
*W Diagnosis Code Ordering*
coding automation, Elation places diagnosis codes starting with W (W00 to W99) at the bottom of the bill. This ensures that diagnosis codes starting with W are not listed as the primary diagnosis code on the bill. If the W diagnosis code is manually reordered, this automation will override your action and return the code to the bottom of the bill upon saving the bill.
## Frequently Asked Questions (FAQ)
### When both the Body Mass Index - BMI Diagnosis Code Ordering coding automation and W Diagnosis Code Ordering coding automation are enabled, will both diagnosis codes be placed at the bottom of the bill?
Yes, when both the [Body Mass Index - BMI Diagnosis Code Ordering coding automation](#BMI_ordering) and [W Diagnosis Code Ordering coding automation](#w_diagnosis_code_ordering) are enabled, both diagnosis codes will be placed bottom of the bill.
**Are there additional coding automations available in Elation?**
No, there are no additional coding automations available. You will be notified if any additional coding automations are added in the future.
### Can I create my own coding automations in Elation?
Yes, you can automatically apply CPT, CPT II, or HCPCS codes to a bill by using the Document Tags feature. To create your own coding automations using Document Tags:
1. First, you need to create a Document Tag with an associated CPT, CPT II, or HCPCS code.
2. Click the **Tag** button in a Report or Document.
3. Enter a name for the Document Tag in the **Edit Document Tags** window.
4. Click the **Add new tag** button at the bottom of the window.
5. Enter a description if needed.
6. Select whether the code you want to associate with the tag is a *CPT*, *CPT II* or *HCPCS* code.
* Coding automation is not available for *ICD-9*, *ICD-10*, *LOINC* or *SNOMED* codes.
6. Enter the code for the Document Tag in the code field.
7. Click **Save** to save the Document Tag and associated code.
8. Apply the Document Tag to the a visit note to input the associated code in the bill.
[Click here to learn more about Document Tags](/articles/tag-reports-and-notes-with-document-tags).
## Related Articles
* [Automatic Coding Guide- Automatically code for BMI, Blood Pressure, and negative PHQ-9 documentation](/articles/elation-coding-automation)
* [Visit Note Documentation Guide- Best practices for documenting a patient encounter](/articles/Best-practices-for-documenting-a-patient-encounter)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Clinical Profile Guide- Structured Questionnaires](/articles/structured-questionnaires)
* [Document Tags for Visit Notes & Reports Guide](/articles/tag-reports-and-notes-with-document-tags)
# Coding Templates Guide - Apply Coding Templates for lab specimen collection and processing (Beta)
Source: https://help.elationhealth.com/articles/Automatic-Coding-Guide-lab-coding-templates
**Beta feature:** The feature described in this article is part of a beta release and is only available to a select number of practices.
## Overview
The Lab Coding Templates feature automatically adds predefined specimen collection and lab processing CPT codes to your bill when corresponding lab tests are detected in a signed, in-house specimen collection Lab Order. You can also associate specific diagnosis codes with specific lab tests as part of this feature.
## Workflow Instructions
### Enabling Lab Coding Templates for specific Lab Vendors
Coding Templates must be enabled at the Lab Vendor level for the Coding Templates to automatically populate in bills when ordering coded tests from specific Lab Vendors.
![Quest lab vendor settings panel showing the Coding Templates section (highlighted) with Specimen Collection and Lab Processing toggles both enabled, and "Elation South" listed as a Service Location.]()
To enable Coding Templates for a Lab:
Go to **Settings** -> **Labs** in Elation.
Click **Details** next to the name of the Lab Vendor. If you need to add a new Lab Vendor, [follow the instructions in this article](/articles/labs-settings#adding_vendor).
**Specimen Collection** - Automatically apply specimen collection CPT code templates to the bill when specimen collection is documented.
**Lab Processing** - Automatically apply lab test CPT code templates to the bill when specimen collection is documented. If your practice has more than one **Service Location**, click **+Add Service Location** and choose the location(s) that can bill for lab processing.
### Creating Lab Coding Templates
Once Coding Templates are enabled for the desired Lab Vendors, you must create Coding Templates for each Lab Vendor.
* Non-eOrdering Lab Vendors do not have vendor-specific compendia, meaning they share a common test database. As a result, any Coding Templates with generic tests can be used for all non-eOrdering Lab Vendors. These vendors will be represented by a dash (**-**) in the Lab Vendors column when adding lab coding.
![Lab Test Management page with an arrow pointing to the "+ Add Test" button in the upper right corner of the Lab Coding section, and the "Add Test" dialog open showing fields for Lab Vendor (Horizon Clinic), Test (Hemoglobin A1c), Specimen Collection Codes (procedure 36415), Test Codes (procedure 83036), Dx for All (Z00.00), and Medical Necessity Dx Codes (E11.9).]()
To create Lab Coding Templates:
Go to **Settings** -> **Lab Test Management**.
Click **+ Add Test**.
Click **Select a lab** to choose a Lab Vendor. Only Lab Vendors with [Coding Templates enabled](#enable_vendor) will be available for selection.
Click into the **Test** field to search for tests to code for.
Click **+ Add Billing Item** in the **Specimen Collection Codes** section to add the specimen collection CPT codes for the selected test. The [Specimen Collection coding templates](#enable_vendor) must be enabled for the selected Lab Vendor in order for you to edit specimen collection codes.
* Select a CPT code from your [Popular CPT Code list](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) or free text any CPT code of your choice.
* Duplicate codes cannot be added.
Click **+ Add Billing Item** in the **Test Codes** section to add the associated test processing CPT code for the selected test. The [Lab Processing coding templates](#enable_vendor) must be enabled for the selected Lab Vendor in order for you to edit test codes.
* Select a CPT code from your [Popular CPT Code list](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) or free text any CPT code of your choice.
* Duplicate codes cannot be added.
Click **Add Dx codes that apply to all code above…** in the **Dx for All** section to add ICD 10 codes to all listed CPT codes when a coding template is applied.
Click **Add Dx codes…** in the **Medical Necessity Dx Codes** section to automatically add listed ICD 10 codes to the bill when the ICD 10 code matches an ICD 10 code in the visit note draft or patient chart.
Click **Add Test**. You can only associate one coding template per lab test and will receive an alert if you attempt to create a coding template for a lab test that already has it.
Repeat the steps above for each lab test you want to apply coding templates to.
* If a Lab Vendor has their own compendium for a test (e.g., **Comprehensive Metabolic Panel** for Quest vs. ‘CMP’ for Labcorp), you will need to create a coding template for the same lab test across different Lab Vendors.
![Lab Test Management page showing three coded tests: Complete Metabolic Panel (CMP) and Comprehensive Metabolic Panel (Quest, code 10231) both highlighted, each with CPT codes 80053 and 36415, and medical necessity code I10.]()
### Viewing Lab Coding Templates
To view all the lab tests that have lab coding templates enabled, go to **Settings** -> **Lab Test Management**. The following details will be displayed:
* **Test Name** - The name of the lab test.
* **Test Code** - The test code as specified by the Lab Vendor (only available for Lab Vendors with their own compendia, e.g. Quest Diagnostics).
* **Lab Vendor** - The name of the **Lab Vendor** the lab test is associated with. If the Lab Vendor is a dash **-** then the associated lab test is associated with all Lab Vendors that do not have their own compendium.
* **Codes** - The first row is the **Test Codes** (lab test processing codes) and the second row is the **Specimen Collection Codes**.
* **Charges** - Charges associated with the Codes will display here.
* **Medical Necessity Codes** - Associated medical necessity diagnosis codes will be displayed here.
![Lab Test Management page showing three coded lab tests: Complete Metabolic Panel (CMP) and Hemoglobin A1c with no Lab Vendor (dash), and Comprehensive Metabolic Panel with test code 10231 assigned to Quest. Each test displays CPT codes 80053 and 36415 in the Codes column, with Medical Necessity Codes I10 or E11.9.]()
### Applying Lab Coding Templates to workflows
When a Lab Order is signed off with documented specimen collection and ordered coded tests, the lab coding templates are automatically applied to the visit note. Depending on the circumstances, the Coding Template can either apply the codes to a draft visit note or create a new Staff Procedure Note.
#### Applying Lab Coding Templates to in-house labs completed ‘Today’
To apply CPT code(s) and related diagnoses codes to your visit notes for in-house labs completed today:
Open a visit note draft in the patient’s chart with today’s Date of Service - create a new visit note if needed.
Click **+ Add Billing Information** if there is no billing information in the visit note draft yet. Confirm the **Rendering Provider** matches the name of the Provider that will sign the Lab Order.
* Select the **Service Location** that will match the **Service Location** of the Lab Order.
* Confirm the **Place of Service** code matches the **Place of Service** code of the **Service Location** of the Lab Order.
* Click **Save & Close**.
Create a Lab Order. Select any of the coded lab tests as appropriate.
* Enter in the specimen collection date of **Today**.
* Select the same **Service Location** as the **Service Location** of the visit note draft.
* Sign the Lab Order.
You will see the codes associated with the selected tests in the billing section of your visit note draft.
Each specimen collection type can only be billed once per date of service and patient. If multiple lab tests share the same specimen collection CPT code, only one unit of the code will appear per date of service.
Lab test processing codes can be billed multiple times per date of service. The quantity billed is indicated by the **Units** field.
To apply Lab Coding Templates to other in-house lab workflows, review the following two rules below:
* [Specimen collection Coding Template rules](#specimen_coding_automation)
* [Lab test processing Coding Template rules](#lab_processing_coding_automation)
#### Applying Lab Coding Templates to on-hold lab orders
If a [lab order is placed on hold](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection), Lab Coding Templates will not be applied until the specimen collection date is recorded in the held order.
If you want the automatic coding to appear in a specific visit note draft, make sure the specimen collection date matches the date of service of that visit note draft.
Review the following two rules below for more details:
* [Specimen collection Coding Template rules](#specimen_coding_automation)
* [Lab test processing Coding Template rules](#lab_processing_coding_automation)
#### Specimen collection Coding Template rules
The following chart explains when specimen collection Coding Templates will be applied to an existing visit note draft versus when a new visit note will be created.
| **Condition** | **True** | **False** | **Tip** |
| ----------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------- | ------- |
| The corresponding lab tests are identified in a signed, in-house specimen collection Lab Order. | CPT code(s) and related diagnoses applied to existing visit note draft | CPT code(s) and related diagnoses applied to a new ‘Staff Procedure Note’ category visit note. | |
| The date of service of specimen collection matches the date of service of the visit note. | If the date of service is in the past, create a visit note draft and update the Date of Service of the visit note draft to match the date the specimen was collected. | | |
| The visit note has an existing associated bill (i.e. the billing section is not blank). | Click **+ Add Billing Information** to create a bill. | | |
| For customers with a PMS integration: The bill has not been pushed to the PMS. | Enable [Delayed Billing](/articles/How-to-set-up-Delayed-Billing) if you wish to sign your visit note while applying lab coding templates at a later time. | | |
#### Lab test processing Coding Template rules
The following chart explains when lab test processing Coding Templates will be applied to an existing visit note draft versus when a new visit note will be created.
| **Condition** | **True** | **False** | **Tip** |
| -------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------- | ------- |
| The corresponding lab tests are identified in a signed, in-house specimen collection Lab Order. | CPT code(s) and related diagnoses applied to existing visit note draft | CPT code(s) and related diagnoses applied to a new ‘Staff Procedure Note’ category visit note. | |
| The date of service of specimen collection matches the date of service of the visit note draft. | If the date of service is in the past, create a visit note draft and update the Date of Service of the visit note draft to match the date the specimen was collected. | | |
| The visit note draft has an existing associated bill (i.e. the billing section is not blank). | Click **+ Add Billing Information** to create a bill. | | |
| For customers with a PMS integration: The bill has not been pushed to the PMS. | Enable [Delayed Billing](/articles/How-to-set-up-Delayed-Billing) if you wish to sign your visit note while applying lab coding templates at a later time. | | |
| The specimen collection Service Location matches the Service Location listed in the existing visit note draft. | | | |
| The rendering provider listed in the billing section of the visit note draft matches the signing provider of the Lab Order. | If an [Authorized Orders Delegate](/articles/staff-permissions--staff-delegates#provider-orders-delegates) is creating the Lab Order, make sure they select the signing Provider that matches the Rendering Provider of the visit note. | | |
| The Place of Service listed in the billing section of the visit note draft matches the Place of Service listed in the Service Location of the Lab Order. | The Place of Service codes should match by default when the exact Service Locations are selected in both the visit note draft and Lab Order. | | |
#### Sample of ‘Staff Procedure Note’
This is what a ‘Staff Procedure Note’ created by a Lab Coding Template looks like:
![Patient chart showing a Staff Procedure Note dated 02/04/2025 with billing codes 36415 and 80053 (both with diagnosis I10) and Billing Status: Queued, created automatically by a Lab Coding Template.]()
## Frequently Asked Questions
### If I collect multiple specimens for a patient, will more than one specimen collection code appear in my bill?
If multiple lab tests share the same specimen collection CPT code, only one unit of the code will appear per date of service. Each specimen collection type can only be billed once per date of service and patient.
### I signed off on an in-house Lab Order after recording specimen collection but the Lab Coding Template feature created a new Staff Procedure Note instead of putting the billing codes into the visit note draft I have open. Why did this happen?
Lab Coding Templates will input codes into a visit note draft only if specific criteria are met. Review the following two rules below for more details:
* [Specimen collection Coding Template rules](#specimen_coding_automation)
* [Lab test processing Coding Template rules](#lab_processing_coding_automation)
### If I record a specimen collection date on a held order, will the Lab Coding Template feature input codes into my signed visit note with the same date of service?
Lab Coding Templates cannot apply codes to a signed visit note when you are using a held Lab Order. Lab Coding Templates will only be applied when the specimen collection date is documented in the held order.
### I created a Lab Coding Template for a lab test, but it does not consistently trigger. Why?
Here are a few reasons why the Lab Coding Template may not trigger:
* The\*\* Lab Vendor\*\* does not match the Lab Vendor specified in the Coding Template for that lab test.
* You did not select **In-house draw** in your Lab Order.
* You did not enter a **Specimen Collection** date in your Lab Order.
If the reasons above do not apply to your situation, review the following two rules below for more details:
* [Specimen collection Coding Template rules](#specimen_coding_automation)
* [Lab test processing Coding Template rules](#lab_processing_coding_automation)
## Related Articles
* [Labs Settings Guide](/articles/labs-settings)
* [Order Forms Guide- Ordering lab tests with the Lab Order Form](/articles/ordering-lab-tests-enhanced)
* [Automatic Coding Guide- Automatically code for BMI, Blood Pressure, and negative PHQ-9 documentation](/articles/elation-coding-automation)
* [Automatic Coding Guide- Advanced coding automations (Premium)](/articles/Automatic-Coding-Guide-Advanced-Coding-Automations)
# Barcode Scanner Calibration Guide - Verifying your scanner for vaccine documentation
Source: https://help.elationhealth.com/articles/Barcode-Scanner-Calibration-Guide
Verify your handheld barcode scanner is programmed to transmit the GS1 DataMatrix Group Separator and a scan terminator so Elation can auto-fill vaccine fields.
This article explains how to use the Barcode Scanner Calibration tool to confirm your handheld scanner is programmed correctly for scanning vaccine barcodes into the Document Vaccination form.
### What is the Barcode Scanner Calibration tool?
The Barcode Scanner Calibration tool is a standalone page that checks whether your handheld barcode scanner is sending the data Elation needs to auto-fill vaccine fields. You can open it at any time at:
[https://app.elationemr.com/utils/barcode-calibrate/](https://app.elationemr.com/utils/barcode-calibrate/)
The page:
* Requires **no login**.
* Stores **no patient data**.
* Shows **live diagnostics** for each scan: whether the Group Separator was detected, which terminator was sent, and the parsed NDC, lot number, and expiration date.
* Displays a **raw keystroke log** so you can see exactly what your scanner transmits.
Because it uses the same barcode detection and parsing logic as the production Document Vaccination form, a successful calibration scan means scanning will work in the patient chart.
### Why scanner calibration matters
Most vaccine vials use a **GS1 DataMatrix** barcode that combines several values (NDC, lot number, expiration date) into one code. A hidden **Group Separator (GS)** character marks where one field ends and the next begins.
For Elation to read the barcode, your scanner must be programmed to:
* **Transmit the Group Separator (GS)** between fields, and
* **End each scan with a terminator** (Enter or Tab).
If the scanner does not send these, Elation cannot parse the barcode, and the vaccine, lot, and expiration fields may not fill in. The calibration tool lets you confirm this setup outside of a live patient encounter, instead of troubleshooting by trial and error in a real chart.
### How to calibrate your scanner
Go to [https://app.elationemr.com/utils/barcode-calibrate/](https://app.elationemr.com/utils/barcode-calibrate/) in your browser. No login is required.
Make sure the calibration page is the active, focused window before you scan. The tool reads keystrokes from your scanner, so the scan must land on this page.
Scan the on-screen reference barcode, or scan any GS1 DataMatrix barcode from a vaccine vial.
Confirm that the page shows:
* **GS detected** (the Group Separator was transmitted)
* A **terminator** (Enter or Tab)
* Correct parsed **NDC**, **Lot #**, and **Expiration Date**
If all three are correct, your scanner is ready to use with the Document Vaccination form.
### Troubleshooting scanner calibration
If a calibration scan does not show the expected results, work through the following steps in order.
Make sure the calibration page is the active browser window, and that your scanner is connected, powered on, and set to keyboard (HID / keyboard wedge) mode. If nothing appears in the keystroke log when you scan, this is usually the cause. Then scan again.
The vaccine, lot, and expiration values are encoded in a 2D **GS1 DataMatrix** barcode, not a 1D (linear) barcode. If the values parse incorrectly or only partially, confirm you are scanning the 2D DataMatrix code on the vial.
If the page does not show **GS detected**, your scanner is not transmitting the Group Separator. Reprogram the scanner using the manufacturer's settings for **GS1 DataMatrix** output. This setting is often labeled "transmit GS," "transmit function codes / AIM ID," or "Group Separator." Then scan again.
If no terminator is detected, configure your scanner to add a **suffix** of **Enter (carriage return)** or **Tab** after each scan. This is usually found under the scanner's "suffix" or "terminator" configuration. Then scan again.
If scans still fail after confirming the settings above, contact Elation Support via the **I need help** button in the blue navigation bar. When reaching out, include the make and model of your scanner and a description of what the calibration page shows (for example, "terminator detected but GS missing").
## Related articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Best Practices Guide- Using Elation for value-based payment programs
Source: https://help.elationhealth.com/articles/Best-Practices-Guide-value-based-payment-programs
This article describes the features that can be used for value-based payment program related workflows.
## What are value-based payment programs?
Value-based payment programs are healthcare models and reimbursement approaches that focus on delivering high-quality healthcare while controlling costs. Value-based payment programs incentivize healthcare providers to prioritize patient outcomes and the overall value of care over volume of services delivered. These programs typically emphasize performance against quality metrics, risk adjustment coding and support for transition of care/care coordination services.
## Which EHR features can be used for value-based payment programs?
The following EHR features can help support value-based payment program related workflows. Features with an asterisk need to be manually enabled in your Elation Settings or be turned on by Elation.
* [Automatic Coding](/articles/elation-coding-automation)\*
* [Clinical Reminders](/articles/clinical-reminders-for-clinical-quality-measures)\*
* [MIPS Reporting](/articles/MIPS-2026-Overview)
* [Popular CPT Codes](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?)
* [Risk Assessment](/articles/what-is-risk-assessment)\*
* [Visit Note Automation](/articles/visit-note-automation)
* [Visit Note Templates](/articles/elation-visit-note-templates)
* [Prescription insurance benefits information](/articles/Prescription-Form-Guide-patient-prescription-benefits)\*
* [Carequality integration](/articles/Carequality-Integration-Introduction)\*
## Quick Start Guide
| **Incorporate quality reporting CPT/ICD-10 codes in your encounter documentation to ease administrative burden and ensure you get credit for services delivered to your patients** |
| --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Feature** |
| [Automatic Coding](/articles/elation-coding-automation) Automatically adds CPT and/or ICD-10 codes to the billing information section of your visit notes for body mass index assessments, blood pressure recordings, and negative PHQ-9 depression screening results documentation. |
| [Popular CPT Codes](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) Store a list of commonly used Category II CPT codes for performance measures in your Popular CPT Codes database to easily add these codes to your encounter documentation. |
| **Drive performance in quality measures to improve quality of care** |
| **Feature** |
| [Clinical Reminders](/articles/clinical-reminders-for-clinical-quality-measures) Reminds you to follow up on certain health conditions based on the patient's demographics and conditions. Tied to certain Clinical Quality Measures if you are participating in MIPS. |
| [MIPS Reporting](/articles/MIPS-2026-Overview) Track your MIPS program performance and submit your data to CMS for reporting. |
| **Define and manage risk tiers within your patient panel** |
| **Feature** |
| [Risk Assessment](/articles/what-is-risk-assessment) Shows you the level of **risk** assigned to each patient based on the Centers for Medicare and Medicaid Services (CMS) HCC Risk Adjustment Model. |
| **Automate documentation for common encounters** |
| **Feature** |
| [Visit Note Templates](/articles/elation-visit-note-templates) Create templated documentation for common evaluations and procedures (ex. annual exams) to expedite charting. |
| [Visit Note Automation](/articles/visit-note-automation) Automatically apply Visit Note Templates to visit notes based on the appointment type tied to the patient's appointment to expedite charting. |
| **Improve patient drug therapy experience while reducing the total cost of care of your patient panel** |
| [Prescription insurance benefits information](/articles/Prescription-Form-Guide-patient-prescription-benefits#cost_estimate) Use prescription formulary and cost estimate details to make cost effective prescribing decisions for your patients |
| **Connect to external patient data sources for a 360 view of your patient’s care delivery** |
| [Carequality integration](/articles/Carequality-Integration-Introduction) Share and query for data from any Carequality-enabled providers |
## Video Library
[Click here to explore our video library about value-based payment program related features](https://vimeo.com/showcase/elation-vbp)
.
## Related Articles
* [Billing Guide- Creating a superbill & coding for your visit](/articles/billing)
* [Billing Guide- Navigating Billing Settings](/articles/billing-settings---service-locations--procedure-codes)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Elation's Carequality Integration Introduction (Beta)](/articles/Carequality-Integration-Introduction)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Prescription Form Guide- Viewing patient prescription benefits](/articles/Prescription-Form-Guide-patient-prescription-benefits)
* [Problem List Guide](/articles/managing-your-problem-list)
* [Risk Assessment Introduction- Risk Assessment Factors (RAF) and Hierarchical Condition Categories (HCC)](/articles/what-is-risk-assessment)
* [Visit Note Documentation Guide- Using visit note automation for appointments](/articles/visit-note-automation)
# Visit Note Documentation Guide - Best practices for documenting a patient encounter
Source: https://help.elationhealth.com/articles/Best-practices-for-documenting-a-patient-encounter
This is a "Best Practice" guide on how to document a patient encounter using Elation's Visit Note feature.
## Overview
### Why should I document patient encounters in Elation?
Elation's Visit Note feature offers many structured fields for storing important details regarding a patient encounter. Storing patient encounter details in a structured way allows for better collaboration amongst various providers and organizations that are caring for the same patient. You can easily view visit notes within a patient's chart or share a copy of the structured visit note with any provider or organization.
## Workflow Instructions
### Ways to speed up Visit Note documentation
There are a few quick ways to speed up Visit Note documentation:
1. For patients who are seeing you for annual exams or chronic conditions follow up you can [copy the content from a prior visit note](#previous_encounter) for use in the new Visit Note. This allows you to re-use existing documentation to speed up documentation.
2. For documenting common encounters, we recommend recording the patient's appointment in the Elation Calendar to use our [calendar to visit note automation](#auto_start) to start your visit note draft. This will allow you to quickly:
3. specify which [Visit Note Format](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) you wish to use to document your encounter and apply the correct format to your documentation
4. specify which [Visit Note Category](/articles/visit-note-categories) you wish to use to assign to the encounter
5. pre-populate important visit note details like the encounter date and time, provider & chief complaint
6. apply [Visit Note Templates](/articles/elation-visit-note-templates) to your documentation
7. Use existing [Clinical Profile documentation](#clinical_profile)
8. [Apply templates](#templates) to your documentation
9. Take [all the actions needed to complete the encounter](#references) directly within the visit note draft
### Copy forward or carry over a previous note
You can use any existing completed visit note from the patient's chart to draft a new patient encounter—copying it forward so you don't have to start from scratch.
* To copy all the contents of a previous visit note, go to the signed visit note that you want to copy and click **Actions** -> **Export to: New Note**.
* To copy only the HPI section of of a previous visit note, go to the signed visit note that you want to copy and click **Actions** -> **Export to: New Note (HPI Only)**.
![Actions dropdown menu expanded on a signed visit note, with an arrow pointing to the "Export to: New Note" and "New Note (HPI Only)" options highlighted in a red box.]()
### Using automations to start a visit note draft
The [visit note automation](/articles/visit-note-automation) features allow you to quickly:
1. specify which [Visit Note Format](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) you wish to use to document your encounter and apply the correct format to your documentation
2. specify which [Visit Note Category](/articles/visit-note-categories) you wish to use to assign to the encounter
3. pre-populate important visit note details like the encounter date and time, provider & chief complaint
4. apply [Visit Note Templates](/articles/elation-visit-note-templates) to your documentation
Learn more about how to configure and utilize the feature in the [Visit Note Documentation Guide- Using visit note automation for appointments](/articles/visit-note-automation) article.
### Using Templates
There are a few template features you can use for any patient encounter. Templates help reduce repetitive documentation for standard evaluations and procedures and allow you to clearly lay out the steps and questions to be addressed during an encounter.
#### Visit Note Templates
*Visit Note Templates* encourage consistent workflows across providers and staff by clearly laying out the steps and questions to be addressed. You can:
* Create custom templates that suit your practice needs
* Export templates across all visit note formats
* Add one or multiple templates to a visit note
* Associate CPT® codes and billing items to templates
* Add POS and billing notes to auto-populate information needed for virtual billing
* Capture document tags to assist with reporting
To apply a Visit Note Template to your visit note draft:
1. Open the Visit Note Template management window by using one of the following options:
2. Click on the **Templates** icon in a patient's chart & select **Visit Note Templates** from the dropdown menu.
3. Click on the **Visit Note Templates** button at the top left-hand corner of the visit note.
4. Select one or more checkboxes next to the template(s) of interest OR click the **Export** button next to a template.
5. Click the **Export All Selected to Note** button.
Learn more about creating *Visit Notes Templates* in the [Visit Note Templates Guide](/articles/elation-visit-note-templates).
#### Physical Exam (PE) & Review of Systems (ROS) templates
PE (Physical Exam) Templates are pre-created texts of the evaluations of a patient's physical appearance divided by their anatomy. To apply a PE Template to a visit note, click the **PE Templates** button and select a template.
ROS (Review of Systems) Templates are pre-created texts of the evaluations of a patients' various organ systems. To apply a ROS Template to a visit note, click the **ROS Templates** button and select a template.
PE Templates and ROS Templates come in handy for inserting standard evaluations based on the patient's exam reason. This way providers only need to edit the evaluations that are different from the standard or normal evaluations. Learn more about PE and ROS Templates in the [Visit Note Documentation Guide- Physical Exam (PE) & Review of Systems (ROS) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates) article.
### Using the Clinical Profile to assist with documentation
Any record in the clinical profile can be referenced into a note or visit note to facilitate documentation of a clinical encounter. You can click the **Actions** button next to any header to export the entire section to a note or visit note. You can also click **Actions** next to a specific record to only export that record to a note or visit note. Certain visit note formats also allow you to import different sections of the Clinical Profile into your visit note with buttons directly within the visit note format itself. Review the various visit note formats in the [Visit Note Documentation Guide- Visit Note Formats](https://elation.lightning.force.com/articles/Knowledge/Visit-Note-Documentation-Guide-Visit-Note-Formats) article to choose the best format for your charting preferences.
[Click here](/articles/no-double-documentation-with-the-clinical-profile) to learn more about using Clinical Profile documentation to facilitate charting.
### Completing the Visit Note
#### Navigating the Visit Note with your keyboard
You can use your keyboard to help you quickly navigate the visit note and document information in different fields. Here are the various ways:
1. When you type in a text field in the **HPI** section of the Visit Note (ex. pressure in chest) and you want to add another record to the HPI section, hit the **TAB** key on your keyboard to add the next record (ex. hip pain)
2. When you type in a text field in the **HPI** section of the Visit Note and you want to add additional sub-text to the record (ex. details about the problem) in a different text box, hit the **ENTER** key on your keyboard to add sub-text.
3. If you want to add a line break in the same text box, hold down the **SHIFT** key on your keyboard and press the **ENTER** key on your keyboard.
4. Use the **TAB** key on your keyboard to jump from the text field of one section of the visit note to the text field of the next section of a visit note.
5. You can also use your keyboard to take various actions. Use the **TAB** key on your keyboard to navigate to specific buttons. When an action is highlighted because of the **TAB** key, you will see a blue border behind the button. Afterwards, hit the **ENTER** key on your keyboard to trigger the action.
This sub-text in a different text box option is only available in the **HPI** & **Assessment** sections of the 2 column visit note formats and only available in the **Assessment** section of the 1 column & Pre-Op visit note formats.
#### Recording vitals
The **Vitals** section of a visit note allows providers/staff to record patient vitals information as applicable for the encounter. We have a couple of automations built into this section to allow for easier and quicker documentation:
1. If the patient's height (**Ht**) was ever recorded for the patient in a previous encounter, you only need to type in the patient's weight in the **Wt** field for the new encounter and Elation will automatically use the previously recorded height to calculate the patient's BMI. This is ideal for use when the patient's height does not fluctuate often.
2. You can enter certain vitals information using an alternative measurement system and Elation will automatically convert the measurement to the unit of measurement utilized in Elation. Values are normalized when you click or tab out of the field and stored in the standard unit for each vital.
| Vital | Stored unit | Metric | Imperial |
| ------------------ | ----------- | ---------------- | ------------ |
| Height | inches | centimeter (cm) | inches (in) |
| Weight | lbs | kilogram (kg) | pounds (lbs) |
| Head circumference | cm | centimeters (cm) | inches (in) |
The auto-conversion feature supports a variety of input formats:
* **Compound inputs** — enter height as `5'10"` or weight as `5 lbs 8 oz`
* **Fractions** — enter values like `5 1/2'` or `13 3/4 in`
* **European-style decimal commas** — enter values like `12,5 kg` (converts to `27.56 lbs`)
* **Case-insensitive units** — `CM`, `Kg`, `LBS`, and other variations all work
* **Invalid input handling** — if the system cannot recognize the input (for example, unrecognizable text or mixed conflicting units), the field silently reverts to the last valid value when you click or tab out of the field
#### Addressing Clinical Reminders
The **Clinical Reminders** feature provides notifications at the top of in-draft visit notes to remind providers of certain actions to take to address gaps in patient care based on the patient's demographics and problems. This reduces the need for providers to review the entire chart to find conditions that they need to follow up on. A majority of the **Clinical Reminders** in Elation are tied to specific [Clinical Quality Measures](/admin-compliance) for different government programs that Elation supports. However, the reminders are still applicable for addressing care gaps even if you are not participating in government programs because a majority of the care gaps apply to the general patient population for primary care providers.
Clinical Reminders are generally addressed by providers, but staff—including nurses and medical assistants—can also view and assist with addressing certain reminders (for example, recording BMI). For this reason, provider and staff Clinical Reminder settings are managed separately:
* **Providers** configure their own reminders under **Settings** > **Preferences** > **Clinical Reminders (MIPS)**.
* **Staff** (including nurses, medical assistants, and care coordinators) see reminders based on the practice-wide settings in **Settings** > **Clinical Care Measure Settings**.
For step-by-step instructions on enabling or disabling reminders for providers and staff, see the [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures) article.
There are 28 **Clinical Reminders** available in Elation and a majority of them are for government programs reporting. If you do not see the full set of **Clinical Reminders** and wish to utilize them, use **I need help** -> **Contact Elation Support** to request access to all the **Clinical Reminders** available. A member of the Support Team will assist you with this request.
#### Taking clinical actions with the visit note draft open
As best practice, when you are taking any actions in the patient's chart while the patient is being seen, keep the in-draft visit note open in the patient's chart. This will automatically:
1. Reference any reports you viewed in the:
* **Documents Referenced** section of the Simple Note and SOAP Note formats.
* **Data** section of all the H\&P notes and the Pre-Op Note formats.
2. Record any prescriptions, orders or referrals you write for the patient in the:
* **Tests** section of the 2-column visit note format.
* **Orders** section of all other visit note formats.
3. Record any vaccinations administered that day in the:
* **HPI** section of the Simple Note format.
* **Plan** section of the SOAP Note format.
* **Assessment**/**Plan** section of the 1 column, 2 col-A/P and Pre-Op Note formats.
* **Tx** (treatment) section of the 2 column format.
4. Record any point-of-care labs entered (if you choose **Sign & Export to Note**) in the:
* **HPI** section of the Simple Note format.
* **Objective** section of the SOAP Note format.
* **Data** section of all other visit note formats.
5. Reference any handouts given to the patient in the **Care Plan** section of all visit note formats.
### Billing
For providers who are submitting claims to payers, make sure you enter the procedures and diagnoses for services rendered along with the place of service information in the **Billing Information** section at the bottom of the visit note. Certain actions taken from the **Problem List** of the **Clinical Profile** or\*\* Assessment\*\* and **Procedures** section of the different H\&P notes or Pre-Op Note formats will assist you with your coding.
Learn more about how to enter billing information in the [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing) article.
## Related Articles
* [Visit Note Categories Guide](/articles/visit-note-categories)
* [Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Visit Note Documentation Guide- Using visit note automation for appointments](/articles/visit-note-automation)
* [Visit Note Documentation Guide- Physical Exam (PE) & Review of Systems (ROS) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates)
* [Visit Note Documentation Guide- Using Clinical Profile documentation to facilitate charting](/articles/no-double-documentation-with-the-clinical-profile)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Billing Guide- Creating a superbill & coding for your visit](/articles/billing)
# User Accounts Guide- Best practices for keeping your Elation account secure
Source: https://help.elationhealth.com/articles/Best-practices-for-keeping-your-Elation-account-secure
This article will describe the best practices for keeping your Elation account, and the Protected Health Information (PHI) within it, secure.
## Overview
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits healthcare providers and healthcare businesses from disclosing protected health information (PHI) to anyone other than a patient and the patient's authorized representatives without the patient's consent. To ensure your practice can meet HIPAA standards and requirements, we recommend implementing certain security practices into your workflows to ensure PHI is not exposed to unauthorized individuals.
Elation's Security Team works hard to ensure Elation meets the security and privacy guidelines set forth by HIPAA, as well as various industry best practices. Regular external audits of our policies and procedures, as well as third-party penetration tests of our systems, are used to verify that we continue to meet the standards we are striving for. Elation is committed to protecting the security, confidentiality, integrity, availability, and privacy of its information resources including PHI.
## Workflow Instructions
### Internet Connection Security
As best practice, never connect any of your devices to an internet connection that is not secure. This exposes your devices to potential security threats. We recommend using a hard-wired connection (ex. via an ethernet cable) when possible.
If you are using a wireless internet connection, please make sure it has the following characteristics:
* The connection is password protected with a strong password that is:
* unique to the connection (do not reuse passwords)
* not readily accessible by non-authorized individuals
* The connection is encrypted
* We recommend the Advanced Encryption Standard (AES)
* The devices that enable the connection:
* are password protected with a strong password
* have up to date software
* Have the following features turned off:
* remote management
* WPS
* Universal Plug and Play (UPnP)
### Device Security
Keeping your devices secure is also important, especially devices you use to access your Elation EHR account. Make sure your devices, such as your mobile phone, laptop or desktop have the following security measures in place to prevent unauthorized individuals from gaining access to your device and the information in your device:
* Use 2 Factor Authentication to access your device(s)
* Keep your operating systems up to date
* Enable your operating system’s firewall
* Utilize Antivirus software
* Implement identity theft protection
* Logout from your account when not in use
* Turn off or shut down your device(s) when not in use
* Turn off bluetooth when not in use
Elation will automatically logout your account after two hours of inactivity in the platform.
### Web Browser Security
Keeping your web browser secure is always important. If hackers gain access to the cookies or cached data in your web browser, they may be able to access your accounts and information. Follow these practices to keep your web browser secure:
* Keep your browser and any plugins/extensions up to date
* Only apply plugins or extensions to your browser if they are from trusted sources
* Block pop-ups from unauthorized websites
* Use an ad-blocker
* Use private/safe browsing, especially when accessing your Elation account
* Clear your web browser cache and cookies on a frequent basis
* Disable saved passwords
* Disable autofill
### Account Security Features
Elation has implemented two features you can use to add extra security to your workflow when accessing your Elation account:
* Multi-factor Authentication: [/articles/Multifactor-Authentication-MFA](/articles/Multifactor-Authentication-MFA)
* Single Sign-On: [/articles/single-sign-on](/articles/single-sign-on)
Elation also implemented a fail-safe in case anyone maliciously tries to access your Elation account; an Elation account will be locked for 1 hour if there were 10 or more unsuccessful login attempts in a row. If you are the owner of the account and have accidentally locked yourself out, [contact support](https://app.elationemr.com/support/) for assistance with unlocking your account.
### Password Best Practices
Use a strong password for your Elation account. Strong passwords are unique passwords that generally have the following characteristics:
* mixture of both uppercase and lowercase letters
* mixture of letters and numbers
* have at least one special character
* Reset your password a few times a year—this guarantees that even if your login information was compromised, the culprit will eventually lose access
* If you need to store your log in information somewhere for ease of access, store your login and password information in a secure and trusted password manager.
Never share your account with anyone as this action is explicitly prohibited by HIPAA.
## Frequently Asked Questions
### I suspect I am a victim of a ransomware attack. Did the attacker gain access to my Elation data as well?
In order for a ransomware attack to take place, the attacker must first gain access to a computer system using some existing vulnerability. Once access has been gained, the attacker proceeds to **scramble** the data on the system, rendering it unusable. The attacker then demands a ransom be paid before the system will be "descrambled".
If you suspect you are a victim of a ransomware attack, please be reassured that the data in your Elation account is secure. There are several ways to make a system resilient to ransomware attacks, and Elation employs all of them; especially preventing unauthorized access in the first place. Elation has policies and procedures in place to ensure that our systems are secure, and those procedures are tested and verified on a regular basis.
We recommend that you work with your IT staff or vendor to assess the specific risks of your IT systems. In the event of a ransomware attack on your systems, the data in your EHR will be safe with Elation, but your ability to access that data from the affected device may be interrupted while you recover access to your device.
### I was suddenly logged out of my account, what happened?
Elation will automatically logout of your account after two hours of inactivity in the platform for security purposes. As best practice, you should always log out of your account when not in use or when you step away from your device to reduce the risk of PHI exposure.
### Why am I locked out from my account?
Elation implemented a fail-safe in case anyone maliciously tries to access your Elation account; an Elation account will be locked for 1 hour if there were 10 or more unsuccessful login attempts in a row. If you are the owner of the account and have accidentally locked yourself out, [contact support](https://help.elationemr.com/s/contactsupport) for assistance with unlocking your account.
### Will I be able to access Elation if I have a Virtual Private Network (VPN) enabled?
Yes, you will be able to access Elation if I have a Virtual Private Network (VPN) enabled.
### Can users log into Elation from outside the United States?
Yes. Elation does not currently enforce location-based blocks on login, so users can access their account while traveling or working internationally, subject to standard requirements like a stable internet connection, a supported browser (Google Chrome or Mozilla Firefox), and any local network or firewall rules on the user's side.
## Related Articles
* [Multi-Factor Authentication - Introduction](https://app.glean.com/articles/Knowledge/Multifactor-Authentication-MFA)
* [Single Sign-On](https://app.glean.com/articles/Knowledge/single-sign-on)
# Billing Guide- Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Billing-Guide-Frequently-Asked-Questions
This article lists all the frequently asked questions and answers around billing workflows and features.
For FAQs specific to Elation Billing (PMS), see [Elation Billing FAQs](/articles/elation-billing-faqs) .
### What billing features are available in Elation?
| Feature | Description | |
| ------------------------------------------------------------------------------------- | ----------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| [Elation Billing](/articles/Elation-Billing-All-in-One) | Elation’s all-in-one billing solution for practices that bill insurance | ![Elation Billing dashboard showing MTD summary cards: Charges 9,659, Adjustments 93.86, Payments 930, Write Off 270, Accounts Receivable $14,266, with Practice Revenue chart and Worklist Tags panel.]()
|
| [Billing Form](/articles/billing) | Enter billing information for each patient encounter | ![Billing Form for Minnie Jones dated 09/09/2022, showing the Edit Billing button at the bottom of the visit note highlighted with a red arrow, and the open Billing Form with Coding section and Save & Close button visible.]()
|
| [Billing Home](/articles/Billing-Home) | Dashboard for managing all your bills | ![Billing Home dashboard showing two bills filtered by last 30 days for Karly Smith, MD — one with "Awaiting sign-off" status and one with "Signed" status, displaying patient names, service location, POS code, insurance details, and procedure codes.]()
|
| [Patient Invoicing](/articles/patient-invoicing) | Generate invoices to bill patients | ![Patient invoice dated 06/29/2023 for Rachel Gramms showing two line items: CPT 99212 at 50.00 and Records Copy at 15.00, with total charges of $65.00.]()
|
| [Patient Payments](/articles/using-elation-to-securely-collect-patient-payments) | Securely collect credit card & debit card payments from patients | ![Patient Payment Request dialog showing patient Jones, Minnie, amount $25, reason Copay, Credit/Debit payment method, and "Send patient a request" option, accessed via the Payment button in the toolbar.]()
|
| [Membership Management](/articles/Introduction-to-Membership-Management-with-Elation) | Collect recurring membership payments from patients | ![Elation Health membership enrollment confirmation email for Paris France practice showing Premium Plan at $150.00 billed monthly, start date 03/29/21, and Visa ending in 4242.]()
|
### Generating bills
Where do I enter billing information in Elation EHR?
Billing information is always tied to a visit note in the EHR. Go to the bottom of a visit note draft, click **+Add Billing Information** or **Edit Billing** to use the [Billing Form](/articles/billing) to add billing information for the encounter.
What billing information can I store in Elation?
Elation’s [Billing Form](/articles/billing) allows you to store the following billing information for each encounter:
* Date of Service
* Service Location
* Place of Service Code
* State in which services were rendered
* Name of a Referring Provider
* Patient payment notes
* Procedure codes, modifiers and diagnosis codes
* Charge details (for patient invoices only)
Who can enter billing information?
While a visit note is still in draft (not signed off), anyone in the practice can enter billing information into the [Billing Form](/articles/billing). Once a visit note is signed by a Provider Level User, only the Provider Level User that signed the visit note or their [billing delegate](/articles/staff-permissions--staff-delegates#bills_view) can edit the billing information tied to the visit note.
How many claims can I generate per encounter?
You can only generate one bill/claim per visit note. If you need multiple claims for the same encounter, you will need to generate two visit notes for that encounter.
How do I enter codes?
See the **Coding for an encounter** section for more details about coding for an encounter.
I want to save the bill and come back at a later time to complete my coding. Is that possible?
Yes! You can save your work at any time by clicking **Save & Close** at the bottom of the [Billing Form](/articles/billing). As best practice, also click **Save as Draft & Close** at the bottom of your Visit Note to save your documentation as well.
Can I edit my billing information at any time?
For PMS integration users, Elation’s PMS integrations are NOT built to receive edits after billing information is sent to the PMS. You must edit the bill/claim in both Elation EHR and your PMS.
Yes! To edit the billing information before a visit note is signed off, simply click **Edit Billing** where the billing information you've entered is displayed at the bottom of the visit note. Once a visit note is signed by a Provider Level User, only the Provider Level User that signed the visit note or their [billing delegate](/articles/staff-permissions--staff-delegates#bills_view) can edit the billing information tied to the visit note. To edit billing information for a visit note after that visit note is signed, find the visit note in the chronological record in the patient's chart and click **Actions** --> **Edit Bill**.
How do I edit billing information before signing?
To edit the billing information before a visit note is signed off, simply click **Edit Billing** where the billing information you've entered is displayed at the bottom of the visit note. Once a visit note is signed by a Provider Level User, only the Provider Level User that signed the visit note or their [billing delegate](/articles/staff-permissions--staff-delegates#bills_view) can edit the billing information tied to the visit note. To edit billing information for a visit note after that visit note is signed, find the visit note in the chronological record in the patient's chart and click **Actions** --> **Edit Bill**.
How do I adjust the Date of Service of a bill?
Billing information is always tied to a visit note in the EHR. To correct the date of service, go to the top of the Visit Note draft and click on the date to adjust it.
Can I add custom fields to the Billing Form?
You cannot customize any field on the Billing Form at this time. For any additional information that you might need to include on a claim (ex. ‘Date of Injury’ or NDC codes), use the **Additional billing notes** field at the bottom of the Billing Form.
Are there any **required** fields in a bill?
As best practice, always verify coding requirements with the Payer.
By default, the only required field is **Service Location**. If you would like to make procedure codes and diagnosis codes required, you can turn on the [Billing Guidance](/articles/billing-settings---service-locations--procedure-codes#billing_guidance) feature to set reminders to add codes before signing off on a visit note. Best practice is to enter all the details and codes needed to effectively receive payment from a Payer when submitting a claim. This information usually includes but is not limited to:
* Procedure codes
* Diagnosis codes
* Service Location
* Place of Service Code
Can I add charges to the Billing Form?
For customers using a Practice Management System (PMS) integration with Elation, the **Amt ($)**, **Qty** and **Subtotal ($)** fields do not sync with any PMS.
Yes, you can use the **Amt ($)**, **Qty** and **Subtotal ($)** fields in the Billing Form to add charges to your Procedure Codes. The charges will display when you use the Patient Invoicing feature to generate patient invoices. [Click here to learn more about Patient Invoicing](/articles/patient-invoicing).
How do I mark my bill as complete?
There isn’t a distinct status that you can set to show that a bill is complete. The best practice for marking a bill as complete is signing the visit note.
Where can I see all my incomplete bills?
You can use [Billing Home](/articles/Billing-Home) to manage all your signed bills; including editing bills. Use the Awaiting sign-off or No bill filters at the top of Billing Home to see all your incomplete bills.
Can I create a bill without a visit note?
No, billing information can only be tied to a visit note in the EHR.
How do I bill for a lab or procedure that I performed in-house?
Codes that are required for you to get paid for labs or procedures need to be added manually to the visit note’s Billing Form. These codes will not automatically appear as a result of other workflows (ex. Lab Order form, Vaccine form).
### Coding for an encounter
How many codes can I add to a bill?
For PMS integration users, certain PMS integrations may limit how many diagnosis codes they can accept. Please consult your PMS User Manual for full details about how many codes sync to your integrated PMS.
You can add as many procedure codes and diagnosis codes as applicable when billing for an encounter.
How do I enter a procedure code?
The recommended workflow for adding procedure codes (such as CPT Code or HCPCS Code) is to open the Billing Form at the bottom of the visit note. Under the Coding section in this form, you can enter a code in the **Procedure** field and add additional codes by clicking **+ Add Billing Item**.
Does Elation have a CPT Code (Procedure Code) database for me to select from?
No, Elation does not have a full CPT Code database for customers to select from. However, customers can use Elation’s [Popular CPT Code Setting](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) feature to save the codes they commonly use.
Do I have to add a CPT Code to my Popular CPT Code Settings in order to use it?
PMS Integration users must consult their PMS User Manual for full details on how to utilize Procedure codes while using an integrated PMS.
No, you do not have to add a CPT Code to your [Popular CPT Code Setting](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) in order to use it. You can free text any code you wish in the Billing Form’s **Procedure** field at any time.
How do I delete or correct procedure codes?
Information deleted from a bill cannot be restored. Please delete with caution.
To delete a procedure code, place your cursor at the end of the code you want to delete and then use the **Delete** key on your keyboard to delete the unwanted code. You can then enter a new procedure code in the **Procedure** field as needed. If you want to delete the entire billing line, including the associated diagnosis codes & modifiers, click on the **trashcan** button ![Red trashcan delete icon used to remove an entire billing line including its procedure codes, diagnosis codes, and modifiers.]()
to the right of the billing line.
How do I enter modifiers?
Use the **Modifiers** field within the Billing Form to enter modifiers.
Does Elation have a modifier database for me to select from?
No, Elation does not have a modifier database for customers to select from. Customers can enter any modifier of their choice when entering billing information into the **Modifiers** field of a bill.
How do I delete or correct modifiers?
Information deleted from a bill cannot be restored. Please delete with caution.
To delete a modifier, place your cursor at the end of the modifier you want to delete and then use the **Delete** key on your keyboard to delete the unwanted code. You can then enter a new modifier as needed.
How do I enter a diagnosis code?
Use the **Dx** field to enter diagnosis codes. Click the **+ Add Dx** button if you need additional diagnosis fields.
Does Elation have an ICD-10 Code (Diagnosis Code) database for me to select from?
Yes, Elation does have a full ICD-10 Code database for customers to select from. You can find any code in the ICD-10 Code database by typing in the code or description in the **Dx** field of a bill. Click the **+ Add Dx** button if you need additional diagnosis fields.
Can I reuse codes from the patient’s Problem List?
Yes, you can reuse codes from the patient’s Problem List. To export an ICD-10 code from the Problem List to a bill, locate the problem in the Problem List, and then click **Actions** --> **Export to Note (Billing)**. Use the **Export to Note (A, Billing)** option if you want to export the problem to the Assessment section as well as the Billing section.
How do I delete or correct diagnosis codes?
Information deleted from a bill cannot be restored. Please delete with caution.
To delete a diagnosis code click the **x** button to the right of the code. You can then click **+ Add Dx** to enter a new diagnosis code as needed.
Can the bill show both ICD-9 and ICD-10 codes for Dx?
Elation will automatically show both the ICD-9 and ICD-10 in the diagnosis database every time you search for a diagnosis code. You can also search by both ICD-9 and ICD-10 codes. Only the ICD-10 code will display in the Billing Form and only the ICD-10 code is sent to an integrated PMS.
Can I edit my billing information at any time?
For PMS integration users, Elation’s PMS integrations are NOT built to receive edits after billing information is sent to the PMS. You must edit the bill/claim in both Elation EHR and your PMS.
Yes! To edit the billing information before a visit note is signed off, simply click **Edit Billing** where the billing information you've entered is displayed at the bottom of the visit note. Once a visit note is signed by a Provider Level User, only the Provider Level User that signed the visit note or their [billing delegate](/articles/staff-permissions--staff-delegates#bills_view) can edit the billing information tied to the visit note. To edit billing information for a visit note after that visit note is signed, find the visit note in the chronological record in the patient's chart and click **Actions** --> **Edit Bill**.
A procedure code is in the wrong place, what’s the quickest way to move it to the correct place in the bill?
To move a procedure code to a different place in the bill:
1. Find the **drag** button to the left of the procedure code you want to move
2. Click and hold onto the button with your mouse cursor
3. Drag it to the desired location in the bill & then let go of your mouse cursor
A diagnosis code is in the wrong place, what’s the quickest way to move it to the correct place in the bill?
To move a diagnosis code to a different place in the bill:
1. Find the **drag** button to the left of the diagnosis code you want to move
2. Click and hold onto the button with your mouse cursor
3. Drag it to the desired location in the bill & then let go of your mouse cursor
I am billing for a couple of services with the same diagnosis codes. Is there a convenient way to enter this information?
Yes, you can use the **duplicate** button ![Duplicate button icon used to copy all procedure and diagnosis codes from a billing line to a new billing line]()
to the right of a billing line to create a copy of all the procedure and diagnosis codes from that billing line to a new billing line. This makes it easy for you to code for multiple procedures that have similar supporting diagnosis codes.
Does Elation offer any coding guidance or coding edits? (Ex. Recommending codes based on certain documentation or workflows.)
Elation does not offer any coding guidance features at this time.
Does Elation offer any automatic coding?
Yes, Elation offers a few automatic coding features:
* When BMI is calculated after you enter the patient’s height and weight in a visit note
* When blood pressure is entered in a visit note
* When you export a PHQ-9 screening into the visit note
1. CPT Codes will automatically be added to the Billing Form if any procedures with CPT codes were added to the [Procedure](/articles/documenting-procedures) section of the Visit Note draft
2. ICD-10 codes will automatically be added to the first line of the Billing Form if any diagnoses were added to the [Assessment](/articles/visit-note-assessments) section of the Visit Note draft
3. Certain CPT codes or ICD-10 codes will automatically be added to the Billing Form when the [Automatic Coding Setting](/articles/elation-coding-automation) is turned on for the following workflows:
Certain codes are always billed together. Can I save those as templates?
You can use the [Visit Note Template](/articles/elation-visit-note-templates) feature to store codes that are commonly billed together as templates. These templates can be used in any visit note draft.
### Managing signed bills
Can I edit a bill after I signed my visit note?
For PMS integration users, Elation’s PMS integrations are NOT built to receive edits after billing information is sent to the PMS. You must edit the bill/claim in both Elation EHR and your PMS.
Once a visit note is signed by a Provider Level User, only the Provider Level User that signed the visit note or their [billing delegate](/articles/staff-permissions--staff-delegates#bills_view) can edit the billing information tied to the visit note. To edit billing information for a visit note after that visit note is signed, find the visit note in the chronological record in the patient's chart and click **Actions** --> **Edit Bill**.
How do I edit billing information after a visit note is signed off?
For PMS integration users, Elation’s PMS integrations are NOT built to receive edits after billing information is sent to the PMS. You must edit the bill/claim in both Elation EHR and your PMS.
Once a visit note is signed by a Provider Level User, only the Provider Level User that signed the visit note or their [billing delegate](/articles/staff-permissions--staff-delegates#bills_view) can edit the billing information tied to the visit note. To edit billing information for a visit note after that visit note is signed, find the visit note in the chronological record in the patient's chart and click **Actions** --> **Edit Bill**.
Where can I see all my signed bills?
You can use [Billing Home](/articles/Billing-Home) to manage all your signed bills; including editing bills. Use the Signed filter at the top of Billing Home to see all your signed bills.
How do I submit a bill to the patient’s insurance company?
You can sign up for Elation Billing or use a Practice Management System (PMS) to send claims to the Payer.
* [Click here to learn more about Elation Billing; Elation’s all-in-one billing solution](/articles/Elation-Billing-All-in-One)
* [Click here for a list of integrated PMS](https://www.elationhealth.com/integrations/)
How can I share all my bills with my biller?
There are two options for sharing billing information with your biller:
1. Give the biller a Staff Level User account in the EHR and the biller can sign in to view all your bills in [Billing Home](/articles/Billing-Home).
* [Click here to learn more about inviting the biller to create an Elation account](/articles/managing-user-accounts#invite_staff).
2. If you do not want or need the biller to have access to the EHR, [download a report of your bills from Billing Home](/articles/Billing-Home#download_report) and share the report with your biller using HIPAA-compliant methods.
How do I bill a patient for the encounter?
The Patient Invoicing feature does not charge the patient. To create a payment request or charge the patient, please use our [Patient Payments feature](/articles/using-elation-to-securely-collect-patient-payments), powered by Stripe.
You can use the Patient Invoicing feature to generate a patient-facing invoice to bill a patient for the encounter. [Click here to learn more about Patient Invoicing](/articles/patient-invoicing).
### Billing Settings
| What Settings need to be configured in order to effectively bill for an encounter? | At a minimum, each practice should Store all their [Practice Locations](/articles/adding-a-second-practice-location) in Elation. You will then be able to see and select from your Practice Locations in the **Service Location** field for each bill. • Turn on [Billing Guidance](/articles/billing-settings---service-locations--procedure-codes#billing_guidance) to ensure coding is completed for each encounter. • Store all your commonly used [CPT Codes](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) in your Billing Settings to easily find and use these codes when coding for an encounter. [Click here to see all available Billing Settings](/articles/billing-settings---service-locations--procedure-codes). |
| ---------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| What billing settings do Elation offer? | To view your Billing Settings, go to **Settings** --> **Billing**. The Billing Settings allows you to do the following for your practice: set automatic coding preferences • turn on Elation's Patient Invoicing feature • turn on reminders to code your visits • manage your practice's CPT Code database • turn on special settings for Practice Management System (PMS) Integration users [Click here to learn more about Billing Settings](/articles/billing-settings---service-locations--procedure-codes). |
| Does the **Patient Invoicing** setting allow me to send an invoice to my patient to collect payment? | Turning “Patient Invoicing” on only allows you to print an invoice for the encounter. It doesn’t not automatically deliver the invoice electronically to the patient nor create a payment request. To generate invoices that patients can pay, please use our [Patient Payments feature](/articles/using-elation-to-securely-collect-patient-payments), powered by Stripe. |
| How do I add more Service Locations? | First, add all your Service Locations to your [Practice Locations](/articles/adding-a-second-practice-location) Setting. You will then be able to see and select from your Practice Locations in the **Service Location** field for each bill. |
| How do I add more CPT codes to my CPT code database? | Use the [Popular CPT Codes Setting](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) to store all your commonly used procedure codes in your Billing Settings to easily find and use these codes when coding for an encounter. |
| What is Billing Guidance? | The [Billing Guidance](/articles/billing-settings---service-locations--procedure-codes#billing_guidance) feature allows you to set reminders to complete coding before signing off on a visit note. |
| What is Automatic Coding? | The [Automatic Coding Setting](/articles/elation-coding-automation) automatically adds CPT codes or ICD-10 codes to the bill for the following workflows: When BMI is calculated after you enter the patient’s height and weight in a visit note • When blood pressure is entered in a visit note • When you export a PHQ-9 screening into the visit note |
### Billing Home
| What is Billing Home? | Billing Home is a dashboard of all the bills for your practice. [Click here to learn more about Billing Home](/articles/Billing-Home). |
| -------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| What can I see in Billing Home? | Billing Home shows you all the visit notes tied to patient encounters as well as their associated billing details including: Date of service • Patient’s name • Status of the bill • Provider tied to the bill • Service location • Place of Service (POS) code • Billing reference # • Primary insurance name, Group ID and Member ID • Secondary insurance name, Group ID and Member ID • Codes • Charges • Patient payment notes • Any other billing notes |
| How many bills can I see in the Billing Home at any given time? | You can see all bills from Billing Home. If you are a Provider Level User, the dashboard will default to only showing your bills. Use the Providers filter to see bills of other Providers in your practice if needed. • If you are a Staff Level User, the dashboard will default to showing bills for all Providers. Use the Providers filter to see bills of specific Providers only if needed. By default Billing Home will show you bills from the last 7 days and you can use the filters to adjust the date range at any time. Each page of Billing Home will show up to 25 bills. |
| What actions can I take on a bill from Billing Home? | Depending on the status of your bill, you may take one or more of the following actions when clicking on the Actions Menu button ![Actions Menu button]()
next to any bill: Edit your bill from Billing Home • Open the Visit Note & chart tied to the bill • Mark a bill as **Billed** • Edit the Billing Reference # associated with a bill • View the history of status changes on a bill • Push the bill to your PMS (for PMS integration users only) [Click here to learn more about the various actions you can take on a bill](/articles/Billing-Home#actions_menu). |
| Can I edit my bill details from Billing Home without opening the chart? | Yes, click on the Actions Menu Actions ![Actions Menu button]()
next to the bill you want to edit and click **Add Bill** or **Open Bill** to edit the bill directly in Billing Home. This action is only available for bills in the No bill or Awaiting Sign Off statuses. |
| What filter options are available in Billing Home? | There are two filter options in Billing Home: Quick Filters - These buttons allow you to see the bills tied to specific statuses with the click of a button. The Quick Filters are: • Customer Filters - You can now apply your own custom filters for the following bill details. Customer filters are: [Click here to learn more about the different filters in Billing Home](/articles/Billing-Home#using_filters). |
| Can I customize the quick filters available? | The available Quick filters cannot be customized at this time. We will notify you if this feature becomes available in the future. |
| Can I save frequently used filters? | The ability to save commonly used filters is not available at this time. We will notify you if this feature becomes available in the future. |
| Can I download a report of my bills? | Yes. To download a copy of the bills displayed as a .CSV file, click on the Download button  at the top of Billing Home. You can open the report using any spreadsheet software and then you can print the report from that software. |
| Can I print a report of my bills? | Yes. To print a report of your bills, first download a copy of the bills displayed by clicking on the Download button ![Download button icon used to export bills as a CSV file from Billing Home]()
at the top of Billing Home. Afterwards, open the report using any spreadsheet software and then print the report from that software. |
| Can I set permissions around the actions that users are permitted to take? | The ability to set permissions around which users can take which actions is not available at this time. We will notify you if this feature becomes available in the future. |
| Can I switch back to the old Billing Report view? | Yes, you can switch back to the old Billing Report view by clicking the **Switch to old Billing Report** button at the top of Billing Home. |
### Practice Management System (PMS) Integration Users
What billing information is typically shared with my integrated PMS?
Always consult your Practice Management System (PMS) user manual for the full details around what information is synchronized between Elation and your integrated PMS and how the information is synchronized.
The following billing information is always sent to the PMS:
* Date of Service
* Service Location
* Place of Service Code
* Procedure Codes and their associated modifiers and diagnosis codes
When is billing information sent to my integrated PMS?
Consult your Practice Management System (PMS) user manual to see which features your integrated PMS supports, if any.
By default, billing information is pushed to the integrated PMS whenever a Provider Level User signs the associated visit note. There are a couple of exceptions that will allow you to send billing information to your PMS that is independent of signing a Visit Note:
1. Certain PMS integrations support a **Send To PMS from Visit Note** feature where you can use the **Send to PMS** button at the bottom of a visit note to send the billing information to your integrated PMS prior to signing the visit note.
2. Certain PMS integrations support the [Delayed Billing](/articles/How-to-set-up-Delayed-Billing) feature which allows you to hold your bills in [Billing Home](/articles/Billing-Home) and manually push them over to your integrated PMS whenever you choose.
How can I tell if billing information was pushed to my integrated PMS?
Consult your Practice Management System (PMS) user manual to see which features your integrated PMS supports, if any.
Depending on which PMS integration you use with Elation: Otherwise, the best option for seeing if a bill was pushed to your PMS is by checking your PMS.
1. Certain PMS will tell us they received the billing information and return a Billing Reference #, which you will see on the bill.
2. Certain PMS will tell us if they failed to receive a bill. If this happens the bill will be put in the Failed to Send status in [Billing Home](/articles/Billing-Home) and you can attempt to resend the bill.
Can I choose when to push my bills to my integrated PMS?
Consult your PMS User Manual to see which features your integrated PMS supports, if any.
Yes, certain PMS integrations support the following features that will allow you to manually push your bills to your integrated PMS at your own preference.
1. Certain PMS integrations support a **Send To PMS from Visit Note** feature where you can use the **Send to PMS** button at the bottom of a visit note to send the billing information to your integrated PMS prior to signing the visit note.
2. Certain PMS integrations support the [Delayed Billing](/articles/How-to-set-up-Delayed-Billing) feature which allows you to hold your bills in [Billing Home](/articles/Billing-Home) and manually push them over to your integrated PMS whenever you choose.
Consult your PMS User Manual to see if it supports the Delayed Billing feature.
Turning on the Delayed Billing feature will allow you to push claims to your integrated PMS independent of signing the visit note. [Click here to learn more about the Delayed Billing feature.](/articles/How-to-set-up-Delayed-Billing)
* To send individual bills, click the Actions Menu next to the bill in Billing Home and select **Send to PMS**.
* To send specific bills in bulk, use the checkboxes in Billing Home to multi-select the bills you want to send, then use the bulk action bar to send them all at once. You can select bills across any status — there is no need to filter by a single status first.
* To send all bills of a specific status at once, turn on the [Billing Home - Bulk Send to PMS](/articles/billing-settings---service-locations--procedure-codes#bulk_send_to_PMS) setting and then click on the **Bulk Send Bills to PMS** button at the top of Billing Home.
The **Billing Home - Bulk Send to PMS** setting will allow you to enable or disable the **Bulk Send Bills to PMS** button in Billing Home. [Click here to learn more about the 'Billing Home - Bulk Send to PMS' setting.](/articles/billing-settings---service-locations--procedure-codes#bulk_send_to_PMS) Note that multi-select bulk actions are always available regardless of this setting.
* When toggled on, the **Bulk Send Bills to PMS** button allows you to bulk send ALL bills of a specific status to your integrated PMS. The following actions are available:
* **Send all Signed** — sends all bills in the **Signed** status to your integrated PMS.
* **Resend all Sent to PMS** — resends all bills in the **Sent to PMS** status to your integrated PMS.
* **Resend all Failed to send** — resends all bills in the **Failed to Send** status to your integrated PMS.
* When toggled off, the **Bulk Send Bills to PMS** button will not be available, but you can still multi-select bills and use the bulk action bar to send them.
How do I send individual bills from a specific date range to my integrated PMS?
To send individual bills from a specific date range to your integrated PMS, use the date filter to filter by the date range you want to send and then click on the Actions Menu ![Actions Menu button]()
next to the bill and select **Send to PMS**.
How do I send bills from a specific date range to my integrated PMS in bulk?
You can use the date filter to filter by the date range you want, then multi-select the bills you want to send using the checkboxes and use the bulk action bar to send them all at once. Alternatively, if you are using the **Bulk Send Bills to PMS** button, note that it applies to ALL bills of the selected status regardless of applied filters.
Do all CPT Codes sync to my integrated PMS?
Certain PMS Integrations might require you to enter the CPT Code in the PMS’s CPT Code database in order for it to sync from Elation. Please consult your PMS User Manual for full details on how to utilize Procedure codes while using an integrated PMS.
How many diagnosis codes can I send to my integrated PMS?
Certain PMS integrations may limit how many diagnosis codes they will accept. Please consult your PMS User Manual for full details about how many codes sync to your integrated PMS.
If I edit a bill in Elation after I send the billing information to my integrated PMS, will my integrated PMS receive the changes?
Elation’s PMS integrations are NOT built to receive edits after billing information is sent to the PMS. You must edit the bill/claim in both Elation EHR and your PMS.
If I edit a bill in my PMS, will Elation receive the changes?
No, edits made to a bill in the PMS will not update the corresponding billing details in Elation.
### Non-insurance billing
Can I use the Billing Form to create bills for my patient?
The Patient Invoicing feature does not charge the patient. To create a payment request or charge the patient, please use our [Patient Payments feature](/articles/using-elation-to-securely-collect-patient-payments), powered by Stripe.
Yes, you can use the Billing Form and the Patient Invoicing feature to generate invoices and bills for services rendered. [Click here to learn more about Patient Invoicing](/articles/patient-invoicing).
Can I bill for services without using any codes?
If you are billing patients directly instead of their insurance for service, you can free text service names (ex. Quarterly Check Up or Records Copy) in the **Procedure** field and not enter any CPT codes or diagnosis codes. The **Procedure** field can store up to 20 characters.
How do I generate an invoice?
You can use the Patient Invoicing feature to generate and print invoices for services rendered. [Click here to learn more about Patient Invoicing](/articles/patient-invoicing).
How do I generate a superbill/receipt for the patient to send to their insurance company for reimbursement?
You can use the Patient Invoicing feature to generate a superbill/receipt for the patient to send to their insurance company for reimbursement. You can enter the amount the patient paid in the **Patient Payment** field in the Billing Form and then print a **Claims Invoice** for your patient to share with their insurance company. [Click here to learn more about Patient Invoicing](/articles/patient-invoicing).
What should I do if part of a visit is payable by insurance and part of it is patient self-pay?
Use a custom CPT Code or Procedure name (Ex. ‘SP99212’ or ‘Self Pay Follow Up’) to easily identity self pay services
Since only one bill can be created for each visit note, include all of the necessary line-items for both insurance and self-pay in the Billing Form.
* ## In Elation, use the **Procedure** field to type in which line-items are self-pay.
Use a custom CPT Code or Procedure name (Ex. ‘SP99212’ or ‘Self Pay Follow Up’) to easily identity self pay services
* After the billing details are transmitted to your PMS, remove self-pay items before submitting your claim.
## Related Articles
* [Elation Billing FAQs](/articles/elation-billing-faqs)
# Billing Home Guide - A dashboard for managing your bills
Source: https://help.elationhealth.com/articles/Billing-Home
This article describes the Billing Home where practices can go to manage all their patient bills.
## Overview
If your practice uses **Elation Billing** , claims are sent from the EHR Billing Home to the Elation Billing PMS for processing. If you are unable to send claims, see [Can't Send Claims from EHR Billing Home (Elation Billing)](/articles/elation-ehr-billing-cant-send-claims-to-elation-billing-from-ehr-billing-home) .
### What is Billing Home?
Billing Home shows you all the visit notes tied to patient encounters as well as their associated billing details. Billing Home can be used as a checklist for monitoring and updating your bills.
### Why is Billing Home useful?
The layout of Billing Home is designed to allow for easy scanning of bill information. The new grid layout for the dashboard adds predictability for where you can expect to find certain details. Each row is one bill and you can easily scroll through the dashboard to find the specific detail you are looking for. **Quick filters** allow you to easily access bills that correlate to common billing workflows. You can also use our custom filters for more advanced workflow.
### How to access Billing Home
Click on the **Billing Home** option under **Reports** in the blue navigation bar at the top of any page in Elation to access Billing Home.
## Workflow Instructions
### How to use Billing Home
#### General Layout
The layout of Billing Home is designed for easy access to information. Each page of the dashboard will show up to 25 bills based on the filters selected. Here is a breakdown of the layout:
A. Quick Filters - See the bills tied to specific statuses with the click of a button.
B. Customer Filters - Apply your own custom filters for bill details. See the [Using Filters](#using_filters) section below for more details.
C. A column for each bill detail
| **Column Name** | **Description** |
| :--------------------------------------- | :--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Date of service** | Shows the date of the visit note tied to the bill. |
| **Patient** | Shows the name and date of birth of the patient. - The name and date of birth will not display for [VIP patients](/articles/vip-chart-feature). You will only see the Patient ID.
|
| **Status** | See the [Custom Filters](#using_filters) section below for more details. |
| **Provider** | If you are a Provider Level User, the dashboard will default to only showing your bills. Use the **Providers** filter to see bills of other Providers in your practice if needed.
If you are a Staff Level User, the dashboard will default to showing bills for all Providers. Use the **Providers** filter to see bills of specific Providers only if needed. |
| **Service location** | Shows the Service Location ([Practice Location](https://app.elationemr.com/settings/practice-locations/)) tied to the bill. |
| **POS** | Shows the place of service code tied to the bill. |
| **Billing ref. #** | You can type your own billing reference number (e.g. a Claim #) when choosing to manually “Mark as Billed”. - If you are using a PMS integration that responds with confirmation of receiving the claim, the reference number will display here.
|
| **Primary insurance** | Shows the patient’s Insurance and Plan Name, Group ID and Member ID |
| **Secondary insurance** | Shows the patient’s Insurance and Plan Name, Group ID and Member ID |
| **Codes** | Displays all procedural and diagnostic codes, including modifiers. - Enable the [Billing Guidance feature](/articles/billing-settings---service-locations--procedure-codes#billing_guidance) to ensure codes are always added to your bills prior to signing your Visit Note.
- If you are using Elation's [Risk Assessment](/articles/how-to-use-elations-risk-assessment-feature) feature, you will also see the risk score of ICD-10 codes.
|
| **Charges**, **Quantity**, and **Total** | Displays the charge, quantity and total amount tied to the procedures in the bill. - Only for customers using the [Patient Invoicing feature](/articles/patient-invoicing).
|
| **Patient Payment** | For customers to record payment received from the patient. - This field is not linked to the [Patient Payment feature powered by Stripe](/articles/using-elation-to-securely-collect-patient-payments).
|
| **Billing Notes** | For any additional notes required for billing. |
D. A single row for each bill
E. Additional actions you can take for specific bills. [See the Actions Menu section below for more details](#actions_menu).
F. Scroll bars for easy navigation
G. Page arrows for navigating across multiple pages of bills (25 bills per page)
H. **Edit Columns** button for customizing the Billing Home column headers
* Select **Compact View** if you want to minimize the white space in each bill line.
* Select the columns you wish to display in the Billing Home by checking off the corresponding column names.
* Rearrange the order in which each column appears as needed.
* The **Actions** button, **Date of service** column and **Patient** column are always On and pinned by default.
I. **Print filtered results** for printing the data you filtered for
J. **Download filtered results** button for downloading the data you filtered for
K. **Bulk Send Bills to PMS** button [*See below.*](#PMS_users)
![Billing Home dashboard showing the bill list with Quick Filters, status columns, patient names, service location, insurance details, procedure codes, and action buttons.]()
![Billing Home dashboard showing the bill list with Quick Filters, status columns, patient names, service location, insurance details, procedure codes, and action buttons.]()
#### Using Filters
A. Quick Filters - These buttons allow you to see the bills tied to specific statuses with the click of a button.
B. Customer Filters - You can now apply your own custom filters for the following bill details:
1. **Visit dates** - Filter by predefined date ranges or a custom date range of your choice. The default is **Last 7 Days**.
2. **Status** - Filter for claims by specific statuses. Reference the following chart for more information:
| **Previous Status Name** | **New Status Name** | **Description** |
| ------------------------ | --------------------- | ----------------------------------------------------------------------------------------------------- |
| --------------------- | **No bill** | Visit notes without any billing information |
| Unbilled | **Awaiting Sign Off** | Unsigned visit notes with billing information |
| Unbilled | **Signed** | Signed visit notes with billing information |
| Billed Manually | **Mark as Billed** | Someone in the practice used the **Mark as Billed** action to manually update the status of the bill. |
3. **Providers** - Filter for bills signed by specific providers.
* If you are a Provider Level User, the dashboard will default to only showing your bills. Use the Providers filter to see bills of other Providers in your practice if needed.
* If you are a Staff Level User, the dashboard will default to showing bills for all Providers. Use the Providers filter to see bills of specific Providers only if needed.
* The filter will also allow you to search for bills tied to deactivated Providers.
4. **Service location** - Filter by the Service Location ([Practice Location](https://app.elationemr.com/settings/practice-locations/)) selected for the bill (including deactivated Service Locations).
5. **Place of service (POS)** - Filter by the Place of Service selected for the bill.
6. **Primary Insurance** - Filter by the Primary Insurance company listed in the patient's demographics.
#### Editing the Patient payment or Billing notes fields
You can click into the **Patient payment** or **Billing notes** field of any bill in Billing Home to add information directly into those fields. Any data entered into the **Patient payment** or **Billing notes** field will automatically save once you click away from the field.
#### Actions Menu
Depending on the status of your bill, you may see one or more of the following actions you can take when clicking on the **Actions Menu** button:
| **Action** | **Description** | **Only available for the following statuses** |
| ----------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------- |
| **Add Bill** | Opens the billing window in Billing Home | **No bill** |
| **Open Bill** | Opens the billing window in Billing Home | **Awaiting Sign Off** |
| **Open Visit Note** | Opens the patient’s chart and visit note draft | All statuses |
| **Mark as Billed** | Marks the status of the bill as **Billed** and allows you to enter a Billing Reference # | **Awaiting Sign Off** and **Signed** |
| **Edit Billing Ref. #** | Allows you to edit the stored Billing Reference # | **Marked as billed** |
| **View Bill History** | Shows the history of status changes on a bill and displays the date of the change \*(*For PMS integration users, if a bill fails to be sent to your PMS and an error message is provided to us by your integrated PMS, we will display the error message in the Bill History log.)* | All statuses except **No bill** |
| **Send to PMS** | Pushes the bill to your integrated PMS. \*(*Only available for customers with PMS Integrations)* | **Signed** |
| **Resend to PMS** | Re-pushes the bill to your integrated PMS \*(*Only available for customers with PMS Integrations)* | **Sent to PMS** and **Failed to send** |
#### Practice Management System (PMS) Integration users
If you use a Practice Management System (PMS) Integration alongside Elation, you will see clearer filters, statuses and actions that detail or drive the synchronization of bills from Elation to your integrated PMS.
* Filters & Statuses
| **Previous Status Name** | **New Status Name** | **Description** |
| ------------------------ | ------------------- | ------------------------------------------------------------ |
| Pushed | Sent to PMS | Bill sent to PMS |
| Pushed | **Failed to Send** | Bill sent to PMS and PMS sent notice of a failure to receive |
| Billed | Received by PMS | Bill sent to PMS and PMS confirmed receipt |
* Sent & Received details
* Underneath the Sent to PMS and Received by PMS statuses you will see a date and time indicator of when the bill was sent to or received by your integrated PMS
##### Sending bills to your PMS
There are three ways to send bills from Billing Home to your integrated PMS:
1. **Send individual bills** — In the **Actions Menu** next to each bill, click **Send to PMS** or **Resend to PMS** to send or resend a single bill.
2. **Bulk Send Bills to PMS button** — When enabled in your [Billing Settings](/articles/billing-settings---service-locations--procedure-codes), the **Bulk Send Bills to PMS** button at the top of the dashboard sends all bills of a specific status to your integrated PMS. Go to the [Additional Billing Settings](#additional_settings) section of this article to learn more about configuring this setting.
* If you have applied additional filters to **Billing Home**, click **Send ... filtered bills** if you want to only send filtered bills to your PMS.
* Select individual bills using the checkboxes next to each row in Billing Home. After selecting the bills you want, click **Send ... selected bills.**
* The following actions can be made available when enabling this button:
* **Send all Signed** — sends all bills in the **Signed** status to your integrated PMS.
* **Resend all Sent to PMS** — resends all bills in the **Sent to PMS** status to your integrated PMS.
* **Resend all Failed to send** — resends all bills in the **Failed to Send** status to your integrated PMS.
Use the multi-select option when you want to send specific bills to the PMS regardless of their status. Use the other send buttons when you want to send all bills of a particular status at once.
Consult the User Manual for your integrated PMS for full details on how to push bills from Elation to your integrated PMS.
##### Example of the journey of a bill for PMS users
![Flowchart showing the journey of a bill for PMS users: from No Bill → User Creates Bill → Awaiting Sign Off → if Delayed Billing on, Signed → User Marks as Billed → Marked as Billed; if Delayed Billing off → User Sends Bill to PMS → Sent to PMS → if no PMS response, stays Sent to PMS; if PMS responds with Billing ID → Received by PMS (green); if PMS responds with failure → Failed to Send (red) → User Resends Bill to PMS.]()
##### Best Practices for PMS users
When Elation pushes a bill to your PMS the bill will be placed in the **Sent to PMS** status. This does not mean that the PMS received your bill as not all PMS integrations notify Elation when they successfully receive a bill or if they fail to receive a bill. Consult your PMS Integration Manual for full details on what kind of statuses your PMS integration supports.
* PMS Integrations that support a confirmation of receipt will place the bill in the Received by PMS status and return a billing reference number which Elation will store in the **Billing ref. #** field.
* PMS integrations that support a failed receipt notification will place the bill in the **Failed to Send** status. Failed bills will also appear in the Requiring Actions queue for Providers to review.
For bills in the **Sent to PMS** status, always review the claim in your PMS to understand and correct potential errors. After corrective measures are taken to update the bill in Elation, practices should choose to resend the bill to the PMS.
Consult your PMS Integration Manual for full details on what kind of statuses your PMS integration supports and what actions you can take for bills in Elation.
##### Additional Billing Settings for PMS users
The **Billing Home - Bulk Send to PMS** setting in your [Billing Settings](/articles/billing-settings---service-locations--procedure-codes) will allow you to enable or disable the **Bulk Send Bills to PMS** button in **Billing Home**. When toggled on, the **Bulk Send Bills to PMS** button allows you to bulk send filtered bills or all bills of a specific status to your integrated PMS. When toggled off the **Bulk Send Bills to PMS** button will not be available. Note that bulk send actions impact ALL bills in the respective status you select.
Even if the **Bulk Send Bills to PMS** button is toggled off, you can still multi-select individual bills in Billing Home and send them to your PMS in bulk using the bulk action bar. The **Bulk Send Bills to PMS** setting only controls the status-based bulk send button.
You also have 3 options that you can configure along with the **Bulk Send Bills to PMS** button:
* Enable option to bulk send **Signed** bills
* This Setting requires the **Delayed Bills** setting to also be enabled in your **Billing Settings**. A **Send all Signed** action will be available under **Bulk Send Bills to PMS** to allow you to send all bills in the **Signed** status to your integrated PMS.
* Enable option to bulk resend **Failed to Send** bills
* A **Resend all Failed to send** action will be available under **Bulk Send Bills to PMS** to allow you to send all bills in the **Failed to Send** status to your integrated PMS.
* Enable option to bulk resend **Sent to PMS** bills
* A **Resend all Sent to PMS** action will be available under **Bulk Send Bills to PMS** to allow you to send all bills in the **Sent to PMS** status to your integrated PMS.
![Billing Home – Bulk Send to PMS settings panel: the main "Enable Bulk Send Bills to PMS" toggle is ON; the three sub-options for Signed, Failed to Send, and Sent to PMS bills are all toggled OFF.]()
### How to print a report of my bills
To print a copy of the bills displayed (filtered view), click on the **Print filtered bills** button ![Print filtered results icon button in Billing Home toolbar]()
at the top of **Billing Home**. The printed report will separate the filtered bills by the status of the bill.
### How to download a report of my bills
To download a copy of the bills displayed (filtered view), click on the **Download filtered bills** button ![Download filtered bills button in Billing Home toolbar]()
at the top of **Billing Home**.
Patient Tags will be visible in the downloaded report. You can filter for bills based on tags you add to the patient. [Learn more about the Patient Tags feature here](/articles/adding-patient-tags) .
## Common use cases
### Following up on incomplete bills
Billing Home can be used to follow up on incomplete bills to make sure coding is complete before generating a claim for services rendered. You can use the following Quick Filters to quickly view all your incomplete bills:
* **No Bill**
* **Awaiting Sign Off**
You can also use the **Service location** and **Place of service (POS)** Custom Filters to make sure you are entering the correct service location and Place of Service Code for your claim.
### Worklist for generating claims
Billing Home can be used by a biller to make sure a bill is submitted to the Payer for processing. Billers can use the **Signed** Quick Filter to view all the signed bills and create claims from the details listed for each bill. Once a claim is sent, they can click on the Actions Menu ![Actions Menu button]()
next to the bill and click the **Mark as Billed** button to enter a billing reference number (ex. Claim #) for that bill. This allows for quick referencing and follow up between Elation and your billing system.
### Following up on unbilled claims
Billing Home can be used to follow up unbilled claims to make sure a bill is submitted to the Payer for processing. You can use the **Signed** Quick Filter to view all your signed bills and then look at the **Billing ref. #** column to see which bill is missing a billing reference number. That claim could potentially be unprocessed.
### Get yearly totals for each CPT code
You can use Billing Home together with a spreadsheet software (e.g. Excel or Google Sheets) to get yearly totals by CPT code for your practice's accounting needs.
| 1 | **Open Billing Home** In Elation, go to Reports -> Billing Home . |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | **Set the date range to the desired year** Use the Visit dates filter to set a custom range for the full year you want to review (for example, Jan 1–Dec 31). |
| 3 | **Download the filtered results as a CSV** At the top of Billing Home, click Download filtered bills to export the filtered view of your bills. |
| 4 | **Create a pivot table in a spreadsheet software** Open the CSV in a spreadsheet software (e.g. Excel or Google Sheets). • Insert a pivot table. • Configure the pivot: • This gives you a yearly CPT summary. |
##### Use the same pattern for other summary questions
You can repeat the same instructions — filter in **Billing Home** -> Download filtered bills -> Build a pivot table — to answer many other operational and accounting questions that require aggregate answers, such as:
1. **Totals by Provider** - Filter by the date range you care about in Billing Home, download the filtered CSV, then build a pivot table with **Provider** as rows and sum of charge amounts (and/or count of bills) as values.
2. **Totals by Payer** - Filter by Visit dates and insurance, download the filtered CSV, then pivot on your payer field (for example, **Primary Insurance**) as rows, with sum of charge amounts and/or count of bills as values.
3. **Monthly trends** - After downloading the CSV, derive a **month** column from **Date of Service** and use it in the pivot table as rows or columns with sum of charge amounts as values to see volume and revenue trends across months in the same year.
## Frequently Asked Questions (FAQ)
##### Can I edit my bill details from the Billing Home?
Yes, click on the Actions Menu ![Actions Menu button]()
next to the bill you want to edit and click **Add Bill** or **Open Bill** to edit the bill directly in **Billing Home**. This action is only available for bills in the **No bill** or **Awaiting Sign Off** statuses.
##### Can I customize the quick filters available?
The available Quick Filters cannot be customized at this time. We will notify you if this feature becomes available in the future.
##### Can I save frequently used filters?
The ability to save commonly used filters is not available at this time. We will notify you if this feature becomes available in the future.
##### Can I customize the columns available in the Billing Home?
You can click the **Edit Columns** button ![Edit Columns button in Billing Home for customizing which columns appear in the dashboard]()
to select which available columns you want displayed in the Billing Home for your entire practice. However, you cannot add columns that are not available.
##### Can I set permissions around which users can take which actions?
The ability to permissions around which users can take which actions is not available at this time. We will notify you if this feature becomes available in the future.
##### Can I restrict Billing Home access for certain staff, like billers?
Billing Home does not yet offer detailed, per-user permission controls - selective hiding of CPT codes, diagnoses, payments, or insurance information for individual users is not currently possible.
To manage who can view and edit billing data, consider the following approach:
* **Limit User Access** – Only grant access to users in your practice who can have full visibility into billing metrics.
* **Use Staff Level accounts for billers** – Staff Level users can enter and edit billing information before a visit note is signed. For editing billing information on signed visit notes, providers can designate specific staff as **Billing delegates** through their **Provider Managed Delegates** settings.
* **Keep Admin access restricted to owners and managers** – Admin Level privileges should be assigned only to practice owners or managers who need to configure settings and manage user accounts.
For more information on configuring billing delegates, see the [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates) article.
##### Can I send bills from a specific date range to my integrated PMS?
To send bills from a specific date range to your integrated PMS, use the date filter to filter by the date range you want to send. Then you can:
* Click the **Actions Menu** ![Actions Menu button]()
next to an individual bill and select **Send to PMS**.
* Use the checkboxes to multi-select the specific bills you want to send from the filtered results, then use the bulk action bar to send them all at once.
* Click the **Bulk Send** button to send all filtered bills of a specific status to your PMS.
## Related Articles
* [Billing Guide- Creating a Super Bill & coding for your visit](/articles/billing)
* [Billing Guide- Navigating Billing Settings](/articles/billing-settings---service-locations--procedure-codes)
* [Billing Guide- Frequently Asked Questions](/articles/Billing-Guide-Frequently-Asked-Questions)
* [Practice Locations Guide- Listing your service locations](/articles/adding-a-second-practice-location)
* [Billing Guide- Patient Invoicing- Generating invoices to patients for services rendered](/articles/patient-invoicing)
* [Elation Billing- Using Elation's all-in-one billing solution to manage your claims](/articles/Elation-Billing-All-in-One)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
* [Can't Send Claims from EHR Billing Home (Elation Billing)](/articles/elation-ehr-billing-cant-send-claims-to-elation-billing-from-ehr-billing-home)
* [Using the Claims Manager (Elation Billing)](/articles/using-the-claims-manager)
* [Claims Queue (Elation Billing)](/articles/claims-queue)
# Blue Navigation Bar Guide
Source: https://help.elationhealth.com/articles/Blue-Navigation-Bar
This article describes the Blue Navigation Bar feature in Elation.
## What is the blue navigation bar?
The blue navigation bar is a consistent and static resource bar located at the top of the Elation screen to help you navigate between the various pages of the EHR.
![The blue navigation bar highlighted at the top of the Elation EHR screen, showing the Elation logo, Practice Home, Find Chart, Reports, I need help, email address, and Logout options.]()
## What are the benefits of the blue navigation bar?
The blue navigation bar organizes Elation's pages so that you can easily move from page to page. The navigation bar remains fixed at the top of every Elation page, ensuring consistent access to resources whenever needed.
## How to use the blue navigation bar option
The following sections detail how to best utilize each option in the blue navigation bar:
* [Practice Home](#practice_home)
* [Find Chart](#find_chart)
* [Reports](#reports)
* [I need help](#help)
* [Elation Updates](#updates)
* [Email Address](#email_address)
* [Log Out](#log_out)
### Practice Home
Navigate to the [Practice Home](/articles/practice-home-introduction) at any time by clicking the Elation logo or clicking **Practice Home**.
### Find Chart
Click **Find Chart** to pull up the patient search window below. In the patient search window, you can navigate directly to any patient chart by [searching for their name, DOB, or phone number](/articles/Patient-Chart-Guide-Searching-for-patient-charts).
### Reports
Click **Reports** to pull up a list of the various reporting features Elation offers.
* [Patient List](/articles/find-patients-with-elations-patient-list)
* **Patient List** allows your practice to run complex searches and generate specific lists from your entire patient panel. These lists can be exported as Excel-compatible spreadsheets for further analysis.
* [Bulk Letter Dashboard](/articles/introduction-to-bulk-letters#Dashboard)
* **Bulk Letter Dashboard** shows a summary level view of all the Letters that have been sent in bulk. From here, providers and staff can get a quick glance at the progress and status of their Bulk Letters.
* [Billing Home](/articles/Billing-Home)
* **Billing Home** helps your practice track all billing information recorded in both signed and unsigned visit notes and allows you to generate patient invoices.
* [Patient Payment Report](/articles/using-elation-to-securely-collect-patient-payments#manage)
* This Report will only have data if your practice is using [Elation's Patient Payment integration](/articles/using-elation-to-securely-collect-patient-payments).
* **Patient Payment Report** allows your practice to view all patient payment transactions including completed payments (from a request, charge, or submitted through the payment site), outstanding requests, and cash/check collections.
* [Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments)
* Appointment Report is an administrative report that helps your practice track patient appointments over a period of time.
### Additional Reports
The following reports will only appear in the **Reports** option if you are using certain optional features, add-on features or Premium EHR features.
* [Patient Cohort](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria)
* This Report will only be visible for Premium EHR customers using the [Patient Cohort feature](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria).
* The **Patient Cohort** dashboard allows you to segment access to charts based on a patient's criteria.
* [Appointment Dashboard](/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting#appointment_dashboard)
* This Report will only be visible for Premium EHR customers.
* The **Appointment Dashboard** shows you visuals and graphs about your practice's appointment data.
* [Appointment List](/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting#appointment_list_report)
* This Report will only be visible for Premium EHR customers.
* The **Appointment List** shows you a tabular view of your practice's appointment data with extra granularity.
* [Visit Notes Dashboard](/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting#visit_notes_dashboard)
* This Report will only be visible for Premium EHR customers.
* The **Visit Notes Dashboard** shows you visuals and graphs about your practice's visit note data.
* [Visit Notes List](/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting#visit_notes_list_report)
* This Report will only be visible for Premium EHR customers.
* The **Visit Notes List** shows you a tabular view of your practice's appointment data with extra granularity.
* [Membership Report](/articles/Introduction-to-Membership-Management-with-Elation)
* This Report will only be visible for practices using the [Membership Management feature](/articles/Introduction-to-Membership-Management-with-Elation).
* **Membership Report** helps your practice track patient membership plans and recurring patient membership payments.
* [Clinical Quality Measures](/articles/elations-cqm-dashboards) (MIPS)
* This Report is only visible for practices that are reporting for MIPS.
* The **Clinical Quality Measures** dashboard provides detailed information about the specific MIPS measures that can be tracked during reporting years. For more general information about MIPS, please reference Elation's [MIPS Help Center landing page](/articles/MIPS-2026-Overview).
* [Promoting Interoperability](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (MIPS)
* This Report is only visible for practices that are reporting for MIPS.
* The **Promoting Interoperability** report helps your practice track their Health Information Exchange data. For additional information on Promoting Interoperability, please reference the articles detailed on [this page](/articles/MIPS-2026-Promoting-Interoperability-Category).
### I need help
Click **I need help** if you are looking for training content, need any guidance about the EHR or if you need support. Reference the [Support Guide- How to get help on Elation](https://help.elationemr.com/s/contactsupport) for more detailed information about contacting our Support Team. We are here to help!
* **Search our Help Center**
* Access our [Help Center](/) to search for resources on your topic of interest.
* **Learn on Elation University**
* Learn about different features and workflows based on your role in the practice via [Elation University](https://training.elationhealth.com/elation-university/).
* **Show me a map of this page**
* View a mapping layer on your screen that provides brief detail on the areas of the page with applicable Help Center links, and shows how you can best navigate the page.
This option is exclusively available on the Practice Home and patient chart screens.
* **Contact Elation Support**
* Selecting this option will open a window where you can contact the Elation Support Team to:
* Report an issue
* Use this option to report an issue to our Support Team.
* Check off the **Urgent** box if the issue you are experiencing impacts patient care.
This option is reserved for inquiries and issues that are blocking immediate patient care and can only be sent from [Admin Level Users](/articles/managing-user-accounts) . We will try to reach you within 30 minutes via the email address you provided in the inquiry.
You can securely share patient identifying information by sharing the unique patient chart ID. The patient ID is located in the patient demographics and can be found by clicking on the patient's name in the top left to open their demographics window. The ID will be in the top section of their demographics with a 'copy' link button. Another location to find the ID is in the URL. This patient ID is intended for internal reference and Support. It is different from billing account numbers or the 'Account #' requested on the Patient Payments self-service page.
* Request a feature
* Use this option to request we enable an optional, add-on or paid feature for your practice.
* Use this option to submit feedback about a new enhancement or feature you're interested in. We value your feedback!
* Request an integration
* Use this option to request an established integration or interface be enabled for your practice.
* Inquire about something else
* Use this option to inquire about any other topics.
Clicking the **I need help** options from the patient chart view will display an additional option called [I accidentally deleted a note or report](https://help.elationemr.com/s/contactsupport) . This option will pull up a window where you can easily restore a deleted visit note or report from the patient's chart.
You can also restore deleted patient charts, visit notes, non-visit notes, reports, and medications using the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice). Go to **Reports** > **User Activity Log** to find and restore deleted records without contacting support.
### Email Address
Click your email address (which is your Elation username) to see the following resources:
* [Settings](/index)
* Click **Settings** to view and configure the settings for your account or your EHR.
* Product Updates
* Click **Product Updates** to read about the latest additions and enhancements via [Elation's Product Updates Help Center page](/product-updates).
* Invite a Colleague
* Click **Invite a Colleague** to recommend Elation to a colleague. The Elation Team will contact your referral to learn more about their practice and needs.
* [Provider Security Code](/articles/secure-Provider-Portal#email)
* Click **Provider Security Code** to view the unique code that your practice must provide to your Referral recipients to ensure they can access the [interactive chart link](/articles/secure-Provider-Portal) shared with them.
### Log Out
Click **Log Out** to log out of your Elation session. Once logged out, you will need to log back in with your email and password to access Elation.
## Frequently Asked Questions
### Is there a phone number to reach Elation Support?
Elation Support does not offer a general inbound phone line. Reach the Support Team by clicking **I need help** → **Contact Elation Support** in the blue navigation bar, or through [our support page](https://app.elationemr.com/support/).
For **Urgent** issues that block immediate patient care, Elation will try to reach you within 30 minutes. Include your email and phone number in case we need to call.
* In support chat, click the **💬 Urgent: An issue is blocking patient care** chat suggestion or mention "Urgent" to the agent.
* In support contact forms, your message will be routed to our Urgent queue based on the nature of your request.
## Related Articles
* [Elation EHR Quick Start Training Resources](/articles/Elation-EHR-Quick-Start-Training-Resources)
* [Administrative Training Videos](/articles/administrative-training-series---individual-videos)
* [Patient Chart Guide- Creating a new patient chart](/articles/Patient-Chart-Guide-Creating-a-new-patient-chart)
# Elation Health - Building Clinical-First AI
Source: https://help.elationhealth.com/articles/Building-Clinical-First-AI
This article explains how we use AI in Elation Health, our commitment to your control and patient privacy, and how you can transparently identify AI-powered solutions.
## Overview
### Introducing AI-Powered Enhancements in Elation Health
Elation Health is evolving to become the first clinical-first EHR with AI embedded at its core. This isn’t a separate add-on—it’s a natural extension of the tools you already use, designed to help you:
* Work more efficiently
* Deliver high-quality care
* Stay focused on patients
* Get insights faster and more reliably
This article explains how we use AI in Elation Health, our commitment to your control and patient privacy, and how you can transparently identify AI-powered solutions.
### Why is Elation Health building clinical-first AI?
Artificial intelligence represents a powerful new chapter in healthcare—but for it to truly make a difference, it must be deployed thoughtfully and responsibly. At Elation Health, we are committed to using AI in reliable, meaningful ways to solve the everyday challenges you face.
We use AI both behind the scenes to improve our platform and workflows, and within our products to power intelligent features that help you work more efficiently and deliver better care. Our goal isn’t to chase hype, but to accelerate our ability to meet your needs with solutions that are intuitive to adopt, seamless to use, and focused on strengthening your connection to patients.
With AI thoughtfully embedded in the Elation platform, we aim to support effortless documentation, deeper patient insights, reduced administrative work, and accurate, on-time payments—so you can stay focused on what matters most: caring for your patients.
### Elation Health’s Guiding Principles
Elation Health’s approach to AI is grounded in the following core principles:
* **Full Transparency**: You'll always know when a feature is being assisted by AI.
* **You Are in Control**: Our AI tools are designed to assist, not direct. You, the clinician, always have the final say and remain in control.
* **Clinical Reliability**: We strive to maximize accuracy by rigorously testing and optimizing our AI features for specific, relevant use cases within the practice of medicine.
## Staying Informed
### Feature Availability
As new features roll out across care delivery, patient engagement, financial workflows, and clinical quality, you’ll be able to track what’s new and what’s coming next.
Visit the **Resource Center** inside the EHR for the latest updates and helpful guides on intelligent features included in your subscription.
1. Click **I need help** -> **See what’s new** OR
2. Click **your email** ->**Product Updates**
We want to make sure you can give direct feedback about how AI powered features are working for you and we are committed to incorporating the feedback we receive across our community to ensure the product drives the intended outcomes. Each feature is built with a specific feedback mechanism that enables you to share your thoughts directly with the product development teams at Elation effortlessly right from the workflow.
### Regulatory Documentation
* [Decision Support Interventions Regulatory Documentation](/articles/Decision-Support-Interventions-Regulatory-Documentation)
* The information included in this page includes requirements for the Certified EHR Technology Program for Predictive Decision Support Interventions which are defined as AI utilization in the product and which Elation Health certified to.
* [AI-Data Use Policy](https://www.elationhealth.com/ai-data-use-policy/)
* This document describes how Elation Health utilizes artificial intelligence (**AI**) within Elation’s products and services, and how such use conforms to Elation’s privacy commitment.
## Frequently Asked Questions
### How does Elation ensure data security and privacy with its AI service?
Elation’s AI powered features are built on reputable large language models from trusted third party providers. A list of Elation’s LLM providers can be found [here](https://www.elationhealth.com/ai-data-use-policy/supported-ai-providers/). Elation uses enterprise versions of its LLM services that do not use your inputs to inform algorithms or train models. Your data is used only to provide the Elation services to you.
### Can the AI make a mistake?
Yes. Like any tool, AI is not perfect and is intended to assist, not replace, your clinical judgment. This is why you are always in control to review, edit, and approve any AI-generated suggestion. If you encounter an inaccuracy, we strongly encourage you to use the integrated feedback options to help us improve the system.
### Do I have to use the AI features?
No. AI features are optional and designed to assist, not replace, your clinical judgment. Each AI feature is configurable individually, so you can choose which ones fit your workflows. There is no single setting that disables all AI features at once. If you have questions about configuring a specific AI feature, contact our Support Team using the **I need help** -> **Contact Elation Support** button in the EHR.
### Does Elation sell patient data?
No. Elation Health never has and never will sell patient data.
## Related Articles
* [Decision Support Interventions Regulatory Documentation](/articles/Decision-Support-Interventions-Regulatory-Documentation)
# [CMS122v12] Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%) (MIPS 2024)
Source: https://help.elationhealth.com/articles/CMS122v12-Diabetes-Hemoglobin-A1c-Poor-Control-MIPS-2024
Elation supports CMS122v12 measure, Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%), for Advancing Care Information (QPP).
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Report on the percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period. *This is a reverse measure; the goal is to ensure patients keep their A1c \< 9%. Practices should try to lower their percentage for this reverse measure.*
## Measure Parameters
**Numerator**: Patients whose most recent HbA1c level (performed during the measurement period) is >9.0% or is missing, or was not performed during the measurement period.
**Denominator**: Patients 18-75 years of age with diabetes with a visit during the measurement period.
Exclusions/Exceptions:
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time during the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who meet any of the following criteria:
* Advanced illness with two outpatient encounters during the measurement period or the year prior
* OR advanced illness with one inpatient encounter during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
* Exclude patients receiving palliative care for any part of the measurement period.
The qualifying exclusion tags for this measure are called (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
## How to document frailty in Elation
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Office Visit Note showing "Questions for Promoting Interoperability Compliance": MIPS-tagged "Transition of care?" with unchecked referral checkboxes, and "Current Medications Patient Is Taking Documented in Chart?" answered "No".]()
**Elation Workflows**
1. Ensure the patient has a diagnosis of Diabetes (E11.9, etc):
1. Receive HbA1c Labs from a Lab Vendor electronically through Elation
2. Manually document a patient’s HbA1c Results.
3. The HbA1c can be recorded in a structured format by clicking **Actions** next to an uploaded report and then selecting **Add Lab Values for Trending.**
* Reference: How to record structured lab results from in-house or faxed lab report
1. Clicking **Notes** --> **Point-of-Care Labs**
* Reference: How to use the Point-of-Care Labs feature
**Measure Information**
Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5% of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention \[CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs (CDC, 2018).
In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34% increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association \[ADA], 2018).
Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0122v12)
## Additional Information/FAQ
Although this measure can be satisfied by manually entering lab results, we recommend getting interfaced lab results, if possible. Electronic lab results directly from the lab will also count towards this measure, limiting the need for additional documentation.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-a1c-2024.zip)
* [Frailty Codes](/files/frailty-codes-a1c-2024.csv)
* [Frailty Descriptions](/files/frailty-descriptions-a1c-2024.zip)
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [How to record structured lab results from in-house or faxed lab reports](/articles/record-structured-data-from-in-house-or-faxed-lab-reports)
* [How to use the Point-of-Care Labs feature](/articles/point-of-care-labs)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS122v13] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS122v13-Diabetes-Glycemic-Status-Greater-than-9percent
Elation supports CMS122v13 measure, Diabetes: Glycemic Status Assessment Greater Than 9%.
## Measure Details
Report on the percentage of patients 18-75 years of age with diabetes who had who had a glycemic status assessment (hemoglobin A1c \[HbA1c] or glucose management indicator \[GMI]) > 9.0% during the measurement period. *This is a reverse measure; the goal is to ensure patients keep their A1c \< 9%. Practices should try to lower their percentage for this reverse measure.*
## Measure Parameters
**Numerator**: Patients whose most recent glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is >9.0% or is missing, or was not performed during the measurement period.
**Denominator**: Patients 18-75 years of age with diabetes with a visit during the measurement period.
Exclusions/Exceptions:
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time during the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who meet any of the following criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
* Exclude patients receiving palliative care for any part of the measurement period.
The qualifying exclusion tags for this measure are called (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
## How to document frailty in Elation
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Office Visit Note showing "Questions for Promoting Interoperability Compliance": MIPS-tagged "Transition of care?" with unchecked referral checkboxes, and "Current Medications Patient Is Taking Documented in Chart?" answered "No".]()
**Elation Workflows**
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
1. Ensure the patient has a diagnosis of Diabetes (E11.9, etc):
1. Receive HbA1c Labs from a Lab Vendor electronically through Elation
2. Manually document a patient’s HbA1c Results.
3. The HbA1c can be recorded in a structured format by clicking **Actions** next to an uploaded report and then selecting **Add Lab Values for Trending.**
* Reference: How to record structured lab results from in-house or faxed lab report
1. Clicking **Notes** --> **Point-of-Care Labs**
* Reference: How to use the Point-of-Care Labs feature
**Measure Information**
Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5% of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention \[CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs (CDC, 2018).
In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34% increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association \[ADA], 2018).
Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0122v13?qt-tabs_measure=measure-information)
## Additional Information/FAQ
Although this measure can be satisfied by manually entering lab results, we recommend getting interfaced lab results, if possible. Electronic lab results directly from the lab will also count towards this measure, limiting the need for additional documentation.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-glycemic.zip)
* [Frailty Codes](/files/frailty-codes-glycemic.csv)
* [Frailty Descriptions](/files/frailty-descriptions-glycemic.zip)
## Related Articles
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [How to record structured lab results from in-house or faxed lab reports](/articles/record-structured-data-from-in-house-or-faxed-lab-reports)
* [How to use the Point-of-Care Labs feature](/articles/point-of-care-labs)
# [CMS122v14] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS122v14-Diabetes-Glycemic-Status-Assessment-Greater-Than-9
Elation supports CMS122v14 measure, Diabetes: Glycemic Status Assessment Greater Than 9%.
## Measure Details
Report on the percentage of patients 18-75 years of age with diabetes who had who had a glycemic status assessment (hemoglobin A1c \[HbA1c] or glucose management indicator \[GMI]) > 9.0% during the measurement period. *This is a reverse measure; the goal is to ensure patients keep their A1c \< 9%. Practices should try to lower their percentage for this reverse measure.*
## Measure Parameters
### Numerator
Patients whose most recent glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is >9.0% or is missing, or was not performed during the measurement period.
**Denominator**
Patients 18-75 years of age with diabetes with a visit during the measurement period.
### Exclusions/Exceptions
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time during the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who meet any of the following criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
### Documenting diabetes diagnosis in the patient's chart
Patients must have an active diagnosis of diabetes recorded in their chart during the measurement period. Elation looks for a diabetes ICD-10 code in either a visit note for the measurement period or in the Problem List.
To add a diabetes diagnosis to the Problem List:
| **1** | Go to the Problem List and click **+ Add Problem** . |
| ----- | ---------------------------------------------------------------------------------- |
| **2** | Search for the appropriate diabetes diagnosis and then select it from the results. |
| **3** | Adjust the **Title** and **Dx Date** as needed. |
| **4** | Click **Save** . |
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Click **Address** in the **Hemoglobin A1c is undocumented or uncontrolled (>9%**) reminder at the top of the visit note. This reminder will automatically appear if ALL of the following denominator requirements are met: Patient is 18 years of age or older at time of visit.Patient has an active diagnosis of diabetes either recorded:in a visit note dated on or prior to December 31, 2026 ORin the Problem List with a start date on or prior to December 31, 2026. |
| ------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | To immediately address Numerator requirements by recording an existing HbA1c result: Click **Enter A1c**. • Update the **Title**, **Collected** and **Resulted** fields as needed. • Click **Hemoglobin A1c**. • Enter the HbA1c result into the **%** field. • Click **Sign** or **Sign & Export to Note** to save the record. |
| **3a** | If the result is \<9% then the patient will not appear in the Numerator. **This is the desired result for this reverse measure.** |
| **3b** | If the result is >9% then the patient will automatically appear in the Numerator. |
All other selections in the Clinical Reminder do not impact numerator or denominator requirements and are provided solely for follow-up purposes.
Clicking
**Dismiss**
will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Meeting measurement requirements through an electronic lab report
When HbA1c lab results come into Elation through an electronic lab interface, Elation automatically reviews each result and determines whether it satisfies the measure requirements.
### Documenting measure requirements through the point-of-care labs feature
If you receive HbA1c lab results via paper or fax, you must record the result as structured data in order for Elation to determines whether it satisfies the measure requirements.
| **1** | Open the patient's chart. |
| ----- | ----------------------------------------------------------------------- |
| **2** | Click **Notes** -> **Point-of-Care Labs** . |
| **3** | Update the **Title** , **Collected** and **Resulted** fields as needed. |
| **4** | Click **Hemoglobin A1c** . |
| **5** | Enter the HbA1c result into the **%** field. |
| 6 | Click **Sign** or **Sign & Export to Note** to save the record. |
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Step(s)** |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Exclude patients who are in hospice care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: EXCLUSION: HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE |
| Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time during the measurement period. | Click \*\*+ Tag \*\* at the bottom of the visit note draft and add the following document tag - **EXCLUSION: Living Long Term in a Nursing Home** |
| Exclude patients receiving palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: PALLIATIVE CARE** |
| Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who meet any of the following criteria: Advanced illness diagnosis during the measurement period or the year prior • OR taking dementia medications during the measurement period or the year prior | See below. |
**Documenting frailty**
To document frailty in Elation using
1. Frailty diagnosis, advanced illness codes and/or medications
2. Add a frailty diagnosis to the Problem List. You must select from one of the frailty codes listed [here](/files/frailty-codes-2026.csv).
3. Record one of the following:
4. an advanced illness diagnosis in 2 outpatient encounters using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
5. an advanced illness in 1 inpatient counter using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
6. a dementia medication in the patient's chart.
7. A frailty device code
8. Click **+ Tag** at the bottom of the visit note draft.
9. Create/add the appropriate document tag for the relevant frailty device from [this list of frailty device codes](/files/frailty-descriptions-2026.zip).
10. If you are creating the document tag for the first time for a frailty device, make sure the document tag has the device's HCPCS code listed. [](/articles/record-structured-data-from-in-house-or-faxed-lab-reports)
## Measure Information
Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5% of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention \[CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs (CDC, 2018).
In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34% increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association \[ADA], 2018).
Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0122v14)
## Additional Information
Although this measure can be satisfied by manually entering lab results, we recommend getting interfaced lab results, if possible. Electronic lab results directly from the lab will also count towards this measure, limiting the need for additional documentation.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-glycemic.zip)
* [Frailty Codes](/files/frailty-codes-glycemic.csv)
* [Frailty Descriptions](/files/frailty-descriptions-glycemic.zip)
## Frequently Asked Questions
### If there are 2 HbA1c results for the patient for the same date, which result will the patient use for the measure?
If there are 2 HbA1c results for the patient for the same date, the lowest result will be used for the measure.
## Related Articles
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [How to record structured lab results from in-house or faxed lab reports](/articles/record-structured-data-from-in-house-or-faxed-lab-reports)
* [How to use the Point-of-Care Labs feature](/articles/point-of-care-labs)
# [CMS124v12] Cervical Cancer Screening (MIPS 2024)
Source: https://help.elationhealth.com/articles/CMS124v12-Cervical-Cancer-Screening-MIPS-2024
Elation supports the automatic calculation of CMS124v12, Cervical Cancer Screening.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
* Women age 21-64 who had cervical cytology (Pap Test) performed within the last 3 years
* Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years
### Measure Parameters
**Numerator:** Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria:
* Cervical cytology (Pap Test) performed during the measurement period or the two years prior to the measurement period for women who are at least 24-64 years of age by the end of the measurement period.
* Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test.
**Denominator:** Women 24-64 years of age with a visit during the measurement period
**Exclusions/Exceptions:**
* Women who had a hysterectomy with no residual cervix or a congenital absence of cervix.
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
**Additional CMS Guidance:**
To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.
These are the qualifying exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
* EXCLUSION: HYSTERECTOMY
* CQM EXCL: CONGENITAL ABS OF CERVIX
## Elation Workflows
1. Recording from a visit note:
* Elation's Clinical Reminders Feature allows you to easily document screenings. When a patient is due for a Cervical Cancer Screen, an alert will report at the top of the patient's visit note. Selecting Address on any of these will give a set of options to address that Quality Measure:
1. Click on Cervical Cancer Screening, and indicate the date of the patient’s most recent Pap Smear and/or HPV test, enter result of test, and click **Save New**.
1. Tag a report in the patient’s record with the approved document tag(s). This alone will meet the health maintenance requirement.
* 4 Document Tags that will satisfy this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* HPV test (result: negative)
* HPV test (result: positive)
* Pap Smear (result: negative)
* Pap Smear (result: positive)
* The following test LOINC codes qualify for these screenings
* HPV Test
* 21440-3, 30167-1, 38372-9, 59263-4, 59264-2, 59420-0, 69002-4, 71431-1, 75694-0, 77379-6, 77399-4, 77400-0, 82354-2, 82456-5, 82675-0, 95539-3
* Pap Test
* 10524-7, 18500-9, 19762-4, 19764-0, 19765-7, 19766-5, 19774-9, 33717-0, 47527-7, 47528-5
## Measure Information
All women are at risk for cervical cancer. In 2020, an estimated 13,800 women were diagnosed with cervical cancer in the U.S., resulting in an estimated 4,290 deaths (National Cancer Institute, 2020). Screening can identify precancerous lesions and can detect invasive cancer early, when treatment is more likely to be successful (American Cancer Society, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0124v12)
## Frequently asked questions
While clinical guidelines recommend starting cervical cancer screenings at age **21**, the official CMS technical specifications require the patient to be **24** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 3-year buffer to align with the 3-year cytology screening cycle so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 21 for the entirety of 2026 and does not turn 24 until 2029, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 24.
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS124v13] Cervical Cancer Screening (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS124v13-Cervical-Cancer-Screening-MIPS-2025
Elation supports the automatic calculation of CMS124v13, Cervical Cancer Screening.
## Measure Details
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
* Women age 21-64 who had cervical cytology (Pap Test) performed within the last 3 years
* Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years
### Measure Parameters
**Numerator:** Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria:
* Cervical cytology (Pap Test) performed during the measurement period or the two years prior to the measurement period for women who are at least 24-64 years of age by the end of the measurement period.
* Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test.
**Denominator:** Women 24-64 years of age with a visit during the measurement period
**Exclusions/Exceptions:**
* Women who had a hysterectomy with no residual cervix or a congenital absence of cervix.
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
**Additional CMS Guidance:**
To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.
These are the qualifying exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
* EXCLUSION: HYSTERECTOMY
* CQM EXCL: CONGENITAL ABS OF CERVIX
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
1. Recording from a visit note:
* Elation's Clinical Reminders Feature allows you to easily document screenings. When a patient is due for a Cervical Cancer Screen, an alert will report at the top of the patient's visit note. Selecting Address on any of these will give a set of options to address that Quality Measure:
1. Click on Cervical Cancer Screening, and indicate the date of the patient’s most recent Pap Smear and/or HPV test, enter result of test, and click **Save New**.
1. Tag a report in the patient’s record with the approved document tag(s). This alone will meet the health maintenance requirement.
* 4 Document Tags that will satisfy this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* HPV test (result: negative)
* HPV test (result: positive)
* Pap Smear (result: negative)
* Pap Smear (result: positive)
* The following test LOINC codes qualify for these screenings
* HPV Test
* 21440-3, 30167-1, 38372-9, 59263-4, 59264-2, 59420-0, 69002-4, 71431-1, 75694-0, 77379-6, 77399-4, 77400-0, 82354-2, 82456-5, 82675-0, 95539-3
* Pap Test
* 10524-7, 18500-9, 19762-4, 19764-0, 19765-7, 19766-5, 19774-9, 33717-0, 47527-7, 47528-5
## Measure Information
All women are at risk for cervical cancer. In 2020, an estimated 13,800 women were diagnosed with cervical cancer in the U.S., resulting in an estimated 4,290 deaths (National Cancer Institute, 2020). Screening can identify precancerous lesions and can detect invasive cancer early, when treatment is more likely to be successful (American Cancer Society, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0124v13)
## Frequently asked questions
While clinical guidelines recommend starting cervical cancer screenings at age **21**, the official CMS technical specifications require the patient to be **24** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 3-year buffer to align with the 3-year cytology screening cycle so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 21 for the entirety of 2026 and does not turn 24 until 2029, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 24.
## Related Articles
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS124v14] Cervical Cancer Screening (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS124v14-Cervical-Cancer-Screening
Elation supports the automatic calculation of CMS124v14, Cervical Cancer Screening.
## Measure Details
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
* Women age 21-64 who had cervical cytology (Pap Test) performed within the last 3 years
* Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years
**Additional CMS Guidance:** To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.
The measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria.
Evidence of hrHPV testing within the last 5 years also captures patients who had co-testing; therefore additional methods to identify co-testing are not necessary.
## Measure Parameters
### Numerator
Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria:
* Cervical cytology (Pap Test) performed during the measurement period or the two years prior to the measurement period for women who are at least 24-64 years of age by the end of the measurement period.
* Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test.
### Denominator
Women 24-64 years of age with a visit during the measurement period.
**Exclusions/Exceptions**
* Exclude women who had a hysterectomy with no residual cervix or a congenital absence of cervix.
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Click **Address** in the **Cervical Cancer Screening is due** reminder at the top of the visit note draft. This reminder will automatically appear if ALL of the following denominator requirements are met: |
| ------ | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | To immediately meet the numerator requirements by documenting a test for the patient Click **Document existing screening results**. • Record the details of a Pap Smear or HPV Test: • Click **Save New**. |
| **2b** | To work toward meeting the numerator requirements: Click **Order Pap Smear** to create a lab order for the patient. • Click **Order HPV Test** to create a lab order for the patient. • Click **Send office message to follow-up on open order** to have staff follow up on an outstanding lab order. Once the test is completed and you have the results, return to **Step 2a**. |
| **2c** | To exclude the patient due to a hysterectomy with no residual cervix or a congenital absence of the cervix, select one of the applicable exclusion options below. The corresponding document tag will automatically be appended to the visit note to exclude the patient from the measure. **Document exclusion: patient had a hysterectomy** • **Document exclusion: patient has congenital or acquired absence of cervix** [Click here for instructions on how to document other exclusions/exceptions](#document_exclusion_or_exception). |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements using the Health Maintenance section
| **1** | Click on **Cervical Cancer Screening** in the **Health Maintenance** section of the **Clinical Profile** . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Enter the date of the test in the **Date** field. |
| **3** | Select the **appropriate** document tag in the **Type** field: **Pap Smear (result: negative)** • **Pap Smear (result: positive)** • **HPV Test (result: negative)** • **HPV Test (result: positive)** |
| **4** | Click **+ Link a report to this item** to link the test results in the patient's chart to the record. |
| **5** | Click **Save New**. |
### Documenting measure requirements from the test results
| **1** | Open the test results in the patient's chart. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and select the appropriate document tag below: **Pap Smear (result: negative)** • **Pap Smear (result: positive)** • **HPV Test (result: negative)** • **HPV Test (result: positive)** |
| **4** | Click **Save** . |
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Step(s)** |
| ----------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Exclude women who had a hysterectomy with no residual cervix or a congenital absence of cervix. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: **EXCLUSION: HYSTERECTOMY** • **CQM EXCL: CONGENITAL ABS OF CERVIX** |
| Patients whose hospice care overlaps the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: **EXCLUSION: HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE** |
| Patients receiving palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: PALLIATIVE CARE** |
## Measure Information
All women are at risk for cervical cancer. In 2020, an estimated 13,800 women were diagnosed with cervical cancer in the U.S., resulting in an estimated 4,290 deaths (National Cancer Institute, 2020). Screening can identify precancerous lesions and can detect invasive cancer early, when treatment is more likely to be successful (American Cancer Society, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0124v14)
## Frequently Asked Questions
### What test codes are linked to the Pap Smear and HPV Tests?
The following test LOINC codes qualify for these screenings
* Pap Smear - 10524-7, 18500-9, 19762-4, 19764-0, 19765-7, 19766-5, 19774-9, 33717-0, 47527-7, 47528-5
* HPV Test - 21440-3, 30167-1, 38372-9, 59263-4, 59264-2, 59420-0, 69002-4, 71431-1, 75694-0, 77379-6, 77399-4, 77400-0, 82354-2, 82456-5, 82675-0, 95539-3
### Why isn't my patient (age 21) appearing in the denominator or showing a health maintenance reminder?
While clinical guidelines recommend starting cervical cancer screenings at age **21**, the official CMS technical specifications require the patient to be **24** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 3-year buffer to align with the 3-year cytology screening cycle so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 21 for the entirety of 2026 and does not turn 24 until 2029, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 24.
**Related Articles**
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
# [CMS125v12] Breast Cancer Screening
Source: https://help.elationhealth.com/articles/CMS125v12-Breast-Cancer-Screening
Elation supports the automatic calculation of Clinical Quality Measure CMS125v12, Breast Cancer Screening.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
This measure has been removed as an eCQM for Traditional MIPS reporting. This measure is still an applicable eCQM in other programs and is still available in Elation. It will not be eligible to be counted towards Traditional MIPS submissions via QRDA in the 2024 MIPS Performance Year. There are additional ways to report MIPS, please see our [MIPS (2024) Overview](/articles/MIPS-2024-Overview) article to better understand 2024 MIPS measure options.
## Measure Details
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period
## Measure Parameters
**Numerator:** Women with one or more mammograms any time on or between October 1st two years prior to the measurement period and end of the measurement period
**Denominator:** Women 52-74 years of age with a visit by the end of the measurement period.
**Exclusions/Exceptions:**
* Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy on or before the end of the measurement period.
* Exclude patients whose hospice care overlaps the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
* Advanced illness with two outpatient encounters during the measurement period or the year prior
* OR advanced illness with one inpatient encounter during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
These are the exclusion document tags for this measure: (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags))
* EXCLUSION: NO BSC SCRN Absence of Left Breast
* EXCLUSION: NO BSC SCRN Absence of Right Breast
* EXCLUSION: NO BSC SCRN BIL MAST
* EXCLUSION: NO BSC SCRN UNI MAST
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
**How to document frailty:**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Reports with the various frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the frailty diagnosis part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note for the reporting year. The document tag should have the device's HCPCS code and description and can be created directly in the visit note or within your [Document Tags](https://app.elationemr.com/settings/doc-tags/) settings page in Elation. A report with the various frailty devices and their corresponding HCPCS codes are also in the [Attachments](#attachments) section of this article.
![Four-step workflow showing how to create a new "CANE ADJUST/FIXED WITH TIP" document tag with HCPCS code E0100 in Elation, using the Edit Document Tags dialog and Add or Edit a Document Tag form.]()
## Elation Workflows
1. Recording from a visit note:
2. While documenting a visit note, if the patient requires a breast cancer screening, a Clinical Reminders alert will appear at the top of the visit note.
3. On the right hand side of this alert, you'll be given an option to address or dismiss the alert. Clicking Address will bring up options to address the measure.
4. When addressing the alert, the only option that will include the patient in the numerator is the **Document existing Mammogram details** option, which will give you a prompt to record the details of a previous mammogram. Use the **MAMMOGRAM (2022 AND LATER)** document tag to record a mammogram for the 2024 MIPS. If they haven't had a mammogram in the measurement, the prompt also gives the options to order a mammogram, or to direct the clinic staff to order one.
5. Recording from a patient chart:
6. At the bottom of the clinical profile, in the lower left corner of the patient's chart, you'll see the patient's active Health Maintenance items.
7. If the patient is eligible for the breast cancer screening measure, an alert will appear in the Health Maintenance section. If it's due within the calendar year, a due date will appear in orange to the right of the measure.
*
**Reference** : [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
3. To document and address the measure, click on Breast Cancer Screening, and indicate the date of the patient’s most recent Mammogram, the actual result, and click Save New. Use the **MAMMOGRAM ( 2022 AND LATER)** document tag to record a mammogram for the 2024 MIPS if needed.
![Breast Cancer Screening item in Health Maintenance highlighted as due by 12/31/2023, with the Add New Item dialog open showing date 06/28/2023 and type "MAMMOGRAM (EFFECTIVE 2022 AND LATER)" selected.]()
1. Tag any document in the patient’s record with a result-defined “MAMMOGRAM (2022 AND LATER)” document tag. This alone will meet the health maintenance requirement.
![Edit Report Details dialog showing a Mammogram report with the Tags field highlighted, containing the "MAMMOGRAM (EFFECTIVE 2022 AND LATER)" document tag applied.]()
## Measure Information
Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Noone et al, 2018). In 2015, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Noone et al, 2018).
While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Noone et al, 2018).
The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 68; by age 50 it becomes 1 in 43; by age 60, it is 1 in 29 (American Cancer Society, 2017).
[Reference: Measure information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0125v12)
## Frequently asked questions
While clinical guidelines recommend starting breast cancer screenings at age **40**, the official CMS technical specifications require the patient to be **42** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 2-year buffer to align with the 27-month look-back period so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 40 for the entirety of 2026 and does not turn 42 until 2028, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 42.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-breast-2024.zip)
* [Frailty Codes](/files/frailty-codes-breast-2024.csv)
* [Frailty Descriptions](/files/frailty-descriptions-breast-2024.zip)
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS125v13] Breast Cancer Screening
Source: https://help.elationhealth.com/articles/CMS125v13-Breast-Cancer-Screening
Elation supports the automatic calculation of Clinical Quality Measure CMS125v13, Breast Cancer Screening.
This measure has been removed as an eCQM for Traditional MIPS reporting. This measure is still an applicable eCQM in other programs and is still available in Elation. It will not be eligible to be counted towards Traditional MIPS submissions via QRDA in the 2025 MIPS Performance Year. There are additional ways to report MIPS, please see our [MIPS (2025) Overview](/articles/MIPS-2025-Overview) article to better understand 2025 MIPS measure options.
## Measure Details
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period
## Measure Parameters
**Numerator:** Women with one or more mammograms any time on or between October 1st two years prior to the measurement period and end of the measurement period
**Denominator:** Women 52-74 years of age with a visit by the end of the measurement period.
**Exclusions/Exceptions:**
* Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy on or before the end of the measurement period.
* Exclude patients whose hospice care overlaps the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
These are the exclusion document tags for this measure: (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags))
* EXCLUSION: NO BSC SCRN Absence of Left Breast
* EXCLUSION: NO BSC SCRN Absence of Right Breast
* EXCLUSION: NO BSC SCRN BIL MAST
* EXCLUSION: NO BSC SCRN UNI MAST
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
**How to document frailty:**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Reports with the various frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the frailty diagnosis part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note for the reporting year. The document tag should have the device's HCPCS code and description and can be created directly in the visit note or within your [Document Tags](https://app.elationemr.com/settings/doc-tags/) settings page in Elation. A report with the various frailty devices and their corresponding HCPCS codes are also in the [Attachments](#attachments) section of this article.
![Four-step workflow showing how to create a new document tag for a frailty device: clicking "+ Tag" (1), selecting "Add new tag" (2), entering HCPCS code E0100 for "CANE ADJUST/FIXED WITH TIP" (3), and clicking Save (4).]()
## Elation Workflows
1. Recording from a visit note:
2. While documenting a visit note, if the patient requires a breast cancer screening, a Clinical Reminders alert will appear at the top of the visit note.
3. On the right hand side of this alert, you'll be given an option to address or dismiss the alert. Clicking Address will bring up options to address the measure.
4. When addressing the alert, the only option that will include the patient in the numerator is the **Document existing Mammogram details** option, which will give you a prompt to record the details of a previous mammogram. Use the **MAMMOGRAM (2022 AND LATER)** document tag to record a mammogram for the 2024 MIPS. If they haven't had a mammogram in the measurement, the prompt also gives the options to order a mammogram, or to direct the clinic staff to order one.
5. Recording from a patient chart:
6. At the bottom of the clinical profile, in the lower left corner of the patient's chart, you'll see the patient's active Health Maintenance items.
7. If the patient is eligible for the breast cancer screening measure, an alert will appear in the Health Maintenance section. If it's due within the calendar year, a due date will appear in orange to the right of the measure.
*
**Reference** : [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
3. To document and address the measure, click on Breast Cancer Screening, and indicate the date of the patient’s most recent Mammogram, the actual result, and click Save New. Use the **MAMMOGRAM ( 2022 AND LATER)** document tag to record a mammogram for the 2024 MIPS if needed.
![Breast Cancer Screening item in Health Maintenance highlighted as due 12/31/2023, with the Add New Item dialog open showing date 06/28/2023 and type "MAMMOGRAM (EFFECTIVE 2022 AND LATER)" selected.]()
1. Tag any document in the patient’s record with a result-defined “MAMMOGRAM (2022 AND LATER)” document tag. This alone will meet the health maintenance requirement.
![Edit Report Details dialog showing a Mammogram report tagged with "MAMMOGRAM (EFFECTIVE 2022 AND LATER)" highlighted in red, demonstrating the required document tag for CMS125v13 compliance.]()
## Measure Information
Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Noone et al, 2018). In 2015, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Noone et al, 2018).
While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Noone et al, 2018).
The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 68; by age 50 it becomes 1 in 43; by age 60, it is 1 in 29 (American Cancer Society, 2017).
[Reference: Measure information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0125v13)
## Frequently asked questions
While clinical guidelines recommend starting breast cancer screenings at age **40**, the official CMS technical specifications require the patient to be **42** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 2-year buffer to align with the 27-month look-back period so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 40 for the entirety of 2026 and does not turn 42 until 2028, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 42.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-2026.zip)
* [Frailty Codes](/files/frailty-codes-2026.csv)
* [Frailty Descriptions](/files/frailty-descriptions-2026.zip)
## Related Articles
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS125v14] Breast Cancer Screening
Source: https://help.elationhealth.com/articles/CMS125v14-Breast-Cancer-Screening
Elation supports the automatic calculation of Clinical Quality Measure CMS125v14, Breast Cancer Screening.
This measure has been removed **as an eCQM for Traditional MIPS reporting** .
It remains an applicable eCQM for other programs and will continue to be available in Elation. However, it will **not** be eligible to count toward Traditional MIPS submissions via QRDA for the 2026 MIPS Performance Year. For a list of 2026 MIPS eligible eCQMs, see our [MIPS (2026) Overview](/articles/MIPS-2026-Overview) article.
## Measure Details
Percentage of women 40-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period.
### New in 2026: Stratification
Report a total rate, and each of the following age strata:
* Stratum 1: Patients age 42-51 by the end of the measurement period
* Stratum 2: Patients age 52-74 by the end of the measurement period
## Measure Parameters
### Numerator
Women with one or more mammograms any time on or between October 1st two years prior to the measurement period and end of the measurement period
**Denominator**
Women 42-74 years of age with a visit by the end of the measurement period.
**Exclusions/Exceptions**
* Exclude women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy on or before the end of the measurement period.
* Exclude patients whose hospice care overlaps the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Click **Address** in the **Breast Cancer Screening is due** reminder at the top of the visit note draft. This reminder will automatically appear if ALL of the following denominator requirements are met: |
| ------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | To immediately meet the numerator requirements by documenting a mammogram for the patient Click **Document existing Mammogram details**. • Record the details of a previous mammogram: • Click **Save New**. |
| **2b** | To move closer to meeting the numerator requirements: Click **Order Mammogram** to create a mammogram imaging order for the patient. • Click **Send office message to follow-up on open order** to have staff follow up on an outstanding mammogram imaging order. Once the mammogram is completed and you have the results, return to **Step 2a**. |
| **2c** | To exclude the patient from the measure because they had a bilateral mastectomy, click **Address** in the **Breast Cancer Screening is due** reminder at the top of the visit note draft and then click **Document exclusion: patient had a bilateral mastectomy**. The **EXCLUSION: NO BSC SCRN BIL MAST** document tag will automatically be appended to the visit note to exclude the patient from the measure. [Click here for instructions on how to document other exclusions/exceptions](#document_exclusion_or_exception). |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements using the Health Maintenance section
| **1** | Click on **Breast Cancer Screening** in the **Health Maintenance** section of the **Clinical Profile** . |
| ----- | -------------------------------------------------------------------------------------------------------- |
| **2** | Enter the date of the mammogram in the **Date** field. |
| **3** | Select the **Mammogram (Effective 2022 and later)** document tag in the **Type** field. |
| **4** | Click **+ Link a report to this item** to link mammogram report in the patient's chart to the record. |
| **5** | Click **Save New** . |
![Breast Cancer Screening Items dialog with Date set to 06/28/2023 and Type field showing "MAMMOGRAM (EFFECTIVE 2022 AND LATER)" selected, opened via "+ Add New Item" from the Health Maintenance section.]()
### Documenting measure requirements from a mammogram report
| **1** | Open the mammogram report in the patient's chart. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and select the **Mammogram (Effective 2022 and later)** document tag. ![Edit Report Details dialog for a mammogram report, showing the Tags field highlighted in red with "MAMMOGRAM (EFFECTIVE 2022 AND LATER)" tag applied, ready to save.]()
|
| **4** | Click **Save** . |
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Document Tag(s)** |
| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy on or before the end of the measurement period. | Click\*\*+ Tag \*\* at the bottom of the visit note draft and add the appropriate document tag from this list: **EXCLUSION: NO BSC SCRN Absence of Left Breast** • **EXCLUSION: NO BSC SCRN Absence of Right Breast** • **EXCLUSION: NO BSC SCRN BIL MAST** • **EXCLUSION: NO BSC SCRN UNI MAST** |
| Patients whose hospice care overlaps the measurement period. | Click\*\*+ Tag \*\* at the bottom of the visit note draft and add the appropriate document tag from this list: **EXCLUSION: HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE** |
| Patients receiving palliative care for any part of the measurement period. | Click\*\*+ Tag \*\* at the bottom of the visit note draft and add the following document tag-**EXCLUSION: PALLIATIVE CARE** |
| Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. | Click **+ Tag \*\* at the bottom of the visit note draft and add the following document tag**- EXCLUSION: Living Long Term in a Nursing Home\*\* |
| Exclude patients 66 and older by the end of the measurement period with indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: Advanced illness diagnosis during the measurement period or the year prior • OR taking dementia medications during the measurement period or the year prior | See below. |
**Documenting frailty**
To document frailty in Elation using
1. Frailty diagnosis, advanced illness codes and/or medications
2. Add a frailty diagnosis to the Problem List. You must select from one of the frailty codes listed [here](/files/frailty-codes-2026.csv).
3. Record one of the following:
4. an advanced illness diagnosis in 2 outpatient encounters using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
5. an advanced illness in 1 inpatient counter using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
6. a dementia medication in the patient's chart.
7. A frailty device code
8. Click **+ Tag** at the bottom of the visit note draft.
9. Create/add the appropriate document tag for the relevant frailty device from [this list of frailty device codes](/files/frailty-descriptions-2026.zip).
10. If you are creating the document tag for the first time for a frailty device, make sure the document tag has the device's HCPCS code listed.
![Four-step workflow showing how to add a frailty device document tag: clicking "+ Tag" on a visit note, searching "CANE ADJUST/FIXED WITH TIP," selecting "Add new tag," then entering the HCPCS code E0100 and clicking Save.]()
## Measure Information
Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Noone et al, 2018). In 2015, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Noone et al, 2018).
While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Noone et al, 2018).
The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 68; by age 50 it becomes 1 in 43; by age 60, it is 1 in 29 (American Cancer Society, 2017).
[Reference: Measure information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0125v14)
## Frequently asked questions
While clinical guidelines recommend starting breast cancer screenings at age **40**, the official CMS technical specifications require the patient to be **42** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 2-year buffer to align with the 27-month look-back period so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 40 for the entirety of 2026 and does not turn 42 until 2028, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 42.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-2026.zip)
* [Frailty Codes](/files/frailty-codes-2026.csv)
* [Frailty Descriptions](/files/frailty-descriptions-2026.zip)
## Related Articles
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
# [CMS130v13] Colorectal Cancer Screening
Source: https://help.elationhealth.com/articles/CMS130v13-Colorectal-Cancer-Screening
Elation supports the automatic calculation of CMS130v13, Colorectal Cancer Screening.
This measure has been removed as an eCQM for Traditional MIPS reporting. This measure is still an applicable eCQM in other programs and is still available in Elation. It will not be eligible to be counted towards Traditional MIPS submissions via QRDA in the 2025 MIPS Performance Year. There are additional ways to report MIPS, please see our [MIPS (2025) Overview](/articles/MIPS-2025-Overview) article to better understand 2025 MIPS measure options.
## Measure Details
Percentage of adults 45-75 years of age who had appropriate screening for colorectal cancer
## Measure Parameters
**Numerator**: Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria:
* Fecal occult blood test (FOBT) during the measurement period
* Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
* Colonoscopy during the measurement period or the nine years prior to the measurement period
* Stool DNA (sDNA) with FIT test during the measurement period or the two years prior to the measurement period
* CT Colonography during the measurement period or the four years prior to the measurement period
**Denominator**: Patients 46-75 years of age by the end of the measurement period with a visit during the measurement period.
**Exclusions/Exceptions:**
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer.
* Exclude patients receiving palliative care during the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following criteria advanced illness criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications for any part of the measurement period or the year prior
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
* EXCLUSION: COLECTOMY NO COL SCRN
**How to document frailty:**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Visit note bottom section showing the "Questions for Promoting Interoperability Compliance" area with a MIPS-tagged "Transition of care?" question and checkboxes for care setting options, above the Sign Visit Note button.]()
## Elation Workflows
1. Documenting a screening from a visit note:
* Elation's Clinical Reminders Feature allows you to easily document screenings. When a patient is due for a Colorectal Cancer Screening, an alert will report at the top of the patient's visit note. Options for selecting the measure will appear after clicking address:
1. Documenting a screening from the patient chart:
2. For a patient in the denominator, scroll to the bottom of their clinical profile, where their Health Maintenance items appear.
3. Click on Colorectal Screening, indicate the date of the patient’s most recent Colorectal Screening (FOBT, Colonoscopy, Flexible sigmoidoscopy, FIT DNA, or CT Colonography), and click ***Save New***.
1. Tag a report in the patient’s record with one of the following document tags. This alone will meet the health maintenance requirement (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* COLONOSCOPY (RESULT: NEGATIVE)
* COLONOSCOPY (RESULT: POSITIVE)
* FIT DNA (RESULT: NEGATIVE)
* FIT DNA (RESULT: POSITIVE)
* FLEXIBLE SIGMOIDOSCOPY (RESULT: NEGATIVE)
* FLEXIBLE SIGMOIDOSCOPY (RESULT: POSITIVE)
* FOBT (RESULT: NEGATIVE)
* FOBT (RESULT: POSITIVE)
* CT COLONOGRAPHY (RESULT: NEGATIVE)
* CT COLONOGRAPHY (RESULT: POSITIVE)
## Measure Information
Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (National Cancer Institute, 2020).
Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0130v13)
## Frequently asked questions
While clinical guidelines recommend starting colorectal cancer screenings at age **45**, the official CMS technical specifications require the patient to be **46** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 1-year buffer to ensure eligibility for a full annual cycle so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 45 for the entirety of 2026 and does not turn 46 until 2027, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 46.
The lookback window is tied to the measurement period, not to a fixed 3 years from the test date. Each measurement period counts a test performed during that period or the two calendar years immediately before it.
**Example:** A Stool DNA (sDNA) with FIT test completed in 2024 satisfies the numerator for measurement periods 2024, 2025, and 2026, since each of those periods' window reaches back to 2024. That same test will **not** count for measurement period 2027, since 2027's window only reaches back to 2025.
In short, don't count 3 years forward from the test date. Instead, check whether the test date falls within the current measurement year or the two years immediately before it.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-colorectal.zip)
* [Frailty Codes](/files/frailty-codes-colorectal.csv)
* [Frailty Descriptions](/files/frailty-descriptions-colorectal.zip)
## Related Articles
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS130v14] Colorectal Cancer Screening
Source: https://help.elationhealth.com/articles/CMS130v14-Colorectal-Cancer-Screening
Elation supports the automatic calculation of CMS130v14, Colorectal Cancer Screening.
This measure has been removed **as an eCQM for Traditional MIPS reporting** .
It remains an applicable eCQM for other programs and will continue to be available in Elation. However, it will **not** be eligible to count toward Traditional MIPS submissions via QRDA for the 2026 MIPS Performance Year. For a list of 2026 MIPS eligible eCQMs, see our [MIPS (2026) Overview](/articles/MIPS-2026-Overview) article.
## Measure Details
Percentage of adults 45-75 years of age who had appropriate screening for colorectal cancer
## Measure Parameters
### Numerator
Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria:
* Fecal occult blood test (FOBT) during the measurement period.
* Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period.
* Colonoscopy during the measurement period or the nine years prior to the measurement period.
* Stool DNA (sDNA) with FIT test during the measurement period or the two years prior to the measurement period.
* CT Colonography during the measurement period or the four years prior to the measurement period.
### Denominator
Patients 46-75 years of age by the end of the measurement period with a visit during the measurement period.
### Exclusions/Exceptions
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer.
* Exclude patients receiving palliative care during the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following criteria advanced illness criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications for any part of the measurement period or the year prior
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Click **Address** in the **Colorectal Cancer Screening is due** reminder at the top of the visit note draft. This reminder will automatically appear if ALL of the following denominator requirements are met: |
| ------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | To immediately meet the numerator requirements by documenting a Cologuard, FIT, FIT-DNA or FOBT test result for the patient Click **Enter FOBT or Fit DNA result**. • Record the details of a Pap Smear or HPV Test: • Click **Sign** or **Sign & Export to Note** to save the results. |
| **2b** | To immediately meet the numerator requirements by linking a test result: Click **Document existing screening results**. • Record the details of a test: • Click **Save New**. |
| **2c** | To move closer to meeting the numerator requirements: Click **Order FOBT or FIT DNA** to create a lab order for the patient. • Click **Refer for colonoscopy** to create a referral for the patient. • Click **Refer for CT colonography** to create an imaging order for the patient. • Click **Refer for flexible sigmoidoscopy** to create a referral for the patient. • Click **Send office message to follow-up on open order** to have staff follow up on an outstanding lab order. Once the test is completed and you have the results, return to **Step 2a or 2b**. |
| **2d** | To exclude the patient due to total colectomy, click **Document exclusion: patient had a total colectomy.** This will append the **EXCLUSION: COLECTOMY NO COL SCRN** document tag to the visit note to exclude the patient from the measure. [Click here for instructions on how to document other exclusions/exceptions](#document_exclusion_or_exception). |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements using the Health Maintenance section
| **1** | Click on **Colorectal Cancer Screening** in the **Health Maintenance** section of the **Clinical Profile** . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Enter the date of the test in the **Date** field. |
| **3** | Select the **appropriate** document tag in the **Type** field: **COLONOSCOPY (RESULT: NEGATIVE)** • **COLONOSCOPY (RESULT: POSITIVE)** • **FIT DNA (RESULT: NEGATIVE)** • **FIT DNA (RESULT: POSITIVE)** • **FLEXIBLE SIGMOIDOSCOPY (RESULT: NEGATIVE)** • **FLEXIBLE SIGMOIDOSCOPY (RESULT: POSITIVE)** • **FOBT (RESULT: NEGATIVE)** • **FOBT (RESULT: POSITIVE)** • **CT COLONOGRAPHY (RESULT: NEGATIVE)** • **CT COLONOGRAPHY (RESULT: POSITIVE)** |
| **4** | Click **+ Link a report to this item** to link the test results in the patient's chart to the record. |
| **5** | Click **Save New**. |
### Documenting measure requirements from the test results
| **1** | Open the test results in the patient's chart. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and select the appropriate document tag below: **COLONOSCOPY (RESULT: NEGATIVE)** • **COLONOSCOPY (RESULT: POSITIVE)** • **FIT DNA (RESULT: NEGATIVE)** • **FIT DNA (RESULT: POSITIVE)** • **FLEXIBLE SIGMOIDOSCOPY (RESULT: NEGATIVE)** • **FLEXIBLE SIGMOIDOSCOPY (RESULT: POSITIVE)** • **FOBT (RESULT: NEGATIVE)** • **FOBT (RESULT: POSITIVE)** • **CT COLONOGRAPHY (RESULT: NEGATIVE)** • **CT COLONOGRAPHY (RESULT: POSITIVE)** |
| **4** | Click **Save** . |
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Step(s)** |
| ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Patients whose hospice care overlaps the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: **EXCLUSION: HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE** |
| Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer. | Add a diagnosis of total colectomy or colorectal cancer in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026. Alternatively for total colectomy, you can add click **+ Tag** at the bottom of the visit note draft and add the document tag - **EXCLUSION: COLECTOMY NO COL SCRN** |
| Patients receiving palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: PALLIATIVE CARE** |
| Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: Living Long Term in a Nursing Home** . |
| Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following criteria advanced illness criteria: Advanced illness diagnosis during the measurement period or the year prior • OR taking dementia medications for any part of the measurement period or the year prior | See below. |
**Documenting frailty**
To document frailty in Elation using
1. Frailty diagnosis, advanced illness codes and/or medications
2. Add a frailty diagnosis to the Problem List. You must select from one of the frailty codes listed [here](/files/frailty-codes-2026.csv).
3. Record one of the following:
4. an advanced illness diagnosis in 2 outpatient encounters using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
5. an advanced illness in 1 inpatient counter using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
6. a dementia medication in the patient's chart.
7. A frailty device code
8. Click **+ Tag** at the bottom of the visit note draft.
9. Create/add the appropriate document tag for the relevant frailty device from [this list of frailty device codes](/files/frailty-descriptions-2026.zip).
10. If you are creating the document tag for the first time for a frailty device, make sure the document tag has the device's HCPCS code listed.
![Visit note bottom section showing the "Questions for Promoting Interoperability Compliance" area with a MIPS-tagged "Transition of care?" question and checkboxes for care setting options, above the Sign Visit Note button.]()
## Measure Information
Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (National Cancer Institute, 2020).
Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0130v14)
## Frequently asked questions
While clinical guidelines recommend starting colorectal cancer screenings at age **45**, the official CMS technical specifications require the patient to be **46** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 1-year buffer to ensure eligibility for a full annual cycle so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 45 for the entirety of 2026 and does not turn 46 until 2027, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 46.
The lookback window is tied to the measurement period, not to a fixed 3 years from the test date. Each measurement period counts a test performed during that period or the two calendar years immediately before it.
**Example:** A Stool DNA (sDNA) with FIT test completed in 2024 satisfies the numerator for measurement periods 2024, 2025, and 2026, since each of those periods' window reaches back to 2024. That same test will **not** count for measurement period 2027, since 2027's window only reaches back to 2025.
In short, don't count 3 years forward from the test date. Instead, check whether the test date falls within the current measurement year or the two years immediately before it.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-colorectal.zip)
* [Frailty Codes](/files/frailty-codes-colorectal.csv)
* [Frailty Descriptions](/files/frailty-descriptions-colorectal.zip)
## Related Articles
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
# [CMS131v12] Diabetes: Eye Exam (MIPS 2024)
Source: https://help.elationhealth.com/articles/CMS131v12-Diabetes-Eye-Exam-MIPS-2024
Elation supports the automatic calculation of CMS131v12, Diabetes: Eye Exam.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period
## Measure Parameters
**Numerator**:
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:
* Diabetic with a diagnosis of retinopathy that overlaps the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period
* Diabetic with no diagnosis of retinopathy overlapping the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period
**Denominator**: Patients 18-75 years of age by the end of the measurement period with diabetes with a visit during the measurement period.
**Exclusions/Exceptions:**
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
* Advanced illness with two outpatient encounters during the measurement period or the year prior
* OR advanced illness with one inpatient encounter during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
**How to document frailty in Elation:**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Office Visit Note bottom section showing the "Questions for Promoting Interoperability Compliance" area, with a MIPS-labeled "Transition of care?" question and transfer-of-care checkboxes.]()
## Elation Workflows
1. Elation's Clinical Reminders Feature allows you to easily document screenings.
2. When a patient is due for a Diabetic Eye Exam, an alert will report at the top of the patient's visit note:
1. After selecting address, relevant options for documenting or addressing the Eye Exam will be given.
2. For patients who do not have an office visit:
* Ensure the patient has a diagnosis of Diabetes (E11.9, etc):
1. Scroll to the bottom of their clinical profile, where their Health Maintenance items appear.
*
2. Click on Diabetes Eye Exam, indicate the date of the patient’s most recent Eye Exam and click **Save New**.
* **Reference**: [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
1. Tag a report in the patient’s record with the result-corresponding one of the following document tags. This alone will meet the health maintenance requirement (Reference: Tag Reports and Notes with Document Tags):
* EYE EXAM (NEGATIVE FOR RETINOPATHY)
* EYE EXAM (POSITIVE FOR RETINOPATHY)
## Measure Information
Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5 percent of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention \[CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020b). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs, and premature death (CDC, 2018).
In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34 percent increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association, 2018).
Diabetic retinopathy is progressive damage to the small blood vessels in the retina that may result in loss of vision. It is the leading cause of blindness in adults between 20-74 years of age. Approximately 4.1 million adults are affected by diabetic retinopathy (CDC, 2020c).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0131v12)
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-eye-exam.zip)
* [Frailty Codes](/files/frailty-codes-eye-exam.csv)
* [Frailty Descriptions](/files/advanced-illness-codes-eye-exam.zip)
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS131v13] Diabetes: Eye Exam (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS131v13-Diabetes-Eye-Exam-MIPS-2025
Elation supports the automatic calculation of CMS131v13, Diabetes: Eye Exam.
## Measure Details
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period
## Measure Parameters
**Numerator**:
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:
* Diabetic with a diagnosis of retinopathy that overlaps the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period
* Diabetic with no diagnosis of retinopathy overlapping the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period
**Denominator**: Patients 18-75 years of age by the end of the measurement period with diabetes with a visit during the measurement period.
**Exclusions/Exceptions:**
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
**How to document frailty in Elation:**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Office visit note showing the "Questions for Promoting Interoperability Compliance" section with MIPS Transition of care question and document tag options at the bottom of the visit note.]()
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
1. Elation's Clinical Reminders Feature allows you to easily document screenings.
2. When a patient is due for a Diabetic Eye Exam, an alert will report at the top of the patient's visit note:
1. After selecting address, relevant options for documenting or addressing the Eye Exam will be given.
2. For patients who do not have an office visit:
* Ensure the patient has a diagnosis of Diabetes (E11.9, etc):
1. Scroll to the bottom of their clinical profile, where their Health Maintenance items appear.
*
2. Click on Diabetes Eye Exam, indicate the date of the patient’s most recent Eye Exam and click **Save New**.
* **Reference**: [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
1. Tag a report in the patient’s record with the result-corresponding one of the following document tags. This alone will meet the health maintenance requirement (Reference: Tag Reports and Notes with Document Tags):
* EYE EXAM (NEGATIVE FOR RETINOPATHY)
* EYE EXAM (POSITIVE FOR RETINOPATHY)
## Measure Information
Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5 percent of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention \[CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020b). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs, and premature death (CDC, 2018).
In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34 percent increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association, 2018).
Diabetic retinopathy is progressive damage to the small blood vessels in the retina that may result in loss of vision. It is the leading cause of blindness in adults between 20-74 years of age. Approximately 4.1 million adults are affected by diabetic retinopathy (CDC, 2020c).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0131v13)
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-eye-exam.zip)
* [Frailty Codes](/files/frailty-codes-eye-exam.csv)
* [Frailty Descriptions](/files/advanced-illness-codes-eye-exam.zip)
## Related Articles
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS131v14] Diabetes: Eye Exam (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS131v14-Diabetes-Eye-Exam
Elation supports the automatic calculation of CMS131v14, Diabetes: Eye Exam.
## Measure Details
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period
## Measure Parameters
### Numerator
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:
* Diabetic with a diagnosis of retinopathy that overlaps the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period
* Diabetic with no diagnosis of retinopathy overlapping the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period
**Denominator**
Patients 18-75 years of age by the end of the measurement period with diabetes with a visit during the measurement period.
### Exclusions/Exceptions
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care for any part of the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living a nursing home any time on or before the end of the measurement period.
* Exclude patients who have bilateral absence of eyes any time during the patient’s history through the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
### Documenting diabetes diagnosis in the patient's chart
Patients must have an active diagnosis of diabetes recorded in their chart during the measurement period. Elation looks for a diabetes ICD-10 code in either a visit note for the measurement period or in the Problem List.
To add a diabetes diagnosis to the Problem List:
| **1** | Go to the Problem List and click **+ Add Problem** . |
| ----- | ---------------------------------------------------------------------------------- |
| **2** | Search for the appropriate diabetes diagnosis and then select it from the results. |
| **3** | Adjust the **Title** and **Dx Date** as needed. |
| **4** | Click **Save** . |
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Click **Address** in the **Diabetic Eye Exam is due** reminder at the top of the visit note draft. This reminder will automatically appear if ALL of the following denominator requirements are met: |
| ------ | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | To meet the numerator requirements immediately by documenting a diabetic eye exam for the patient: Click **Document existing exam results**. • Record the eye exam and results: • Click **Save New**. |
| **2b** | To move closer to meeting the numerator requirements: Click **Refer to ophthalmologist** to create a referral order for the patient. • Click **Send office message to follow-up on open order** to have staff follow up on an outstanding referral. Once the eye exam is completed and you have the results, return to **Step 2a**. |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements using the Health Maintenance section
| **1** | Click on Diabetic Eye Exam in the **Health Maintenance** section of the **Clinical Profile** . |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Enter the date of the eye exam in the **Date** field. |
| **3** | Select one of the appropriate document tags below in the **Type** field: **Eye Exam (negative for retinopathy)** • **Eye Exam (positive for retinopathy)** |
| **4** | Click **+ Link a report to this item** to link the eye exam report in the patient's chart to the record if available. |
| **5** | Click **Save New**. |
### Documenting measure requirements from an eye exam report
| **1** | Open the eye exam report in the patient's chart. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and select one of the appropriate document tags below: **Eye Exam (negative for retinopathy)** • **Eye Exam (positive for retinopathy)** |
| **4** | Click **Save** . |
[Click here for more details about Document Tags](/articles/tag-reports-and-notes-with-document-tags).
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Steps** |
| ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Patients whose hospice care overlaps the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from the list below: EXCLUSION: HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE |
| Patients receiving palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: PALLIATIVE CARE** . |
| Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: Living Long Term in a Nursing Home**. |
| Exclude patients who have bilateral absence of eyes any time during the patient’s history through the end of the measurement period. | Add the problem **Anophthalmos of both eyes (Q11.1)** in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026. |
| Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: Advanced illness diagnosis during the measurement period or the year prior • OR taking dementia medications during the measurement period or the year prior | See below. |
**Documenting frailty**
To document frailty in Elation using
1. Frailty diagnosis, advanced illness codes and/or medications
2. Add a frailty diagnosis to the Problem List. You must select from one of the frailty codes listed [here](/files/frailty-codes-2026.csv).
3. Record one of the following:
4. an advanced illness diagnosis in 2 outpatient encounters using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
5. an advanced illness in 1 inpatient counter using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
6. a dementia medication in the patient's chart.
7. A frailty device code
8. Click **+ Tag** at the bottom of the visit note draft.
9. Create/add the appropriate document tag for the relevant frailty device from [this list of frailty device codes](/files/frailty-descriptions-2026.zip).
10. If you are creating the document tag for the first time for a frailty device, make sure the document tag has the device's HCPCS code listed.
## Measure Information
Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5 percent of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention \[CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020b). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs, and premature death (CDC, 2018).
In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34 percent increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association, 2018).
Diabetic retinopathy is progressive damage to the small blood vessels in the retina that may result in loss of vision. It is the leading cause of blindness in adults between 20-74 years of age. Approximately 4.1 million adults are affected by diabetic retinopathy (CDC, 2020c).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0131v14)
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-eye-exam.zip)
* [Frailty Codes](/files/frailty-codes-eye-exam.csv)
* [Frailty Descriptions](/files/advanced-illness-codes-eye-exam.zip)
## Related Articles
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
# [CMS139v12] Falls: Screening for Future Fall Risk (MIPS 2024)
Source: https://help.elationhealth.com/articles/CMS139v12-Falls-Screening-for-Future-Fall-Risk-MIPS-2024
Elation supports the automatic calculation of Clinical Quality Measure CMS139v12, Falls: Screening for Future Fall Risk.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Report the percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period.
## Measure Parameters
**Numerator**: Patients who were screened for future fall risk at least once within the measurement period.
**Denominator**: Patients aged 65 years and older at the start of the measurement period with a visit during the measurement period.
**Exclusions/Exceptions:**
* Exclude patients who are in hospice care for any part of the measurement period.
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tag](/articles/tag-reports-and-notes-with-document-tags))
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
## Elation Workflows
1. When prompted in the visit note Clinical Reminder that a **Fall risk screening is due**, click **Address**. Click **Administer fall risk assessment** if you are documenting the results of the screening directly in your current visit note. If you’ve uploaded a separate document to the chart that has the screening results, click on **Document existing assessment**.
1. You can manually apply a **Falls Assessment** document tag to any visit note or report in the patient’s chart.
* **Reference**: [Tag Reports and Notes with Document Tag](/articles/tag-reports-and-notes-with-document-tags)
1. If applying to the document tag to a visit note, scroll towards the bottom of the note and click **+ Tag**. Search for **Falls Assessment** and select the result with a yellow MIPS label.
2. If applying the document tag to a report, you can apply the tag while you’re uploading the report and in the Report Details. If the report has already been uploaded to the chart, locate the report in the chart, then click **Actions >> Edit details** to add the tag.
## Measure Information
As the leading cause of both fatal and nonfatal injuries for older adults, falls are one of the most common and significant health issues facing people aged 65 years or older (Schneider, Shubert and Harmon, 2010). Moreover, the rate of falls increases with age (Dykes et al., 2010). Older adults are five times more likely to be hospitalized for fall-related injuries than any other cause-related injury. It is estimated that one in every three adults over 65 will fall each year (Centers for Disease Control and Prevention 2015). In those over age 80, the rate of falls increases to fifty percent (Doherty et al., 2009). Falls are also associated with substantial cost and resource use, approaching \$30,000 per fall hospitalization Woolcott et al., 2011). Identifying at-risk patients is the most important part of management, as applying preventive measures in this vulnerable population can have a profound effect on public health (al-Aama, 2011). Family physicians have a pivotal role in screening older patients for risk of falls, and applying preventive strategies for patients at risk (al-Aama, 2011).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0139v12)
## Additional Tools
These tools can be used to satisfy Clinical Quality Measure CMS139v12, Falls: Screening for Future Fall Risk
* [Morse Fall Scale](https://www.patientsafety.va.gov/docs/fallstoolkit/morse_falls_pocket_card.pdf)
* [Timed Get-Up-And-Go test](https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf)
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS139v13] Falls: Screening for Future Fall Risk (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS139v13-Falls-Screening-for-Future-Fall-Risk-MIPS-2025
Elation supports the automatic calculation of Clinical Quality Measure CMS139v13, Falls: Screening for Future Fall Risk.
## Measure Details
Report the percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period.
## Measure Parameters
**Numerator**: Patients who were screened for future fall risk at least once within the measurement period.
**Denominator**: Patients aged 65 years and older at the start of the measurement period with a visit during the measurement period.
**Exclusions/Exceptions:**
* Exclude patients who are in hospice care for any part of the measurement period.
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tag](/articles/tag-reports-and-notes-with-document-tags))
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
1. When prompted in the visit note Clinical Reminder that a **Fall risk screening is due**, click **Address**. Click **Administer fall risk assessment** if you are documenting the results of the screening directly in your current visit note. If you’ve uploaded a separate document to the chart that has the screening results, click on **Document existing assessment**.
1. You can manually apply a **Falls Assessment** document tag to any visit note or report in the patient’s chart.
* **Reference**: [Tag Reports and Notes with Document Tag](/articles/tag-reports-and-notes-with-document-tags)
1. If applying to the document tag to a visit note, scroll towards the bottom of the note and click **+ Tag**. Search for **Falls Assessment** and select the result with a yellow MIPS label.
2. If applying the document tag to a report, you can apply the tag while you’re uploading the report and in the Report Details. If the report has already been uploaded to the chart, locate the report in the chart, then click **Actions >> Edit details** to add the tag.
## Measure Information
As the leading cause of both fatal and nonfatal injuries for older adults, falls are one of the most common and significant health issues facing people aged 65 years or older (Schneider, Shubert and Harmon, 2010). Moreover, the rate of falls increases with age (Dykes et al., 2010). Older adults are five times more likely to be hospitalized for fall-related injuries than any other cause-related injury. It is estimated that one in every three adults over 65 will fall each year (Centers for Disease Control and Prevention 2015). In those over age 80, the rate of falls increases to fifty percent (Doherty et al., 2009). Falls are also associated with substantial cost and resource use, approaching \$30,000 per fall hospitalization Woolcott et al., 2011). Identifying at-risk patients is the most important part of management, as applying preventive measures in this vulnerable population can have a profound effect on public health (al-Aama, 2011). Family physicians have a pivotal role in screening older patients for risk of falls, and applying preventive strategies for patients at risk (al-Aama, 2011).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0139v13)
## Additional Tools
These tools can be used to satisfy Clinical Quality Measure CMS139v13, Falls: Screening for Future Fall Risk
* [Morse Fall Scale](https://www.patientsafety.va.gov/docs/fallstoolkit/morse_falls_pocket_card.pdf)
* [Timed Get-Up-And-Go test](https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf)
## Related Articles
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS139v14] Falls: Screening for Future Fall Risk (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS139v14-Falls-Screening-for-Future-Fall-Risk
Elation supports the automatic calculation of Clinical Quality Measure CMS139v14, Falls: Screening for Future Fall Risk.
## Measure Details
Report the percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period.
## Measure Parameters
### Numerator
Patients who were screened for future fall risk at least once within the measurement period.
### Denominator
Patients aged 65 years and older at the start of the measurement period with a visit during the measurement period.
### Exclusions/Exceptions
Exclude patients who are in hospice care for any part of the measurement period.
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Click **Address** in the **Fall Risk Screening is due** reminder at the top of the visit note draft. This reminder will automatically appear if the patient is 65 years of age or older by January 1, 2026. |
| ------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | To immediately meet the numerator requirements by administering an assessment during the visit: Click **Administer fall risk assessment**. • Perform the assessment. • The **Falls Assessment** Document Tag will be appended to the visit note to indicate that it meets the numerator requirements. |
| **2b** | To immediately meet the numerator requirements by documenting an existing assessment for the patient: Click **Document existing assessment**. • Select the report, document or note that satisfies the assessment requirement. • Click **Attach Item**. • The **Falls Assessment** Document Tag will be appended to the selected record to indicate that it meets the numerator requirements. |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements from an existing assessment
| **1** | Open the report, document or note that satisfies the fall assessment requirement. |
| ----- | ----------------------------------------------------------------------------------------------------------------------- |
| **2** | From a report - click **Actions** -> **Edit Details**. • From a visit note - click **Actions** -> **Add or Edit Tags**. |
| **3** | Search for and select **Falls Assessment** in the document tag field. |
| **4** | Click **Save** . |
[Click here for more details about Document Tags](/articles/tag-reports-and-notes-with-document-tags).
### Documenting exclusions/exceptions
Click **+ Tag** at the bottom of the visit note draft and one of the following document tags for the hospice care exclusion:
* **EXCLUSION: HOSPICE CARE**
* **EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE**
* **EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE**
## Measure Information
As the leading cause of both fatal and nonfatal injuries for older adults, falls are one of the most common and significant health issues facing people aged 65 years or older (Schneider, Shubert and Harmon, 2010). Moreover, the rate of falls increases with age (Dykes et al., 2010). Older adults are five times more likely to be hospitalized for fall-related injuries than any other cause-related injury. It is estimated that one in every three adults over 65 will fall each year (Centers for Disease Control and Prevention 2015). In those over age 80, the rate of falls increases to fifty percent (Doherty et al., 2009). Falls are also associated with substantial cost and resource use, approaching \$30,000 per fall hospitalization Woolcott et al., 2011). Identifying at-risk patients is the most important part of management, as applying preventive measures in this vulnerable population can have a profound effect on public health (al-Aama, 2011). Family physicians have a pivotal role in screening older patients for risk of falls, and applying preventive strategies for patients at risk (al-Aama, 2011).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0139v14)
## Screening Tools
These tools can be used to satisfy Clinical Quality Measure CMS139v14, Falls: Screening for Future Fall Risk:
* [Morse Fall Scale](https://www.patientsafety.va.gov/docs/fallstoolkit/morse_falls_pocket_card.pdf)
* [Timed Get-Up-And-Go test](https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf)
## Related Articles
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
# [CMS149v12] Dementia: Cognitive Assessment (MIPS 2024)
Source: https://help.elationhealth.com/articles/CMS149v12-Dementia-Cognitive-Assessment-MIPS-2024
Elation supports CMS149v12, Dementia: Cognitive Assessment.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12 month period who have two or more visits during the measurement period.
## Measure Parameters
**Numerator**: Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period.
**Denominator**: All patients, regardless of age, with a diagnosis of dementia.
**Exclusions/Exceptions:** Documentation of patient reason(s) for not assessing cognition.
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: NO COG ASSESSMT
## Elation Workflows
1. Add a diagnosis of dementia to the patient’s problem list:
2. Patients with dementia will also receive a Clinical Reminders alert if a cognitive assessment is due. This will appear at the top of the chart, and allow you to address the issue directly.
1. Create any document that allows for document tags (Visit Note, Non-Visit Note, or Report) complete the cognitive assessment, and click the **+Tag** item at the bottom of the note, after clicking **+Tag,** search for **Cognitive Assessment** and add it to the note.
* **Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
2. If the document tagged with **COGNITIVE ASSESSMENT** is a Non-Visit Note or Report, a visit note needs to be documented on or after the date of the report in order for the measure to be properly counted.
**To Document an Exclusion:**
* Click +Tag at the bottom of a visit note, or other area where document tags can be added, and select **EXCLUSION: NO COG ASSESSMT**.
## Measure Information
An estimated 5.8 million of adults in the US were living with dementia in 2019. Dementia is often characterized by the gradual onset and continuing cognitive decline in one or more domains including memory, communication and language, ability to focus or pay attention, reasoning and judgment and visual perception (Alzheimer’s Association, 2019). Cognitive deterioration represents a major source of morbidity and mortality and poses a significant burden on affected individuals and their caregivers (Daviglus et al., 2010). Although cognitive deterioration follows a different course depending on the type of dementia, significant rates of decline have been reported. For example, one study found that the annual rate of decline for Alzheimer's disease patients was more than four times that of older adults with no cognitive impairment (Wilson et al., 2010). Nevertheless, measurable cognitive abilities remain throughout the course of dementia (American Psychiatric Association, 2007). Initial and ongoing assessments of cognition are fundamental to the proper management of patients with dementia. These assessments serve as the basis for identifying treatment goals, developing a treatment plan, monitoring the effects of treatment, and modifying treatment as appropriate.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0149v12)
## Additional Information
Tools for cognitive assessment:
* [Mini-Mental State Examination](/files/mmse-assessment.pdf)
*
The MMSE has not been well validated for non-Alzheimer's dementias
* [Mini-cog](/files/mini-cog-assessment.pdf)
Use these tools to satisfy Dementia: Cognitive Assessment, which tracks the percentage of older adults with a Dementia diagnosis who have had an annual cognitive assessment.
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS149v13] Dementia: Cognitive Assessment (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS149v13-Dementia-Cognitive-Assessment-MIPS-2025
Elation supports CMS149v13, Dementia: Cognitive Assessment.
## Measure Details
Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12 month period who have two or more visits during the measurement period.
## Measure Parameters
**Numerator**: Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period.
**Denominator**: All patients, regardless of age, with a diagnosis of dementia.
**Exclusions/Exceptions:** Documentation of patient reason(s) for not assessing cognition.
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: NO COG ASSESSMT
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
1. Add a diagnosis of dementia to the patient’s problem list:
2. Patients with dementia will also receive a Clinical Reminders alert if a cognitive assessment is due. This will appear at the top of the chart, and allow you to address the issue directly.
1. Create any document that allows for document tags (Visit Note, Non-Visit Note, or Report) complete the cognitive assessment, and click the **+Tag** item at the bottom of the note, after clicking **+Tag,** search for **Cognitive Assessment** and add it to the note.
* **Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
2. If the document tagged with **COGNITIVE ASSESSMENT** is a Non-Visit Note or Report, a visit note needs to be documented on or after the date of the report in order for the measure to be properly counted.
**To Document an Exclusion:**
* Click +Tag at the bottom of a visit note, or other area where document tags can be added, and select **EXCLUSION: NO COG ASSESSMT**.
## Measure Information
An estimated 5.8 million of adults in the US were living with dementia in 2019. Dementia is often characterized by the gradual onset and continuing cognitive decline in one or more domains including memory, communication and language, ability to focus or pay attention, reasoning and judgment and visual perception (Alzheimer’s Association, 2019). Cognitive deterioration represents a major source of morbidity and mortality and poses a significant burden on affected individuals and their caregivers (Daviglus et al., 2010). Although cognitive deterioration follows a different course depending on the type of dementia, significant rates of decline have been reported. For example, one study found that the annual rate of decline for Alzheimer's disease patients was more than four times that of older adults with no cognitive impairment (Wilson et al., 2010). Nevertheless, measurable cognitive abilities remain throughout the course of dementia (American Psychiatric Association, 2007). Initial and ongoing assessments of cognition are fundamental to the proper management of patients with dementia. These assessments serve as the basis for identifying treatment goals, developing a treatment plan, monitoring the effects of treatment, and modifying treatment as appropriate.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0149v13)
## Additional Information
Tools for cognitive assessment:
* [Mini-Mental State Examination](/files/mmse-assessment.pdf)
The MMSE has not been well validated for non-Alzheimer's dementias
* [Mini-cog](/files/mini-cog-assessment.pdf)
Use these tools to satisfy Dementia: Cognitive Assessment, which tracks the percentage of older adults with a Dementia diagnosis who have had an annual cognitive assessment.
## Related Articles
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2025) Overview](/articles/MIPS-2024-Overview)
# [CMS149v14] Dementia: Cognitive Assessment (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS149v14-Dementia-Cognitive-Assessment
Elation supports CMS149v14, Dementia: Cognitive Assessment.
## Measure Details
Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within 12 months preceding who have two or more visits during the measurement period.
## Measure Parameters
### Numerator
Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period.
### Denominator
All patients, regardless of age, with a diagnosis of dementia.
### Exclusions/Exceptions
Except patients with documentation of patient reason(s) for not assessing cognition.
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
### Documenting dementia diagnosis in the patient's chart
Patients must have an active diagnosis of dementia recorded in their chart during the measurement period. Elation looks for a dementia ICD-10 code in either a visit note for the measurement period or in the Problem List.
To add a dementia diagnosis to the Problem List:
| **1** | Go to the Problem List and click **+ Add Problem** . |
| ----- | ---------------------------------------------------------------------------------- |
| **2** | Search for the appropriate dementia diagnosis and then select it from the results. |
| **3** | Adjust the **Title** and **Dx Date** as needed. |
| **4** | Click **Save** . |
### Documenting measure requirements using a Clinical Reminder in a visit note
| 1 | Click **Address** in the **Cognitive assessment for dementia is due** reminder at the top of the visit note draft. Patient has an active diagnosis of dementia either recorded: • Patient has a signed visit note dated within the last 12 months. |
| ------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | To meet the numerator requirements immediately by administering a cognitive assessment for the patient: Click **Administer cognitive assessment**. • Administer the cognitive assessment through your normal workflows. • A **Cognitive Assessment** document tag will be appended to the visit note to indicate that it meets numerator requirements.  |
| **2b** | To meet the numerator requirements immediately by documenting a cognitive assessment for the patient: Click **Document cognitive assessment**. • Select the report that documents the completed cognitive assessment. • Click **Attach Item**. • A **Cognitive Assessment** document tag will be appended to the selected report to indicate that it meets numerator requirements. |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements from an existing cognitive assessment report
| **1** | Open the cognitive assessment report in the patient's chart. |
| ----- | --------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and add the **Cognitive Assessment** document tag. |
| **4** | Click **Save** . |
[Click here for more details about Document Tags](/articles/tag-reports-and-notes-with-document-tags).
### Documenting exclusions/exceptions
Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: NO COG ASSESSMENT**.
## Measure Information
An estimated 5.8 million of adults in the US were living with dementia in 2019. Dementia is often characterized by the gradual onset and continuing cognitive decline in one or more domains including memory, communication and language, ability to focus or pay attention, reasoning and judgment and visual perception (Alzheimer’s Association, 2019). Cognitive deterioration represents a major source of morbidity and mortality and poses a significant burden on affected individuals and their caregivers (Daviglus et al., 2010). Although cognitive deterioration follows a different course depending on the type of dementia, significant rates of decline have been reported. For example, one study found that the annual rate of decline for Alzheimer's disease patients was more than four times that of older adults with no cognitive impairment (Wilson et al., 2010). Nevertheless, measurable cognitive abilities remain throughout the course of dementia (American Psychiatric Association, 2007). Initial and ongoing assessments of cognition are fundamental to the proper management of patients with dementia. These assessments serve as the basis for identifying treatment goals, developing a treatment plan, monitoring the effects of treatment, and modifying treatment as appropriate.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0149v14)
## Additional Information
Use these tools to satisfy the cognitive assessment requirement:
* [Mini-cog](/files/mini-cog-assessment.pdf)
* [Mini-Mental State Examination](/files/mmse-assessment.pdf)
The Mini-Mental State Examination (MMSE) has not been well validated for non-Alzheimer related dementias.
## Related Articles
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
# [CMS155v12] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2024)
Source: https://help.elationhealth.com/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2024
Elation supports the automatic calculation of Clinical Quality Measure CMS155v12, Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
* Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
* Percentage of patients with counseling for nutrition
* Percentage of patients with counseling for physical activity
## Measure Parameters
**Numerator 1**: Patients in the denominator have their height, weight, and BMI recorded in EHR.
**Numerator 2**: Patients in the denominator that have had counseling for nutrition.
**Numerator 3**: Patients in the denominator that have had counseling for physical activity.
**Denominator**: Patients 3-17 years of age by the end of the measurement period with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period.
**Exclusions/Exceptions:**
* Patients who have a diagnosis of pregnancy during the measurement period.
* Exclude patients who are in hospice care for any part of the measurement period.
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
## Elation Workflows
All 3 numerators need to be met in order to close this measure for the patient.
1. To meet Numerator 1, ensure that the patient has had their height and weight recorded in a visit note during the measurement period. Once these are recorded, the BMI will be automatically calculated.
1. To meet Numerator 2 and Numerator 3, use the Clinical Reminders rules that apply to this measure, one to meet the requirement for Exercise Counseling, and the other to meet the requirement for Nutrition Counseling. You can also add one of these document tags in a visit note or report (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* Nutrition Cnsl
* Diet Cnsl
* Ref to Diet Svc
* Ref to Wt Mgt Program
* Exc Cnsl
## Measure Information
Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017).
Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention, 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (Centers for Disease Control and Prevention, 2016).
The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014).
Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0155v12)
## Frequently asked questions
While the patient may have been 17 at the time of their visit, the official CMS technical specifications calculate age based on a specific "snapshot" date: **December 31st** of the measurement year.
**Age snapshot date: December 31st.** Patients who turn 18 during the year are excluded from the report, even if they were 17 at the time of their visit. This ensures that every patient in the report was within the age bracket for the required portion of the measurement period according to federal standards.
**Pro tip:** For quality reporting, the "Age" column in the EHR usually refers to the patient's current age today, but the CQM report only cares about their age on December 31st. If a patient turns 18 at any point during the measurement year, they will not be included in that year's report for this measure.
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS155v13] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2025
Elation supports the automatic calculation of Clinical Quality Measure CMS155v13, Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents.
## Measure Details
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
* Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
* Percentage of patients with counseling for nutrition
* Percentage of patients with counseling for physical activity
## Measure Parameters
**Numerator 1**: Patients in the denominator have their height, weight, and BMI recorded in EHR.
**Numerator 2**: Patients in the denominator that have had counseling for nutrition.
**Numerator 3**: Patients in the denominator that have had counseling for physical activity.
**Denominator**: Patients 3-17 years of age by the end of the measurement period with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period.
**Exclusions/Exceptions:**
* Patients who have a diagnosis of pregnancy during the measurement period.
* Exclude patients who are in hospice care for any part of the measurement period.
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
All 3 numerators need to be met in order to close this measure for the patient.
1. To meet Numerator 1, ensure that the patient has had their height and weight recorded in a visit note during the measurement period. Once these are recorded, the BMI will be automatically calculated.
1. To meet Numerator 2 and Numerator 3, use the Clinical Reminders rules that apply to this measure, one to meet the requirement for Exercise Counseling, and the other to meet the requirement for Nutrition Counseling. You can also add one of these document tags in a visit note or report (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* Nutrition Cnsl
* Diet Cnsl
* Ref to Diet Svc
* Ref to Wt Mgt Program
* Exc Cnsl
## Measure Information
Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017).
Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention, 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (Centers for Disease Control and Prevention, 2016).
The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014).
Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0155v13)
## Frequently asked questions
While the patient may have been 17 at the time of their visit, the official CMS technical specifications calculate age based on a specific "snapshot" date: **December 31st** of the measurement year.
**Age snapshot date: December 31st.** Patients who turn 18 during the year are excluded from the report, even if they were 17 at the time of their visit. This ensures that every patient in the report was within the age bracket for the required portion of the measurement period according to federal standards.
**Pro tip:** For quality reporting, the "Age" column in the EHR usually refers to the patient's current age today, but the CQM report only cares about their age on December 31st. If a patient turns 18 at any point during the measurement year, they will not be included in that year's report for this measure.
## Related Articles
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS155v14] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS155v14-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents
Elation supports the automatic calculation of Clinical Quality Measure CMS155v14, Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents.
## Measure Details
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
* Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
* Percentage of patients with counseling for nutrition
* Percentage of patients with counseling for physical activity
## Measure Parameters
### Numerator 1
Patients who had a height, weight, and body mass index (BMI) percentile recorded during the measurement period..
### Numerator 2
Patients who had counseling for nutrition during the measurement period.
### Numerator 3
Patients who had counseling for physical activity during the measurement period.
### Denominator
Patients 3-17 years of age by the end of the measurement period with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period.
### Exclusions/Exceptions
* Exclude patients who have a diagnosis of pregnancy during the measurement period.
* Exclude patients who are in hospice care for any part of the measurement period.
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
**All 3 numerators need to be met in order to close this measure for patients who are between 3 to 17 years of age by December 31, 2026.**
| **1** | To immediately meet the requirements for **Numerator 1**, create a visit note with a date within the measurement period and record the patient's height and weight in the vitals section. After a few seconds, the BMI will be calculated.  |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | To immediately meet the requirements for **Numerator 2**, Click **Address** in the **Preventative: Nutrition Counseling for Children and Adolescents** reminder at the top of the visit note draft. • Click **Counseled re: nutrition**. • Counsel the patient and/caretaker as you would through your normal workflows. • A **NUTRITION CNSL** document tag will be appended to the visit note to indicate that it meets numerator 2 requirements.  |
| **3** | To immediately meet the requirements for **Numerator 3**, Click **Address** in the **Preventative: Exercise Counseling for Children and Adolescents** reminder at the top of the visit note draft. • Click **Counseled re: physical activity**. • Counsel the patient and/caretaker as you would through your normal workflows. • A **PHYS ACTIVITY** **CNSL** document tag will be appended to the visit note to indicate that it meets numerator 3 requirements. |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements from a report
| **1** | Open the report in the patient's chart. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and select one of the appropriate document tags below: **Ref to Diet Svc** • **Ref to Wt Mgt Program** • **Diet Cnsl** • **Exc Cnsl** • **Nutrition Cnsl** |
| **4** | Click **Save** . |
[Click here for more details about Document Tags](/articles/tag-reports-and-notes-with-document-tags).
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Steps** |
| -------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Exclude patients who are pregnant during the measurement period. | Add a diagnosis of pregnancy in the patient’s [Problem List](/articles/managing-your-problem-list)or visit note with a start date prior to December 31, 2026. |
| Exclude patients who are in hospice care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: EXCLUSION: HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE |
## Measure Information
Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017).
Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention, 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (Centers for Disease Control and Prevention, 2016).
The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014).
Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0155v14)
## Frequently asked questions
While the patient may have been 17 at the time of their visit, the official CMS technical specifications calculate age based on a specific "snapshot" date: **December 31st** of the measurement year.
**Age snapshot date: December 31st.** Patients who turn 18 during the year are excluded from the report, even if they were 17 at the time of their visit. This ensures that every patient in the report was within the age bracket for the required portion of the measurement period according to federal standards.
**Pro tip:** For quality reporting, the "Age" column in the EHR usually refers to the patient's current age today, but the CQM report only cares about their age on December 31st. If a patient turns 18 at any point during the measurement year, they will not be included in that year's report for this measure.
## Related Articles
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
# [CMS159v13] Depression Remission at Twelve Months (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS159v13
Elation supports CMS159v13 measure, Depression Remission at Twelve Months.
## Measure Details
The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event.
## Measure Parameters
**Numerator**: Adolescent patients 12 to 17 years of age and adult patients 18 years of age and older who achieved remission at twelve months as demonstrated by the most recent twelve month (+/- 60 days) PHQ-9 or PHQ-9M score of less than five.
**Denominator**: Adolescent patients 12 to 17 years of age and adult patients 18 years of age and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 or PHQ-9M score greater than nine during the index event. Patients may be assessed using PHQ-9 or PHQ-9M on the same date or up to 7 days prior to the encounter (index event).
**Exceptions**:
* Exclude patients who died before the end of the measurement period.
* Exclude patients who are in hospice or palliative care for any part of the measurement period.
* Exclude patients with a diagnosis of bipolar disorder any time prior to the end of the measure assessment period.
* Exclude patients with a diagnosis of personality disorder emotionally labile any time prior to the end of the measure assessment period.
* Exclude patients with a diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period.
* Exclude patients with a diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period.
## Elation Workflows
The automated clinical reminders for this measure are currently unavailable - which means you won't receive an alert in the patient's visit note when a depression screening needs to be performed. Review the denominator definition carefully so that you can independently identify when a depression screening is necessary.
To address this measure, follow the exact instructions below to appropriately add patients to the denominator, numerator, exclusion, and/or exception.
When asked to apply a Document Tag, make sure you select one that was created by Elation, and not by a user in your practice. Patients who are accounted for correctly with the workflows below will automatically appear in your CQM report.
Once the automated clinical reminders and optimized workflows are available later this year, we will update the instructions below to reflect these changes.
### Meeting requirements
If the patient is 12 years and older **AND** if a diagnosis of depression or dysthymia is recorded in their Problem List:
1. Document a Depression Screening:
2. Go to the Psych section of the Clinical Profile and then click **add special**.
3. Select **Depression (PHQ-9 Questionnaire)**.
4. Complete the questionnaire with the patient.
5. Document a patient encounter for the 2025 calendar year and make sure the visit note has one of the following CPT or HCPCS Codes: [CMS159v13 - Visit Codes](/files/cms159-visit-codes.zip).
### Measure calculations
**Denominator Criteria**
If the patient is 12 years and older by November 1, 2023,
1. Check if they have a signed visit note in their chart with a date between between November 1, 2023 to October 31, 2024 where the visit note has one of the following CPT or HCPCS Codes: [CMS159v13 - Visit Codes](/files/cms159-visit-codes.zip).
2. Check and see if the patient had a PHQ-9 Score greater than 9 documented in their Clinical Profile within 7 days prior to the visit note date from step #1 **AND** if a diagnosis of depression or dysthymia was recorded in their Problem List with a start date less than or equal to the visit note date from step #1. [Click here for a list of ICD-10 codes for depression and dysthymia that will be counted towards the Denominator criteria](/files/depression-dysthymia-icd10-codes.zip).
If step #1 and #2 are true then the patient will be included in the measure’s Denominator- proceed to step #3.
**Numerator Criteria**
1. Calculate if your current encounter is within 10-14 months of the date from step #1 - if so proceed to step #4.
2. Document a patient encounter for the 2025 calendar year and make sure the visit note has one of the following CPT or HCPCS Codes: [CMS159v13 - Visit Codes](/files/cms159-visit-codes.zip).
3. Document a follow-up Depression Screening:
4. Go to the **Psych** section of the Clinical Profile and then click **add special**.
5. Select **Depression (PHQ-9 Questionnaire)**.
6. Complete the questionnaire with the patient.
7. If the result is less than or equal to 4, the patient will automatically be included in the measure’s Numerator and no further action is needed.
8. If the result is greater than or equal to 5, the patient does not meet the Numerator requirements and will not be included in the Numerator. Proceed with the instructions in the [\[CMS2v14\] Preventive Care and Screening: Screening for Depression and Follow-Up Plan](/articles/CMS2v14) article.
### Documenting Exceptions
| To exclude patients who died before the end of the measurement period. | Record the patient’s deceased status in their chart: Click on the patient’s name to open their demographics. • Go to the **Notes & Chart Management** section. • Select **Deceased** in the **Status** field. • Enter the deceased date. • Click **Save** to save your changes to their demographics. |
| ---------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Exclude patients who are in hospice or palliative care for any part of the measurement period. | Add the following Document Tag to the visit note: EXCLUSION: IP Discharge Status to Health Care Facility for Hospice Care |
| Exclude patients with a diagnosis of bipolar disorder any time prior to the end of the measure assessment period. | Document a diagnosis of bipolar disorder in the patient’s [Problem List](/articles/managing-your-problem-list) with a start date prior to the end of 2025. [Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
| Exclude patients with a diagnosis of personality disorder emotionally labile any time prior to the end of the measure assessment period. | Document a diagnosis of personality disorder emotionally labile in the patient’s [Problem List](/articles/managing-your-problem-list) with a start date prior to the end of 2025. [Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
| Exclude patients with a diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period. | Document a diagnosis of schizophrenia or psychotic disorder in the patient’s [Problem List](/articles/managing-your-problem-list) with a start date prior to the end of 2025. [Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
| Exclude patients with a diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period. | Document a diagnosis of pervasive developmental disorder in the patient’s [Problem List](/articles/managing-your-problem-list) with a start date prior to the end of 2025. [Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
## Measure Information
Depression is a common and treatable mental disorder. During 2013-2016, 8.1% of American adults age 20 and over had depression in a given 2 week period. Women (10.4%) were almost twice as likely as men (5.5%) to have had depression. The prevalence of depression among adults decreased as family income levels increased. About 80% of adults with depression reported at least some difficulty with work, home, or social activities because of their depression symptoms (Brody, Pratt, and Hughes, 2018).
Depression is a risk factor for development of chronic illnesses such as diabetes and coronary heart disease and adversely affects the course, complications and management of chronic medical illness. Both maladaptive health risk behaviors and psychobiological factors associated with depression may explain depression's negative effect on outcomes of chronic illness (Katon, 2011).
[Reference: Measure information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0159v13?qt-tabs_measure=measure-information)
## Frequently Asked Questions
### How can I enter a PHQ-9 result from last year to count toward this measure’s Denominator?
To document a past PHQ-9 result, enter it in the Psych section of the patient’s Clinical Profile in the exact format shown below:
* Depression: PHQ-9 Score: X (MM/DD/YYYY)
For example, a PHQ-9 evaluation performed on May 1, 2024 with a score of 11 will look like:
* Depression: PHQ-9 Score: 11 (05/01/2024)
### Do I need to reference the PHQ-9 result in the visit note for it to count towards the Numerator?
No, you do not need to reference any PHQ-9 results in visit notes for it to count towards the Numerator. By default, the measure will look for the score and the date of the evaluation in the Psych section of the patient’s Clinical Profile.
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
# [CMS159v14] Depression Remission at Twelve Months (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS159v14-Depression-Remission-at-Twelve-Months
Elation supports CMS159v14 measure, Depression Remission at Twelve Months.
## Measure Details
The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event.
## Measure Parameters
### Numerator
Adolescent patients 12 to 17 years of age and adult patients 18 years of age and older who achieved remission at twelve months as demonstrated by the most recent twelve month (+/- 60 days) PHQ-9 or PHQ-9M score of less than five.
### Denominator
Adolescent patients 12 to 17 years of age and adult patients 18 years of age and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 or PHQ-9M score greater than nine during the index event. Patients may be assessed using PHQ-9 or PHQ-9M on the same date or up to 7 days prior to the encounter (index event).
### Exclusions/Exceptions
* Exclude patients who died before the end of the measurement period.
* Exclude patients who are in hospice or palliative care for any part of the measurement period.
* Exclude patients with a diagnosis of bipolar disorder any time prior to the end of the measure assessment period.
* Exclude patients with a diagnosis of personality disorder emotionally labile any time prior to the end of the measure assessment period.
* Exclude patients with a diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period.
* Exclude patients with a diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period.
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in the visit note
Click **Address** in the **Depression Screening Follow-Up is Due** reminder at the top of the visit note draft.
* This reminder will automatically appear if **ALL** of the following denominator requirements are met:
1. Patient is 12 years of age or older at the time of visit.
2. Patient has a signed visit note in their chart dated within the past 12 months (plus or minus 60 days) that includes a qualifying [CMS159v13 - Visit Code](https://elation.my.salesforce.com/sfc/p/37000000L9cg/a/Ui000003c59p/aGLlBghzWiBQpej3BMZXDhLLSlNgtsvVdInKUkhE6Ig).
3. Patient has an active diagnosis of major depression or dysthymia in their **Problem List** with a start date equal to or prior to the date of the visit note in **Step b**.
* [Click here for a list of ICD-10 codes for depression and dysthymia that will be counted towards the Denominator criteria](https://elation.my.salesforce.com/sfc/p/37000000L9cg/a/Ui000003c5Px/7gTNJEMuxfzc3Yq_ilALBJY6G1x.NCxTtUH62hQuRaU).
4. Patient has a PHQ-9 score greater than 9 documented in their Clinical Profile within 7 days prior to the date of the visit note in **Step b**.
To immediately meet the numerator requirements by administering a PHQ-9 Screening click **Launch PHQ-9 Questionnaire**.
Complete the PHQ-9 Questionnaire with the patient and click **Save**.
If the PHQ-9 result is less than or equal to 4, the patient will automatically be included in the measure’s Numerator and no further action is needed.
If the PHQ-9 result is greater than or equal to 5, the patient does not meet the Numerator requirements and will not be included in the Numerator. Proceed with the instructions in the [\[CMS2v15\] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2026)](/articles/CMS2v15-Preventive-Care-and-Screening-Screening-for-Depression-and-Follow-Up-Plan) article for follow-up plan options.
### Documenting exclusions/exceptions
Some exclusions/exceptions can be documented by clicking **Address** in the **Depression Screening Follow-Up is Due** reminder at the top of the visit note draft and selecting the appropriate exclusion.
For other exclusions/exceptions and other ways to document them see:
| **Exclusion/exception** | **Step(s)** |
| ---------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| Exclude patients who died before the end of the measurement period. | Record the patient’s deceased status in their chart:
1. Click on the patient’s name to open their demographics.
2. Go to the **Notes & Chart Management** section.
3. Select **Deceased** in the **Status** field.
4. Enter the deceased date.
5. Click **Save** to save your changes to their demographics. |
| Exclude patients who are in hospice or palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: IP Discharge Status to Health Care Facility for Hospice Care**. |
| Exclude patients with a diagnosis of bipolar disorder any time prior to the end of the measure assessment period. | Add a diagnosis of bipolar disorder in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026.
[Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
| Exclude patients with a diagnosis of personality disorder emotionally labile any time prior to the end of the measure assessment period. | Add a diagnosis of personality disorder emotionally labile in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026.
[Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
| Exclude patients with a diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period. | Add a diagnosis of schizophrenia or psychotic disorder in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior December 31, 2026.
[Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
| Exclude patients with a diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period. | Add a diagnosis of pervasive developmental disorder in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior December 31, 2026.
[Click here for a list of mental health disorders that meet this Denominator exception](/files/depression-mental-health-denominator-exceptions.zip). |
## Measure Information
Depression is a common and treatable mental disorder. During 2013-2016, 8.1% of American adults age 20 and over had depression in a given 2 week period. Women (10.4%) were almost twice as likely as men (5.5%) to have had depression. The prevalence of depression among adults decreased as family income levels increased. About 80% of adults with depression reported at least some difficulty with work, home, or social activities because of their depression symptoms (Brody, Pratt, and Hughes, 2018).
Depression is a risk factor for development of chronic illnesses such as diabetes and coronary heart disease and adversely affects the course, complications and management of chronic medical illness. Both maladaptive health risk behaviors and psychobiological factors associated with depression may explain depression's negative effect on outcomes of chronic illness (Katon, 2011).
[Reference: Measure information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0159v14)
## Frequently Asked Questions
### Which ICD-10 codes for major depression or dysthymia are counted towards the Denominator criteria?
[Click here for a list of ICD-10 codes for depression and dysthymia that will be counted towards the Denominator criteria](/files/depression-dysthymia-icd10-codes.zip).
### How can I enter a PHQ-9 result from last year to count toward this measure’s Denominator?
To document a past PHQ-2 or PHQ-9 result, open the questionnaire from the Clinical Profile and then update the **Date administered** to the date in the past, fill in the answers and click **Save**.
### How can I record a missing visit note from last year to count toward this measure’s Denominator?
To document a historical patient encounter:
Go to the patient's chart and click **Visit Note**. Then select a visit note format you want to use for your documentation. An Elation Note will not be counted in MIPS calculations at this time.
Update the date of the visit note to the correct date.
Complete your visit note documentation.
Click **+Add Billing Information** and ensure one of the following CPT or HCPCS Codes are in the bill - [CMS159v13 - Visit Codes](/files/cms159-visit-codes.zip).
Sign the visit note.
### Do I need to reference the PHQ-9 result in the visit note for it to count towards the Numerator?
No, you do not need to reference any PHQ-9 results in visit notes for it to count towards the Numerator. By default, the measure will look for the score and the date of the evaluation in the **Psych** section of the patient’s Clinical Profile.
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
# [CMS165v11] Controlling High Blood Pressure (MIPS 2023)
Source: https://help.elationhealth.com/articles/CMS165v11-Controlling-High-Blood-Pressure-MIPS-2023
Elation supports the automatic calculation of Clinical Quality Measure CMS165v11, Controlling High Blood Pressure.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (\<140/90mmHg) during the measurement period
## Measure Parameters
**Numerator**: Patients whose blood pressure at the most recent visit is adequately controlled (systolic blood pressure \< 140 mmHg and diastolic blood pressure \< 90 mmHg) during the measurement period.
**Denominator**: Patients 18-85 years of age who had a visit and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period.
**Exclusions/Exceptions:**
* Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period.
* Patients with a diagnosis of pregnancy during the measurement period.
* Patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care during the measurement period.
* Patients 66 and older by the end of the measurement period who are living long term a nursing home any time on or before the end of the measurement period.
* Exclude patients 81 and older with an indication of frailty for any part of the measurement period.
* Exclude patients 66 and older with an indication of frailty for any part of the measurement period who meet any of the following criteria:
* Advanced illness with two outpatient encounters during the measurement period or the year prior
* OR advanced illness with one inpatient encounter during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
**How to document frailty**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Office visit note in Elation showing the MIPS "Transition of care?" question under Promoting Interoperability Compliance, with "Current Medications Patient Is Taking Documented in Chart?" answered "No."]()
## Elation Workflows
1. Ensure the patient has a diagnosis of Hypertension in their problem list (I10) whose diagnosis date is in the measurement year or earlier:
1. Record Blood Pressure for the Patient in a Visit Note, readings below 140/90 will count for the numerator of this measure. If you record multiple blood pressure readings, the lowest systolic and lowest diastolic result across all BPs will be used in this measure’s calculation
## Measure Information
High blood pressure (HBP) or hypertension, known as the **silent killer,** increases risks of heart disease and stroke which are two of the leading causes of death in the U.S. (Yoon, Fryar, & Carroll, 2015). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2012). The National Vital Statistics Systems reported that in 2014 there were approximately 73,300 deaths directly due to HBP and 410,624 deaths with any mention of HBP (CDC, 2014). Between 2006 and 2016 the number of deaths due to HBP rose by 46.3 percent (Benjamin et al, 2019). . Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015).
The estimated annual average direct and indirect cost of HBP from 2014 to 2015 was $55.9 billion (Benjamin et al, 2019). Total direct costs of HBP is projected to increase to $220.9 billion by 2035 (Benjamin et al, 2019). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures of >= 160 mm Hg could be effective and cost-saving (Moran, 2015).
Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of \<120 mm Hg compared to a SBP goal of \<140 mm Hg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015).
Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2023/cms165v11)
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-colorectal.zip)
* [Frailty Codes](/files/frailty-codes-colorectal.csv)
* [Frailty Descriptions](/files/frailty-descriptions-colorectal.zip)
## Related Articles
* [MIPS Overview](/articles/MIPS-2026-Overview)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
# [CMS165v12] Controlling High Blood Pressure (MIPS 2024)
Source: https://help.elationhealth.com/articles/CMS165v12-Controlling-High-Blood-Pressure-MIPS-2024
Elation supports the automatic calculation of Clinical Quality Measure CMS165v12, Controlling High Blood Pressure.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (\<140/90mmHg) during the measurement period
## Measure Parameters
**Numerator**: Patients whose blood pressure at the most recent visit is adequately controlled (systolic blood pressure \< 140 mmHg and diastolic blood pressure \< 90 mmHg) during the measurement period.
**Denominator**: Patients 18-85 years of age who had a visit and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period.
**Exclusions/Exceptions:**
* Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period.
* Patients with a diagnosis of pregnancy during the measurement period.
* Patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care during the measurement period.
* Patients 66 and older by the end of the measurement period who are living long term a nursing home any time on or before the end of the measurement period.
* Exclude patients 81 and older with an indication of frailty for any part of the measurement period.
* Exclude patients 66 and older with an indication of frailty for any part of the measurement period who meet any of the following criteria:
* Advanced illness with two outpatient encounters during the measurement period or the year prior
* OR advanced illness with one inpatient encounter during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
**How to document frailty**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Office Visit Note in Elation showing the Questions for Promoting Interoperability Compliance section, with the MIPS-tagged "Transition of care?" question and "Current Medications Patient Is Taking Documented in Chart?" set to "No."]()
## Elation Workflows
1. Ensure the patient has a diagnosis of Hypertension in their problem list (I10) whose diagnosis date is in the measurement year or earlier:
1. Record Blood Pressure for the Patient in a Visit Note, readings below 140/90 will count for the numerator of this measure. If you record multiple blood pressure readings, the lowest systolic and lowest diastolic result across all BPs will be used in this measure’s calculation
## Measure Information
High blood pressure (HBP) or hypertension, known as the **silent killer,** increases risks of heart disease and stroke which are two of the leading causes of death in the U.S. (Yoon, Fryar, & Carroll, 2015). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2012). The National Vital Statistics Systems reported that in 2014 there were approximately 73,300 deaths directly due to HBP and 410,624 deaths with any mention of HBP (CDC, 2014). Between 2006 and 2016 the number of deaths due to HBP rose by 46.3 percent (Benjamin et al, 2019). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015).
The estimated annual average direct and indirect cost of HBP from 2014 to 2015 was $55.9 billion (Benjamin et al, 2019). Total direct costs of HBP is projected to increase to $220.9 billion by 2035 (Benjamin et al, 2019). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures of >= 160 mm Hg could be effective and cost-saving (Moran, 2015).
Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of \<120 mm Hg compared to a SBP goal of \<140 mm Hg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015).
Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0165v12)
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-bp.zip)
* [Frailty Codes](/files/frailty-codes-bp.csv)
* [Frailty Descriptions](/files/frailty-descriptions-bp.zip)
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS165v13] Controlling High Blood Pressure (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS165v13-Controlling-High-Blood-Pressure-MIPS-2025
Elation supports the automatic calculation of Clinical Quality Measure CMS165v13, Controlling High Blood Pressure.
## Measure Details
Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (\<140/90mmHg) during the measurement period
## Measure Parameters
**Numerator**: Patients whose blood pressure at the most recent visit is adequately controlled (systolic blood pressure \< 140 mmHg and diastolic blood pressure \< 90 mmHg) during the measurement period.
**Denominator**: Patients 18-85 years of age who had a visit and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period.
**Exclusions/Exceptions:**
* Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period.
* Patients with a diagnosis of pregnancy during the measurement period.
* Patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care during the measurement period.
* Patients 66 and older by the end of the measurement period who are living long term a nursing home any time on or before the end of the measurement period.
* Exclude patients 81 and older with an indication of frailty for any part of the measurement period.
* Exclude patients 66 and older with an indication of frailty for any part of the measurement period who meet any of the following criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
**How to document frailty**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
![Office Visit Note in Elation showing the MIPS-tagged "Transition of care?" question under Promoting Interoperability Compliance, with "Current Medications Patient Is Taking Documented in Chart?" answered "No".]()
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
1. Ensure the patient has a diagnosis of Hypertension in their problem list (I10) whose diagnosis date is in the measurement year or earlier:
1. Record Blood Pressure for the Patient in a Visit Note, readings below 140/90 will count for the numerator of this measure. If you record multiple blood pressure readings, the lowest systolic and lowest diastolic result across all BPs will be used in this measure’s calculation
## Measure Information
High blood pressure (HBP) or hypertension, known as the **silent killer,** increases risks of heart disease and stroke which are two of the leading causes of death in the U.S. (Yoon, Fryar, & Carroll, 2015). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2012). The National Vital Statistics Systems reported that in 2014 there were approximately 73,300 deaths directly due to HBP and 410,624 deaths with any mention of HBP (CDC, 2014). Between 2006 and 2016 the number of deaths due to HBP rose by 46.3 percent (Benjamin et al, 2019). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015).
The estimated annual average direct and indirect cost of HBP from 2014 to 2015 was $55.9 billion (Benjamin et al, 2019). Total direct costs of HBP is projected to increase to $220.9 billion by 2035 (Benjamin et al, 2019). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures of >= 160 mm Hg could be effective and cost-saving (Moran, 2015).
Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of \<120 mm Hg compared to a SBP goal of \<140 mm Hg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015).
Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0165v13)
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-bp.zip)
* [Frailty Codes](/files/frailty-codes-bp.csv)
* [Frailty Descriptions](/files/frailty-descriptions-bp.zip)
## Related Articles
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS165v14] Controlling High Blood Pressure (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS165v14-Controlling-High-Blood-Pressure
Elation supports the automatic calculation of Clinical Quality Measure CMS165v14, Controlling High Blood Pressure.
## Measure Details
Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (\<140/90mmHg) during the measurement period
## Measure Parameters
### Numerator
Patients whose blood pressure at the most recent visit is adequately controlled (systolic blood pressure \< 140 mmHg and diastolic blood pressure \< 90 mmHg) during the measurement period.
### Denominator
Patients 18-85 years of age who had a visit and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period.
### Exclusions/Exceptions
* Exclude patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period.
* Exclude patients with a diagnosis of pregnancy during the measurement period.
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients receiving palliative care during the measurement period.
* Patients 66 and older by the end of the measurement period who are living long term a nursing home any time on or before the end of the measurement period.
* Exclude patients 66-80 with an indication of frailty for any part of the measurement period who meet any of the following criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications during the measurement period or the year prior
* Exclude patients 81 and older with an indication of frailty for any part of the measurement period.
## Elation Workflows
Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article.
### Documenting hypertension diagnosis in the patient's chart
Patients must have an active diagnosis of hypertension recorded in their chart starting before and continuing into, or starting during the first six months of the measurement period. Elation looks for a hypertension ICD-10 code in either a visit note for the measurement period or in the Problem List.
To add a hypertension diagnosis to the Problem List:
| **1** | Go to the Problem List and click **+ Add Problem** . |
| ----- | -------------------------------------------------------------------------------------- |
| **2** | Search for the appropriate hypertension diagnosis and then select it from the results. |
| **3** | Adjust the **Title** and **Dx Date** as needed. |
| **4** | Click **Save** . |
### Documenting measure requirements using a Clinical Reminder in a visit note
This workflow is applicable if
**ALL**
of the following denominator requirements are met:
* Patient is between 18 to 85 years of age during the time of visit.
* Patient has an active diagnosis of hypertension either recorded:
* in a visit note dated on or prior to June 30, 2026 OR
* in the Problem List with a start date on or prior to June 30, 2026.
| **1** | Record a blood pressure reading (both systolic and diastolic) in the **Vitals** section of the visit note. |
| ------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | If the blood pressure reading is within normal parameters (less than 140/90mmHg) then no further action is needed as the patient has met numerator requirements. |
| **2b** | If the blood pressure reading is **outside** of normal parameters (greater than 140/90mmHg) then: Click **Address** in the **Blood pressure is not well controlled** reminder at the top of the visit note draft. • Choose from one of these 2 actions: |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Steps** |
| ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Exclude patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: • Add a diagnosis of end stage renal disease (ESRD), dialysis or renal transplant in the patient’s Problem List or visit note with a start date on or prior to December 31, 2026. |
| Exclude patients with a diagnosis of pregnancy during the measurement period. | Add a diagnosis of pregnancy in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date on or prior to December 31, 2026. |
| Patients whose hospice care overlaps the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: EXCLUSION: HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE |
| Patients receiving palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: PALLIATIVE CARE** . |
| Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: Living Long Term in a Nursing Home** . |
| Exclude patients 66-80 with an indication of frailty for any part of the measurement period who meet any of the following criteria: Advanced illness diagnosis during the measurement period or the year prior • OR taking dementia medications during the measurement period or the year prior | See below. |
| Exclude patients 81 and older with an indication of frailty for any part of the measurement period. | See below. |
**Documenting frailty**
To document frailty in Elation using
1. Frailty diagnosis, advanced illness codes and/or medications
2. Add a frailty diagnosis to the Problem List. You must select from one of the frailty codes listed [here](/files/frailty-codes-2026.csv).
3. Record one of the following:
4. an advanced illness diagnosis in 2 outpatient encounters using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
5. an advanced illness in 1 inpatient counter using one of the codes listed [here](/files/advanced-illness-codes-2026.zip).
6. a dementia medication in the patient's chart.
7. A frailty device code
8. Click **+ Tag** at the bottom of the visit note draft.
9. Create/add the appropriate document tag for the relevant frailty device from [this list of frailty device codes](/files/frailty-descriptions-2026.zip).
10. If you are creating the document tag for the first time for a frailty device, make sure the document tag has the device's HCPCS code listed.
![Office Visit Note in Elation showing the MIPS-tagged "Transition of care?" question under Promoting Interoperability Compliance, with "Current Medications Patient Is Taking Documented in Chart?" answered "No".]()
## Measure Information
High blood pressure (HBP) or hypertension, known as the **silent killer,** increases risks of heart disease and stroke which are two of the leading causes of death in the U.S. (Yoon, Fryar, & Carroll, 2015). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2012). The National Vital Statistics Systems reported that in 2014 there were approximately 73,300 deaths directly due to HBP and 410,624 deaths with any mention of HBP (CDC, 2014). Between 2006 and 2016 the number of deaths due to HBP rose by 46.3 percent (Benjamin et al, 2019). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015).
The estimated annual average direct and indirect cost of HBP from 2014 to 2015 was $55.9 billion (Benjamin et al, 2019). Total direct costs of HBP is projected to increase to $220.9 billion by 2035 (Benjamin et al, 2019). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures of >= 160 mm Hg could be effective and cost-saving (Moran, 2015).
Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of \<120 mm Hg compared to a SBP goal of \<140 mm Hg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015).
Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0165v14)
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-bp.zip)
* [Frailty Codes](/files/frailty-codes-bp.csv)
* [Frailty Descriptions](/files/frailty-descriptions-bp.zip)
## Related Articles
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
# [CMS2v14] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2025)
Source: https://help.elationhealth.com/articles/CMS2v14
Elation supports CMS2v14 measure, Preventive Care and Screening: Screening for Depression and Follow-Up Plan.
## Measure Details
Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter.
## Measure Parameters
**Numerator**: Patients screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the visit.
**Denominator**: All patients aged 12 years and older at the beginning of the measurement period with at least one visit note during the measurement period.
**Exclusions:**
Patients who have ever been diagnosed with bipolar disorder at any time prior to the qualifying encounter.
**Exceptions**:
* Exclude patients who refuse to participate in or complete the depression screening.
* Exclude patients with documentation of medical reason for not screening patient for depression (e.g., cognitive, functional, or motivational limitations that may impact accuracy of results; patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status).
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
Click **Address** in the **Depression screening is due** reminder at the top of the visit note draft.
* The reminder will automatically appear if the patient is 12 years and older by January 1, 2025.
Click **Launch PHQ-9 Questionnaire**.
Complete the PHQ-9 screening with the patient and save the results.
1. If the result is negative (score is less than or equal to 4), then the patient will automatically be added to the measure's Numerator and no further action is needed.
2. If the result is positive (score is greater than or equal to 5), then proceed to the next step.
If the result is positive, record a follow-up plan on the date of the visit or up to 2 days after the date of the visit. The follow-up plan must be one of the following actions.
* **Prescribe pharmaceutical intervention.** Prescribe pharmaceutical intervention using [Elation’s Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) on the date of the visit or two days prior to the visit. Select the appropriate medication from Elation’s database (i.e. not a user created medication) in order for the system to calculate the patient in the Numerator. [Click here for a list of medications that meet this requirement](/files/depression-screening-medications.zip).
* **Refer for counseling.** Use the [Referral](/articles/letter-and-referral-introduction) feature to refer the patient for counseling. Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter. ![Visit note for Leonard Smith showing a highlighted "Referral for Mental Health Counseling (Procedure)" entry, which satisfies the follow-up plan requirement for a positive depression screening result.]()
* **Prescribe other follow-up plan (besides pharmaceutical intervention or counseling).** Take any actions you normally would to prescribe other follow-up plan(s) for depression (see options below). Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter.
### Documenting measure requirements using document tags
Open a visit note draft.
Click **+ Tag** towards the bottom of the visit note draft.
Add one of the following document tags to the visit note draft depending on the patient, results and situation:
* *Adult depression screening: negative (finding)*
* *Adult depression screening: positive (finding)*
* *Adult depression screening: declined (situation)*
* *Adolescent depression screening: negative (finding)*
* *Adolescent depression screening: positive (finding)*
* *Adolescent depression screening: declined (situation)*
Click **Save** to save the document tag to the visit note draft.
### Documenting exclusions
To exclude a **patient that has bipolar disorder**, the patient must have been diagnosed with bipolar disorder at any time prior to the qualifying 2025 visit note. This means one or more of the following must be true:
* An ICD-10 code for bipolar disorder is recorded in the patient’s Problem List with a start date prior to the date of qualifying 2025 visit note.
* An ICD-10 code for bipolar disorder is recorded in a visit note dated prior to the date of qualifying 2025 visit note.
[Click here for a list of qualifying ICD-10 codes for bipolar disorder](/files/bipolar-disorder-icd10-codes.zip).
### Documenting exceptions
To document that a **patient refuses to participate in or complete the depression screening**:
Click the **+Tag** button in the corresponding visit note draft.
Add one of these Document Tags to the visit note based on the patient’s age:
1. 12-17 years old: *Adolescent depression screening - declined (situation)*
2. 18 years and older: *Adult depression screening - declined (situation)*
To document that the **patient has a CMS approved medical reason for not screening the patient for depression**:
Go to the **+Tag** section of the visit note draft.
Add the corresponding Document Tag to the visit note to reflect the CMS approved medical reason for not screening a patient for depression. Choose the **Adolescent** version for patients ages 12-17 and *Adult* version for patients 18 and older.
The following Document Tags can be used for this Denominator exception:
* *Adolescent depression screening not performed - Procedure contraindicated (situation)*
* *Adolescent depression screening not performed - Treatment not indicated (situation)*
* *Adolescent depression screening not performed - Drug treatment not indicated (situation)*
* *Adolescent depression screening not performed - Absent response to treatment (situation)*
* *Adolescent depression screening not performed - Late effect of medical and surgical care complica...*
* *Adolescent depression screening not performed - Drug resistance (disorder)*
* *Adolescent depression screening not performed - Complication of medical care (disorder)*
* *Adolescent depression screening not performed - Treatment not tolerated (situation)*
* *Adolescent depression screening not performed - Not indicated (qualifier value)*
* *Adolescent depression screening not performed - Contraindicated (qualifier value)*
* *Adolescent depression screening not performed - Allergy to drug (finding)*
* *Adolescent depression screening not performed - Procedure not indicated (situation)*
* *Adolescent depression screening not performed - Intolerance to drug (finding)*
* *Adolescent depression screening not performed - Adverse reaction caused by drug (disorder)*
* *Adolescent depression screening not performed - Drug interaction (finding)*
* *Adult depression screening not performed - Procedure contraindicated (situation)*
* *Adult depression screening not performed - Treatment not indicated (situation)*
* *Adult depression screening not performed - Drug treatment not indicated (situation)*
* *Adult depression screening not performed - Absent response to treatment (situation)*
* *Adult depression screening not performed - Late effect of medical and surgical care complication ...*
* *Adult depression screening not performed - Drug resistance (disorder)*
* *Adult depression screening not performed - Complication of medical care (disorder)*
* *Adult depression screening not performed - Treatment not tolerated (situation)*
* *Adult depression screening not performed - Not indicated (qualifier value)*
* *Adult depression screening not performed - Contraindicated (qualifier value)*
* *Adult depression screening not performed - Allergy to drug (finding)*
* *Adult depression screening not performed - Procedure not indicated (situation)*
* *Adult depression screening not performed - Intolerance to drug (finding)*
* *Adult depression screening not performed - Adverse reaction caused by drug (disorder)*
* *Adult depression screening not performed - Drug interaction (finding)*
[Reference: CMS2v14 eCQM Flow](https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS2v14-eCQM-Flow.pdf)
## Measure Information
Depression affects more than two hundred sixty million people across the world and is a leading cause of disability, with a variety of depressive disorders that are independent risk factors for chronic diseases, such as cardiovascular disease and diabetes, lending screening for depression as paramount to identify depressive disorders that can affect the most vulnerable populations (Costantini et al., 2021). Results from a 2018 U.S. survey indicated that 14.4 percent of adolescents (3.5 million adolescents) had a major depressive episode (MDE) in the past year, with nine percent of adolescents (2.4 million adolescents) having one MDE with severe impairment (Substance Abuse and Mental Health Services Administration, 2019). The odds of a diagnosis of depression are believed to be 2.6 times greater for children and adolescents exposed to trauma as compared to those unexposed or less exposed (Vibhakar et al., 2019). Children and teens with major depressive disorder (MDD) have been found to have difficulty carrying out their daily activities, relating to others, growing up healthy, and are at an increased risk of suicide (Siu on behalf of the U.S. Preventive Services Task Force \[USPSTF], 2016).
[Reference: Measure information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0002v14?qt-tabs_measure=measure-information)
## Frequently Asked Questions
### How can I enter a PHQ-2 or PHQ-9 result from the past to count toward this measure’s Numerator?
To document a past PHQ-2 or PHQ-9 result, open the questionnaire from the Clinical Profile and then update the **Date administered** to the date in the past, fill in the answers and click **Save**.
### Do I need to reference the PHQ-2 or PHQ-9 result in the visit note for it to count towards the Numerator?
No, you do not need to reference any PHQ-2 or PHQ-9 results in visit notes for it to count towards the Numerator. By default, the measure will look for the score and the date of the evaluation in the **Psych** section of the patient’s Clinical Profile.
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [Document Tags for Visit Notes & Reports Guide](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
# [CMS2v15] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2026)
Source: https://help.elationhealth.com/articles/CMS2v15-Preventive-Care-and-Screening-Screening-for-Depression-and-Follow-Up-Plan
## Measure Details
Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter.
## Measure Parameters
### Numerator
Patients screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the visit.
### Denominator
All patients aged 12 years and older at the beginning of the measurement period with at least one visit note during the measurement period.
### Exclusions/Exceptions
* Exclude patients who have ever been diagnosed with bipolar disorder at any time prior to the qualifying encounter.
* Except patients who refuse to participate in or complete the depression screening.
* Except patients with documentation of medical reason for not screening patient for depression (e.g., cognitive, functional, or motivational limitations that may impact accuracy of results; patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status).
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
Click **Address** in the **Depression screening is due** reminder at the top of the visit note draft. This reminder will automatically appear if the patient is 12 years of age or older by January 1, 2026.
* Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
Click **Launch PHQ-9 Questionnaire**.
Complete the PHQ-9 Questionnaire with the patient and click **Save**.
Review the results.
1. If the result is negative, no further action is needed.
* If the patient has a PHQ-2 score less than or equal to 2 (negative result), then they will be automatically added to the measure's Numerator and no further action is needed.
* If the patient has a PHQ-9 score less than or equal to 4 (negative result), then they will be automatically added to the measure's Numerator and no further action is needed.
2. If the result is positive, record a follow-up plan on the date of the visit or up to 2 days after the date of the visit. The follow-up plan must be one of the following actions.
* **Prescribe pharmaceutical intervention.** Prescribe pharmaceutical intervention (e.g. depression medication) using [Elation's Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) on the date of the visit or two days prior to the visit. Select the appropriate medication from Elation's database (i.e. not a user created medication) in order for the system to calculate the patient in the Numerator. [Click here for a list of medications that meet this requirement](/files/depression-screening-medications.zip).
* **Refer for counseling.** Use the [Referral](/articles/letter-and-referral-introduction) feature to refer the patient for counseling. Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter. ![Visit note for Leonard Smith showing a highlighted referral entry "REFERRAL FOR MENTAL HEALTH COUNSELING (PROCEDURE)" with an Edit link, demonstrating a completed counseling referral as a depression follow-up plan.]()
* **Prescribe other follow-up plan (besides pharmaceutical intervention or counseling).** Take any actions you normally would to prescribe other follow-up plan(s) for depression (see options below). Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter.
### Documenting measure requirements using a Clinical Questionnaire
Open a visit note draft for the patient.
Go to the **Clinical Profile** > **Psych** section > **add special** and select a **PHQ-2** or **PHQ-9** Questionnaire.
Complete the questionnaire with the patient and click **Save**.
Review the results.
1. If the result is negative, no further action is needed.
* If the patient has a PHQ-2 score less than or equal to 2 (negative result), then they will be automatically added to the measure's Numerator and no further action is needed.
* If the patient has a PHQ-9 score less than or equal to 4 (negative result), then they will be automatically added to the measure's Numerator and no further action is needed.
2. If the result is positive, record a follow-up plan on the date of the visit or up to 2 days after the date of the visit. The follow-up plan must be one of the following actions.
* **Prescribe pharmaceutical intervention.** Prescribe pharmaceutical intervention (e.g. depression medication) using [Elation's Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) on the date of the visit or two days prior to the visit. Select the appropriate medication from Elation's database (i.e. not a user created medication) in order for the system to calculate the patient in the Numerator. [Click here for a list of medications that meet this requirement](/files/depression-screening-medications.zip).
* **Refer for counseling.** Use the [Referral](/articles/letter-and-referral-introduction) feature to refer the patient for counseling. Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter. ![Visit note for Leonard Smith showing a highlighted referral entry "REFERRAL FOR MENTAL HEALTH COUNSELING (PROCEDURE)" with an Edit link, demonstrating a completed counseling referral as a depression follow-up plan.]()
* **Prescribe other follow-up plan (besides pharmaceutical intervention or counseling).** Take any actions you normally would to prescribe other follow-up plan(s) for depression (see options below). Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter.
### Documenting measure requirements from a report/document
Open the relevant report/document in the patient's chart.
Click **Actions** > **Edit Details**.
Add the appropriate tag to the **Tags** section depending on the patient's age and depression screening result:
* *Adolescent depression screening - negative (finding)*
* *Adolescent depression screening - positive (finding)*
* *Adult depression screening - negative (finding)*
* *Adult depression screening - positive (finding)*
Review the results.
1. If the result is negative, no further action is needed as they will be automatically added to the measure's Numerator.
2. If the result is positive, record a follow-up plan on the date of the visit or up to 2 days after the date of the visit. The follow-up plan must be one of the following actions.
* **Prescribe pharmaceutical intervention.** Prescribe pharmaceutical intervention (e.g. depression medication) using [Elation's Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) on the date of the visit or two days prior to the visit. Select the appropriate medication from Elation's database (i.e. not a user created medication) in order for the system to calculate the patient in the Numerator. [Click here for a list of medications that meet this requirement](/files/depression-screening-medications.zip).
* **Refer for counseling.** Use the [Referral](/articles/letter-and-referral-introduction) feature to refer the patient for counseling. Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter. ![Visit note for Leonard Smith showing a highlighted referral entry "REFERRAL FOR MENTAL HEALTH COUNSELING (PROCEDURE)" with an Edit link, demonstrating a completed counseling referral as a depression follow-up plan.]()
* **Prescribe other follow-up plan (besides pharmaceutical intervention or counseling).** Take any actions you normally would to prescribe other follow-up plan(s) for depression (see options below). Add the corresponding Document Tag to the visit note to reflect the action taken during the encounter.
### Documenting measure requirements using document tags
Open a visit note draft.
Click + Tag towards the bottom of the visit note draft.
Add one of the following document tags to the visit note draft depending on the patient, results and situation.
* *Adult depression screening: negative (finding)*
* *Adult depression screening: positive (finding)*
* *Adult depression screening: declined (situation)*
* *Adolescent depression screening: negative (finding)*
* *Adolescent depression screening: positive (finding)*
* *Adolescent depression screening: declined (situation)*
Click **Save** to save the document tag to the visit note draft.
### Documenting exclusions
To exclude a **patient that has bipolar disorder**, add a diagnosis of bipolar disorder to the patient's [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026. [Click here for a list of qualifying ICD-10 codes for bipolar disorder](/files/bipolar-disorder-icd10-codes.zip).
### Documenting exceptions
To document that a **patient refuses to participate in or complete the depression screening**:
Click **+ Tag** at the bottom of the visit note draft.
Add one of these Document Tags to the visit note based on the patient's age:
1. 12-17 years old: *Adolescent depression screening - declined (situation)*
2. 18 years and older: *Adult depression screening - declined (situation)*
To document that the **patient has a CMS approved medical reason for not screening the patient for depression**:
Click **+ Tag** at the bottom of the visit note draft.
Add the appropriate document tag from this list:
* *Adolescent depression screening not performed - Procedure contraindicated (situation)*
* *Adolescent depression screening not performed - Treatment not indicated (situation)*
* *Adolescent depression screening not performed - Drug treatment not indicated (situation)*
* *Adolescent depression screening not performed - Absent response to treatment (situation)*
* *Adolescent depression screening not performed - Late effect of medical and surgical care complica...*
* *Adolescent depression screening not performed - Drug resistance (disorder)*
* *Adolescent depression screening not performed - Complication of medical care (disorder)*
* *Adolescent depression screening not performed - Treatment not tolerated (situation)*
* *Adolescent depression screening not performed - Not indicated (qualifier value)*
* *Adolescent depression screening not performed - Contraindicated (qualifier value)*
* *Adolescent depression screening not performed - Allergy to drug (finding)*
* *Adolescent depression screening not performed - Procedure not indicated (situation)*
* *Adolescent depression screening not performed - Intolerance to drug (finding)*
* *Adolescent depression screening not performed - Adverse reaction caused by drug (disorder)*
* *Adolescent depression screening not performed - Drug interaction (finding)*
* *Adult depression screening not performed - Procedure contraindicated (situation)*
* *Adult depression screening not performed - Treatment not indicated (situation)*
* *Adult depression screening not performed - Drug treatment not indicated (situation)*
* *Adult depression screening not performed - Absent response to treatment (situation)*
* *Adult depression screening not performed - Late effect of medical and surgical care complication ...*
* *Adult depression screening not performed - Drug resistance (disorder)*
* *Adult depression screening not performed - Complication of medical care (disorder)*
* *Adult depression screening not performed - Treatment not tolerated (situation)*
* *Adult depression screening not performed - Not indicated (qualifier value)*
* *Adult depression screening not performed - Contraindicated (qualifier value)*
* *Adult depression screening not performed - Allergy to drug (finding)*
* *Adult depression screening not performed - Procedure not indicated (situation)*
* *Adult depression screening not performed - Intolerance to drug (finding)*
* *Adult depression screening not performed - Adverse reaction caused by drug (disorder)*
* *Adult depression screening not performed - Drug interaction (finding)*
[Reference: CMS2v15 eCQM Flow](https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS2-v15.0.000-eCQM-Flow.pdf)
## Measure Information
Depression affects more than two hundred sixty million people across the world and is a leading cause of disability, with a variety of depressive disorders that are independent risk factors for chronic diseases, such as cardiovascular disease and diabetes, lending screening for depression as paramount to identify depressive disorders that can affect the most vulnerable populations (Costantini et al., 2021). Results from a 2018 U.S. survey indicated that 14.4 percent of adolescents (3.5 million adolescents) had a major depressive episode (MDE) in the past year, with nine percent of adolescents (2.4 million adolescents) having one MDE with severe impairment (Substance Abuse and Mental Health Services Administration, 2019). The odds of a diagnosis of depression are believed to be 2.6 times greater for children and adolescents exposed to trauma as compared to those unexposed or less exposed (Vibhakar et al., 2019). Children and teens with major depressive disorder (MDD) have been found to have difficulty carrying out their daily activities, relating to others, growing up healthy, and are at an increased risk of suicide (Siu on behalf of the U.S. Preventive Services Task Force \[USPSTF], 2016).
[Reference: Measure information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0002v15)
## Frequently Asked Questions
### How can I enter a PHQ-2 or PHQ-9 result from the past to count toward this measure's Numerator?
To document a past PHQ-2 or PHQ-9 result, enter it in the Psych section of the patient's Clinical Profile in the exact format shown below:
* Depression: PHQ-2 Score: X (MM/DD/YYYY)
* Depression: PHQ-9 Score: X (MM/DD/YYYY)
For example, a PHQ-9 evaluation performed on May 1, 2025 with a score of 11 will look like:
* Depression: PHQ-9 Score: 11 (05/01/2025)
### Do I need to reference the PHQ-2 or PHQ-9 result in the visit note for it to count towards the Numerator?
No, you do not need to reference any PHQ-2 or PHQ-9 results in visit notes for it to count towards the Numerator. By default, the measure will look for the score and the date of the evaluation in the **Psych** section of the patient's Clinical Profile.
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Document Tags for Visit Notes & Reports Guide](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
# [CMS69v12] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Source: https://help.elationhealth.com/articles/CMS69v12-Preventive-Care-and-Screening-Body-Mass-Index-BMI-Screening-and-Follow-Up-Plan
Elation supports the automatic calculation of CMS69V12, Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
This measure has been removed as an eCQM for Traditional MIPS reporting. This measure is still an applicable eCQM in other programs and is still available in Elation. It will not be eligible to be counted towards Traditional MIPS submissions via QRDA in the 2024 MIPS Performance Year. There are additional ways to report MIPS, please see our [MIPS (2024) Overview](/articles/MIPS-2024-Overview) article to better understand 2024 MIPS measure options.
## Measure Details
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the measurement period AND who had a follow-up plan documented if most recent BMI was outside of normal parameters.
## Measure Parameters
**Numerator:** Patients with a documented BMI during the encounter or during the measurement period, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the measurement period.
**Denominator:** All patients aged 18 and older on the date of the encounter with at least one qualifying encounter during the measurement period
**Exclusions/Exceptions:**
* Patients who are pregnant (with a diagnosis of pregnancy documented in their chart using ICD-10 codes)
* Patients receiving palliative or hospice care
* Patients with a documented medical reason for not documenting BMI or for not documenting a follow-up plan for a BMI outside normal parameters (e.g., elderly patients (65 or older) for whom weight reduction/weight gain would complicate other underlying health conditions such as illness or physical disability, mental illness, dementia, confusion, or nutritional deficiency such as vitamin/mineral deficiency.
* Patients in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient’s health status.
* Patients who refuse measurement of height and/or weight.
These are the exclusion and exception document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* CQM EXCL: BMI MEAS REFUSED
* CQM EXC: BMI ABOVE NORM FOLL REJ
* CQM EXC: BMI ABOVE NORM MEDS REJ
* CQM EXC: BMI BELOW NORM FOLL REJ
* CQM EXC: BMI BELOW NORM MEDS REJ
* CQM EXC: BMI REF WT ASSESSMT REJ
## Elation Workflows
1. Document the patient's BMI by recording height and weight in the visit note. If the patient's BMI is within normal parameters (between 18.5 and 25), no further action is needed.
1. If the patient's BMI is outside normal parameters (either BMI: Overweight or BMI: Underweight), a second Clinical Reminder will appear within a few seconds. Click **Address** next to the clinical reminder and select any of the pop up dialog boxes.
1. Documenting one of the following document tags in a visit note or report (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* Ref to Diet Svc
* Ref to Dietitian
* Ref to Wt Mgt Program
* Diet Cnsl
* Exc Cnsl
* Nutrition Cnsl
## Measure Information
BMI Above Normal Parameters:
Obesity is a chronic, multifactorial disease with complex psychological, environmental (social and cultural), genetic, physiologic, metabolic and behavioral causes and consequences. The prevalence of obesity in adults increased to 42.4 percent in 2018, with the highest percentage among adults in the 40-59 age bracket compared with other age group. Obesity is associated with several comorbid health problems including increased risk for coronary artery disease, type 2 diabetes, obstructive sleep apnea, various types of cancer, gallstones and disability. These comorbid conditions are associated with higher medical care utilization and costs among obese patients.
Screening for BMI and follow-up is critical and will help in reaching the quality goals of population health and cost reduction. However, due to concerns for other underlying conditions (such as bone health) or nutrition-related deficiencies, providers are cautioned to use their best clinical judgment when considering weight management programs for overweight patients, especially the elderly.
BMI below Normal Parameters:
On the other end of the body weight spectrum is underweight (BMI \<18.5 kg/m2), which is equally detrimental to population health. When compared to normal weight individuals(BMI 18.5-25 kg/m2), underweight individuals have significantly higher death rates with a Hazard Ratio of 2.27 and 95% confidence intervals (CI) = 1.78, 2.90. Poor nutrition or underlying health conditions can result in underweight. Therefore patients should be equally screened for underweight and followed up with nutritional counseling to reduce mortality and morbidity associated with underweight.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2024/cms0069v12)
## Related Articles
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# [CMS69v13] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Source: https://help.elationhealth.com/articles/CMS69v13-Preventive-Care-and-Screening-Body-Mass-Index-BMI-Screening-and-Follow-Up-Plan
Elation supports the automatic calculation of CMS69V13, Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan.
This measure has been removed as an eCQM for Traditional MIPS reporting. This measure is still an applicable eCQM in other programs and is still available in Elation. It will not be eligible to be counted towards Traditional MIPS submissions via QRDA in the 2025 MIPS Performance Year. There are additional ways to report MIPS, please see our [MIPS (2025) Overview](/articles/MIPS-2025-Overview) article to better understand 2025 MIPS measure options.
## Measure Details
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the measurement period AND who had a follow-up plan documented if most recent BMI was outside of normal parameters.
## Measure Parameters
**Numerator:** Patients with a documented BMI during the encounter or during the measurement period, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the measurement period.
**Denominator:** All patients aged 18 and older on the date of the encounter with at least one qualifying encounter during the measurement period
**Exclusions/Exceptions:**
* Patients who are pregnant (with a diagnosis of pregnancy documented in their chart using ICD-10 codes)
* Patients receiving palliative or hospice care
* Patients with a documented medical reason for not documenting BMI or for not documenting a follow-up plan for a BMI outside normal parameters (e.g., elderly patients (65 or older) for whom weight reduction/weight gain would complicate other underlying health conditions such as illness or physical disability, mental illness, dementia, confusion, or nutritional deficiency such as vitamin/mineral deficiency.
* Patients in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient’s health status.
* Patients who refuse measurement of height and/or weight and there's documentation of the refusal during the encounter.
These are the exclusion and exception document tags for this measure (**Reference**:[Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* CQM EXCL: BMI MEAS REFUSED
* CQM EXC: BMI ABOVE NORM FOLL REJ
* CQM EXC: BMI ABOVE NORM MEDS REJ
* CQM EXC: BMI BELOW NORM FOLL REJ
* CQM EXC: BMI BELOW NORM MEDS REJ
* CQM EXC: BMI REF WT ASSESSMT REJ
## Elation Workflows
1. Document the patient's BMI by recording height and weight in the visit note. If the patient's BMI is within normal parameters (between 18.5 and 25), no further action is needed.
1. If the patient's BMI is outside normal parameters (either BMI: Overweight or BMI: Underweight), a second Clinical Reminder will appear within a few seconds. Click **Address** next to the clinical reminder and select any of the pop up dialog boxes.
1. Documenting one of the following document tags in a visit note or report (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* Ref to Diet Svc
* Ref to Dietitian
* Ref to Wt Mgt Program
* Diet Cnsl
* Exc Cnsl
* Nutrition Cnsl
## Measure Information
BMI Above Normal Parameters:
Obesity is a chronic, multifactorial disease with complex psychological, environmental (social and cultural), genetic, physiologic, metabolic and behavioral causes and consequences. The prevalence of obesity in adults increased to 42.4 percent in 2018, with the highest percentage among adults in the 40-59 age bracket compared with other age group. Obesity is associated with several comorbid health problems including increased risk for coronary artery disease, type 2 diabetes, obstructive sleep apnea, various types of cancer, gallstones and disability. These comorbid conditions are associated with higher medical care utilization and costs among obese patients.
Screening for BMI and follow-up is critical and will help in reaching the quality goals of population health and cost reduction. However, due to concerns for other underlying conditions (such as bone health) or nutrition-related deficiencies, providers are cautioned to use their best clinical judgment when considering weight management programs for overweight patients, especially the elderly.
BMI below Normal Parameters:
On the other end of the body weight spectrum is underweight (BMI \<18.5 kg/m2), which is equally detrimental to population health. When compared to normal weight individuals(BMI 18.5-25 kg/m2), underweight individuals have significantly higher death rates with a Hazard Ratio of 2.27 and 95% confidence intervals (CI) = 1.78, 2.90. Poor nutrition or underlying health conditions can result in underweight. Therefore patients should be equally screened for underweight and followed up with nutritional counseling to reduce mortality and morbidity associated with underweight.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0069v13)
## Related Articles
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# [CMS69v14] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Source: https://help.elationhealth.com/articles/CMS69v14-Preventive-Care-and-Screening-BMI-Screening-and-Follow-Up-Plan
Elation supports the automatic calculation of CMS69V14, Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan.
This measure has been removed **as an eCQM for Traditional MIPS reporting** .
It remains an applicable eCQM for other programs and will continue to be available in Elation. However, it will **not** be eligible to count toward Traditional MIPS submissions via QRDA for the 2026 MIPS Performance Year. For a list of 2026 MIPS eligible eCQMs, see our [MIPS (2026) Overview](/articles/MIPS-2026-Overview) article.
## Measure Details
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the measurement period AND who had a follow-up plan documented if most recent BMI was outside of normal parameters.
## Measure Parameters
### Numerator
Patients with a documented BMI during the encounter or during the measurement period, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the measurement period.
### Denominator
All patients aged 18 and older on the date of the encounter with at least one qualifying encounter during the measurement period
### Exclusions/Exceptions
* Exclude patients who are pregnant during the measurement period.
* Exclude patients receiving palliative or hospice care.
* Except patients with a documented medical reason for not documenting BMI or for not documenting a follow-up plan for a BMI outside normal parameters (e.g., elderly patients (65 or older) for whom weight reduction/weight gain would complicate other underlying health conditions such as illness or physical disability, mental illness, dementia, confusion, or nutritional deficiency such as vitamin/mineral deficiency; patients in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient’s health status.
* Except patients who refuse measurement of height and/or weight.
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Create a visit note with a date within the measurement period and record the patient's height and weight in the vitals section. After a few seconds, the BMI will be calculated and the Clinical Reminders will updated.  |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | If the patient's BMI is within normal parameters (between 18.5 and 25), no further action is needed. • If the patient's BMI is outside of normal parameters, proceed to **Step 3**. |
| **3** | Click on the **BMI is out of range...** Clinical Reminder at the top of the visit note and select the appropriate follow-up plan.  |
| **4** | The appropriate Document Tag will be appended to the visit note to indicate that the numerator requirements were met during the encounter. |
Clicking
**Dismiss**
will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements from a report
| **1** | Open the report in the patient's chart. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and select one of the appropriate document tags below: **Ref to Diet Svc** • **Ref to Dietitian** • **Ref to Wt Mgt Program** • **Diet Cnsl** • **Exc Cnsl** • **Nutrition Cnsl** |
| **4** | Click **Save** . |
[Click here for more details about Document Tags](/articles/tag-reports-and-notes-with-document-tags).
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Step(s)** |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Exclude patients who are pregnant during the measurement period. | Add a diagnosis of pregnancy in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026. |
| Exclude patients receiving palliative or hospice care. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: EXCLUSION: HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE • EXCLUSION: PALLIATIVE CARE |
| Except patients with a documented medical reason for not documenting BMI or for not documenting a follow-up plan for a BMI outside normal parameters (e.g., elderly patients (65 or older) for whom weight reduction/weight gain would complicate other underlying health conditions such as illness or physical disability, mental illness, dementia, confusion, or nutritional deficiency such as vitamin/mineral deficiency; patients in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient’s health status. | Add a diagnosis ofunderlying health condition, physical disability, mental illness, dementia, confusion, or nutritional deficiency in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date on or prior to December 31, 2026. |
| Except patients who refuse measurement of height and/or weight. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: **CQM EXCL: BMI MEAS REFUSED** • **CQM EXC: BMI ABOVE NORM FOLL REJ** • **CQM EXC: BMI ABOVE NORM MEDS REJ** • **CQM EXC: BMI BELOW NORM FOLL REJ** • **CQM EXC: BMI BELOW NORM MEDS REJ** • **CQM EXC: BMI REF WT ASSESSMT REJ** |
## Measure Information
### BMI Above Normal Parameters
Obesity is a chronic, multifactorial disease with complex psychological, environmental (social and cultural), genetic, physiologic, metabolic and behavioral causes and consequences. The prevalence of obesity in adults increased to 42.4 percent in 2018, with the highest percentage among adults in the 40-59 age bracket compared with other age group. Obesity is associated with several comorbid health problems including increased risk for coronary artery disease, type 2 diabetes, obstructive sleep apnea, various types of cancer, gallstones and disability. These comorbid conditions are associated with higher medical care utilization and costs among obese patients.
Screening for BMI and follow-up is critical and will help in reaching the quality goals of population health and cost reduction. However, due to concerns for other underlying conditions (such as bone health) or nutrition-related deficiencies, providers are cautioned to use their best clinical judgment when considering weight management programs for overweight patients, especially the elderly.
**BMI below Normal Parameters**
On the other end of the body weight spectrum is underweight (BMI \<18.5 kg/m2), which is equally detrimental to population health. When compared to normal weight individuals(BMI 18.5-25 kg/m2), underweight individuals have significantly higher death rates with a Hazard Ratio of 2.27 and 95% confidence intervals (CI) = 1.78, 2.90. Poor nutrition or underlying health conditions can result in underweight. Therefore patients should be equally screened for underweight and followed up with nutritional counseling to reduce mortality and morbidity associated with underweight.
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0069v14)
**Related Articles**
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
# COVID-19 Vaccination Recommendations
Source: https://help.elationhealth.com/articles/COVID-19-Vaccination-Recommendations
This article outlines recommendation based on a few vaccination scenarios to help you manage your patient panel and create a vaccination strategy
We know that a top priority for you in 2021 is ensuring your patients are vaccinated against COVID-19. We’ve outlined recommendations below based on a few vaccination scenarios to help you manage your panel and create a vaccination strategy.
This article provides an overview of each scenario and recommendations and links to more information and detailed workflows where needed.
Please select the scenario that is applicable to your practice:
1. [I would like more information on becoming a COVID-19 vaccine administration site](#administering)
2. [My practice is administering the COVID-19 Vaccine](#vaccine_available)
3. [My practice is referring patients elsewhere for their COVID-19 vaccine](#no_vaccine)
4. [My patient has already received the COVID-19 vaccine elsewhere and I need to document it in Elation](#already_received)
## 1.) I would like more information on becoming a COVID-19 vaccine administration site
If you’re interested in administering the COVID-19 vaccine, contact your jurisdiction’s Immunization Information System (IIS) (commonly known as an Immunization Registry) or Department of Health to learn how to enroll in the COVID-19 vaccination program.
* **[Directory of State Immunization Information Systems (ISS)](https://www.cdc.gov/vaccines/programs/iis/contacts-locate-records.html)**
* **[Directory of Local Health Departments](https://www.naccho.org/membership/lhd-directory)**
* **[Directory of State Health Departments](https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html)**
After you’ve been approved to administer the vaccine, please refer to the following recommendations on how to use Elation to help recall patients, document vaccines, and report administration to your IIS.
## 2.) My practice is administering the COVID-19 vaccine.
After you’ve been approved to administer the vaccine, you can use Elation to help recall patients, document vaccines, and report administration to your IIS. This section gives a brief overview of how to achieve this in Elation.
\*\*For a comprehensive guide on managing your complete COVID-19 vaccination workflow in Elation, from configuring your settings to recalling patients for their second dose, please visit our workflow guide \*\*
[here](/articles/Administering-the-COVID-19-Vaccine-Workflow-Guide)
\*\*. \*\*
### Recall and Scheduling
To proactively identify and notify patients in your panel who are eligible, you can use Elation’s Patient List and bulk letter feature.
In the [Patient List](/articles/find-patients-with-elations-patient-list), consider applying filters to narrow your results to the eligible cohort. For example:
* Apply the **Age** filter and specify patients older than 64.
* Apply the **Active Problems in Clinical Profile** filter and specify patients with certain high-risk diagnoses in their problem list.
* Apply the **Vaccinations in Clinical Profile** filter and exclude patients who already have a COVID-19 vaccine documented in their chart.
The Patient List results conveniently includes patients’ phone numbers as well as if they have upcoming appointments.
From the Patient List, you can also send a Bulk Letter to notify patients via Patient Passport and/or with a printable mailer. For more detailed guidance on how to create a Bulk Letter, please refer to this [help center article](/articles/introduction-to-bulk-letters).
We recommend creating a [dedicated appointment type](/articles/calendar-and-booking-settings) in Elation to track your “COVID-19 Vaccine” visits. You can also consider making this appointment type available on your [Booking Site](/articles/Patient-Booking-Site) for patient self-scheduling.
### Documenting the vaccine
Use Elation’s structured vaccine form in the Clinical Profile to document your patient’s vaccine. This form saves vaccine details (dose, lot number, manufacturer, and expiration date) so that you don’t need to re-type this information for every administration.
### Reporting administration to your state IIS
Reporting deadlines vary by state, immunizations generally need to be reported within 72 hours of administration at the latest. Please inquire with your state IIS on deadlines and instructions for how to report the required patient demographics and vaccine details.
## 3.) My practice is referring patients elsewhere for their COVID-19 vaccine.
If you’re trying to refer patients for their COVID-19 vaccines, please check your local jurisdiction guidelines to find out which populations are eligible and to find administration sites.
[Directory of Local Health Departments](https://www.naccho.org/membership/lhd-directory)
[Directory of State Health Departments](https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html)
\*\*For more detailed guidance on how to proactively identify, tag, and notify patients in your panel who are eligible for the vaccine, please visit our workflow guide \*\*
[here](/articles/Administering-the-COVID-19-Vaccine-Workflow-Guide)
**.**
## 4.) My patient has already received the COVID-19 vaccine and I need to document it in Elation.
If your patient received the vaccine elsewhere, you are not responsible for reporting the immunization to your state IIS, but you should update this information in Elation.
Ask your patient to bring in their vaccine card and document the vaccine in the Clinical Profile of their chart.
1. Scroll to the Immunization section of the Clinical Profile. Click **+ Add Vaccination Details**
2. Start typing the name of the vaccine and select the vaccine from the dropdown results. Fill in what you’re able to with the available vaccine details.
3. Change the **Given By** field to a description of where your patient got vaccinated.
4. Click **Save**.
Alternatively, you can also contact the vaccine site to request a Direct Message with the vaccine details. The benefit of this method is that the immunization details will arrive in your Elation account and the patient’s chart in a structured format so you do not need to manually document yourself. If asked for your Direct Address, you can locate your Direct Address under your [profile settings page](https://app.elationemr.com/settings/useraccount/).
If you need additional assistance from our team on how best to manage your workflow please
[Contact Support](https://help.elationemr.com/s/contactsupport)
.
# Calendar & Booking Site Guide - Specifying Provider availability by Practice Location & Appointment Type
Source: https://help.elationhealth.com/articles/Calendar-Booking-Site-Guide-Enhanced-Provider-availability-by-Practice-Location-Appointment-Type
This article details enhancements to provider availability and scheduling.
This article only describes the ability to set Provider scheduling availability by Practice Location and Appointment Type on the Elation Calendar and Patient Booking Site. Please reference the [Calendar Guide - How to set up the provider calendar](/articles/calendar-and-booking-settings) and [Patient Booking Site Guide](/articles/Patient-Booking-Site) for more information about other Calendar and Booking Site related features.
## Overview
### What is Provider Availability?
The Provider availability and scheduling features allow Practices to:
* Define the availability of each Provider Level User for any Practice Location and Appointment Type within the EHR. (This is sometimes called setting availability templates, schedule templates, or office hours by location.) This availability will be visible on both the Practice Home calendar and the Booking Site calendar for each Provider Level User.
* Specify overlapping availability for different Practice Locations and Appointment Types.
* Assign a specific time zone to each Practice Location to ensure accurate configuration and patient communication regarding appointments.
### Why is Provider Availability important?
The Provider availability and scheduling features:
* Provide scheduling control and accuracy because:
* Staff can now visually discern on the Calendar both the availability of each Provider and the specific appointment types they are available for.
* Patients using the Booking Site can only select appointments based on the Provider's chosen Practice Locations and Appointment Types.
* Help practices with multiple Practice Locations segment their patients according to each Provider's availability
* Ensure that practices operating across different time zones:
* Provide clear time zone details to patients on the booking site.
* Accurately send appointment details to patients in their respective time zones.
### How Availability, Events, and Booking Work together
Provider availability, calendar events, and the Booking Site all use the same scheduling feature. Understanding how these elements interact helps you configure your calendar accurately.
#### Key scheduling elements
* Provider Availability (by location and appointment type): Weekly recurring time rules that define when a provider can see patients at each Practice Location for specific appointment types. Also referred to as availability templates, schedule templates, or office hours by location.
* **Appointments:** Booked patient visits that occupy calendar time and block additional bookings in that slot.
* Calendar Events: Events on the calendar that occupy time slots. By default, calendar events block patient self-scheduling via the Booking Site. However, staff and providers can still manually book appointments over these times if needed. These include:
* Events you create directly in Elation (such as lunch blocks, meetings, or personal time)
* Events synced from Google Calendar
* Non-Blocking Placeholders: Internal preference cues that do not block booking. Patients can still book appointments during these times via the Booking Site if the provider's main availability allows it. Non-Blocking Placeholders are internal-only and will not appear on your Booking Site.
#### Booking Site and Quick Reschedule evaluation order
When patients view the Booking Site or staff use Quick Reschedule, the system checks availability in this order:
1. Is the provider's availability configured for this location and appointment type?
2. Is the time slot already occupied by an appointment or a calendar event (including synced Google Calendar events)?
3. Does the appointment type meet the minimum notice requirement?
### What actually blocks the Booking Site?
Use this quick reference to understand which calendar elements prevent patients from booking appointments online.
| Calendar Element | Blocks Patient Self-Booking? | Can Staff/Providers Still Book Manually? | Notes |
| --------------------------------------------------------- | ---------------------------- | ---------------------------------------- | ---------------------------------------------------------------------------------------------- |
| Appointments | Yes | Yes | Booked slots are unavailable. |
| Calendar Events (including synced Google Calendar events) | Yes | Yes | Events block patient self-booking by default, but staff can manually book over them if needed. |
| Non-Blocking Placeholders | No | Yes | Internal-only; patients can still book during these times via the Booking Site. |
Non-Blocking Placeholders are meant only as internal preference cues for staff. They do not appear on your Booking Site and do not prevent patients from booking.
### Current limitations of Enhanced Availability
Keep these limitations in mind when configuring provider schedules:
* Weekly patterns only: Availability is configured as weekly recurring patterns. You cannot set availability for a single specific date (e.g., **this one Wednesday only**) without making manual adjustments.
* No automatic rotating schedules: There is no native "every other week" rule. Rotating or irregular schedules must be modeled using weekly patterns plus manual overrides.
* Manual updates for varying hours: Providers who want varying monthly hours on the Booking Site must manually adjust their availability as their schedule changes.
## Workflow Instructions
### Configuring availability preferences for a Provider
The ability to adjust Provider availability preferences can be limited to [Admin Level Users](/articles/administrative-privileges) if the Admin Only toggle located in the top right corner of the Calendar & Booking settings page is toggled on (green).
#### Verifying each Practice Location has the correct time zone
To ensure the Booking Site displays the correct time zone for each Practice Location, make sure the time zone for each Practice Location is accurate when setting availability.
If you attempt to add availability for a Practice Location that does not have a time zone set, you will see the following Location needs a time zone alert. You must click Update location time zone and set a time zone before you can add availability to the location.
![Calendar & Booking Availability tab showing "Elation New York" location expanded for Beverly Crusher, MD with a yellow "Location needs a time zone" warning and an "Update location time zone" link.]()
#### Configuring availability for a Practice Location
![Provider Availability settings for Beverly Crusher, MD showing three configured locations (Elation - AL - Whitewater, Telehealth, GA - Veterans Pkwy), with callouts identifying controls to add locations, expand/collapse availability, update timezone, and an open Appointment Types dropdown for Monday showing Follow-Up and Office Visit checked, plus overlapping availability alert icons on Monday and Wednesday.]()
To define the availability for a specific Practice Location for Provider Level User:
1
Go to Settings → Calendar & Booking and then click into the Availability section.
2
Find the Provider whose availability settings you want to update and click on the arrow to expand their availability preferences.
3
Existing Booking Site users will see the Provider's pre-existing availability preferences linked to the primary Practice Location for the practice. By default, all **Appointment Types** will be associated with the pre-existing specified time frames.
* To edit their availability for the primary Practice Location, jump to step 5 below.
4
[Click here for more information on how to add additional practice locations to your practice settings](/articles/adding-a-second-practice-location#AddLocation) .
To define availability for a new Practice Location for that Provider, click + Add Location .
5
To edit the availability for any Practice Location, click Edit Availability .
5a
If the chosen time frame overlaps with the availability of another Practice Location, you will notice an alert icon next to the time frame indicating this overlap. Place your mouse cursor over the alert icon to see which Practice Location it overlaps with.
If a time frame does not have both a Start Time and End Time , Elation will not allow you to save the time frame.
Select the Start Time and End Time for any day of the week as needed. The selected time will correspond to the time zone configured for that Practice Location. If you need to update the time zone for that Practice Location, click the Update button next to the time zone displayed for that Practice Location.
5b
By default, all Appointment Types will be associated with that day of the week. To change the Appointment Types available, click on the Appointment Types dropdown and then unselect the Appointment Types that you want to remove for that timeframe. The selected Appointment Types will appear on the main Settings page, as space allows. Click Show all… if you want to see the expanded list of the selected Appointment Types. ![Provider availability settings for Beverly Crusher, MD at Elation South, showing Mon–Fri 9 AM–5 PM with Friday's appointment types truncated and a highlighted "Show all 5" link.]()
5c
To delete an availability time frame, click the trash can icon. To add a new availability time frame for that day of the week, click the + icon.
6
Once you are done defining the availability for that Practice Location, click Save Availability to save your changes.
* To discard your changes, click Cancel.
* To remove all of the availability for that Practice Location, click Remove Availability.
7
**Repeat for other locations** - To define availability for the same Provider for another Practice Location, repeat steps 4 through 7.
8
**Repeat for other providers** - To define availability for another Provider in your practice, repeat steps 2 through 7.
#### Removing availability for an entire Practice Location
To completely remove a location and all of its availability for a Provider Level User:
| 1 | Go to Settings → Calendar & Booking and then click into the Availability section. |
| - | --------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Find the Provider whose availability settings you want to update and click on the arrow to expand their availability preferences. |
| 3 | Click Edit Availability for the Practice Location you want to remove. |
| 4 | Click Remove Availability . |
Take caution when removing availability because it cannot be restored.
#### Removing availability within a Practice Location
To completely remove availability for a specific day of the week or a specific Appointment Type for a Provider Level User:
| 1 | Go to Settings → Calendar & Booking and then click into the Availability section. |
| - | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Find the Provider whose availability settings you want to update and click on the arrow to expand their availability preferences. |
| 3 | Click Edit Availability for the Practice Location you want to edit. |
| 4 | To delete an availability time frame, click the trash can icon. |
| 5 | To remove an Appointment Type from a time frame, click on the Appointment Types dropdown and unselect the Appointment Types that you want to remove for that timeframe. |
| 6 | Once you are done editing the availability for the Practice Location, click Save Availability to save your changes. |
Take caution when removing availability because it cannot be restored.
### Viewing a Provider's availability on the EHR Calendar
![EHR Calendar for Monday 07/08 showing two overlapping gray availability bars at 9am with callouts identifying "Overlapping availability," "Availability details" for two locations (Telehealth 9am–12pm and Whitewater 9am–2pm), and diagonal stripes labeled "Outside of available time frame."]()
A Provider Level User's availability is marked using gray vertical bars in their EHR Calendar. Place your cursor over an availability bar to see the availability details. Each availability bar indicates when the provider is available, which location they are working at, and which Appointment Type(s) you can book. If there is overlapping availability then you will see multiple appointment bars in parallel.
In periods when the Provider is unavailable, the Calendar will display diagonal stripes. Your office can still schedule appointments during these time frames if necessary.
#### Adding appointments to the calendar when availability is configured
To schedule appointments on the calendar for a Practice Location where the Provider is available:
| 1 | Click on the gray vertical bar for the corresponding Practice Location at the time the appointment starts. |
| - | ---------------------------------------------------------------------------------------------------------- |
| 2 | The Location field will automatically populate the Practice Location you clicked on. |
| 3 | Fill in the remaining appointment details and then click Create Appointment . |
You can click in the white space of the Calendar to schedule appointments. However, this will set the Location field to **No location specified** by default. You can schedule appointments during any unavailable timeframes by clicking a time in the timeframe or click + Appointment .
### Displaying a Provider's availability on the Booking Site
Two steps are required for a provider to appear on the Booking Site: The appointment type must be marked as available on the Booking Site using the Show this appointment type on the booking site checkbox.
The provider must be listed under Providers in that appointment type's Booking Site section. Setting availability alone is not enough. If either step is missing, patients will not see that provider for that appointment type on the Booking Site.
To ensure that the available appointments are displayed correctly on the [Patient Booking Site](/articles/Patient-Booking-Site):
| 1 | Go to the Appointment Type Settings. |
| - | -------------------------------------------------------------------------------------------- |
| 2 | Click Edit for the Appointment Type you want to make available on your Booking Site. |
| 3 | Check off the Show this appointment type on the booking site box. |
| 4 | Select the name of any Provider you want visible for that Appointment Type under Providers . |
To share a direct URL for each Appointment Type with patients:
| 1 | Go to the Appointment Type Settings. |
| - | ------------------------------------------------------------------------------------------------------------------ |
| 2 | Go to the summary box of the Appointment Type you want to share. |
| 3 | Look for the **Direct URL** under the Booking Site section and click Copy . |
| 4 | Share the **Direct URL** with the patient using any method of your choice (e.g. link it to your business website). |
#### Viewing a Provider's availability on the Patient Booking Site as a patient
The [Patient Booking Site](/articles/Patient-Booking-Site) will only display the Provider availability configured in the Calendar & Booking settings. When patients first navigate to your practice booking site, they will see a list of all available Practice Locations. Patients can narrow down the availability displayed by selecting a Practice Location, and/or filtering by Provider, Appointment Type, or Time zone.
**Default Booking Site display:**
![Patient Booking Site showing three available locations — Elation AL Whitewater, Elation GA Veterans Pkwy, and Elation AL Telehealth — each with a "View Available Appointments" link. Filters for Provider, Appointment Type, and Timezone are shown at the top.]()
**Booking Site display after a Practice Location is selected:**
* If the patient selects a Practice Location, the page will display available providers and appointments for that Practice Location and the appointment times will display in the Practice Location's default time zone unless the patient changes the time zone selection at the top of the Booking Site.
![Patient Booking Site showing Elation - AL - Whitewater location selected, with Beverly Crusher MD's Follow-Up and Office Visit slots available tomorrow starting 9:00 AM, and Physical Exam slots today from 3:45 PM. Timezone filter shows America - Chicago (CDT).]()
### Configuring rotating or irregular schedules
If a provider works a rotating schedule (e.g., Mondays & Wednesdays one week, Tuesdays & Thursdays the next), you can still manage their availability using weekly patterns and manual overrides.
**Supported behavior:**
* Availability is configured as weekly recurring patterns by location and appointment type.
* You can define multiple availability blocks per day and remove availability for specific days or locations.
* There is no native "every other week" rule. Rotating schedules must be modeled using recurring weekly patterns plus manual overrides.
#### Example Scenario
Provider works Mondays and Wednesdays one week and Tuesdays and Thursdays the next:
| 1 | Set a pattern that covers all potential work days. For example, set availability for Mondays through Thursdays, 9:00 AM-5:00 PM. |
| - | ------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | **For weeks when the provider does not work on certain days,** add a calendar event on those specific days to prevent patient self-booking. |
| 3 | **For one-off days when the provider is working outside their usual pattern,** remove any calendar events that would prevent booking. |
For complex patterns over a limited window (e.g., 2-3 months), set a baseline weekly template and then use one-off overrides on specific days as needed.
### Storing & utilizing a patient's time zone preferences
To ensure that appointment confirmation and reminder notifications display the appointment date and time according to the patient's preference, save each patient's preferred time zone in their [Patient Demographics](/articles/Patient-Demographics-Guide). The Time zone field is in the **Contact Information** section of Patient Demographics.
Any patient communications sent by the EHR will follow these time zone rules:
1. If a patient’s preferred time zone is saved for the patient then appointment confirmation and appointment reminder notifications will use the preferred time zone.
2. If a patient's preferred time zone is not saved, but their Patient Demographics include a valid zip code, appointment confirmation and reminder notifications will calculate the appropriate time zone based on the patient's zip code and use it for sending notifications.
3. For practices with a single Practice Location:
4. If a patient's preferred time zone is not saved AND the patient does not have a valid zip code in the Patient demographics, then appointment confirmation and appointment reminder notifications will use the time zone of your practice’s primary Practice Location.
5. For practice’s with multiple Practice Locations:
6. If a patient's preferred time zone is not saved AND the patient does not have a valid zip code in the Patient demographics, then the appointment confirmation and reminder notifications will be based on the time zone associated with the Practice Location of the appointment.
* If the Practice Location of the appointment does not have a defined time zone, then we will use the time zone of your practice’s primary Practice Location.
* Go to your Practice Location Settings to define a time zone for each Practice Location. Contact Elation Support if you need to update the time zone of your practice’s primary Practice Location.
2. If a patient's preferred time zone is not saved AND the patient does not have a valid zip code in the Patient demographics, AND the Practice Location for the appointment does not have a time zone set, then appointment confirmation and appointment reminder notifications will use the time zone of your practice’s primary Practice Location.
## Frequently Asked Questions (FAQ)
### Why are changes to availability not saving?
If a time frame does not have both a Start Time and End Time, Elation will not allow you to save that time frame. Add both a Start Time and End Time to save availability preferences.
### I work in multiple time zones. How should I indicate my Practice Hours on my Booking Site?
Currently, you are unable to designate a time zone for your Booking Site Practice Hours. We recommend leaving the Practice Hours blank if you have Practice Locations in different time zones.
### Can I specify which locations appear on the booking site?
Currently all locations configured on the Practice Locations Settings page will appear on the Booking Site.
### I sometimes see patients virtually or I run a fully virtual practice, how should I set up my availability?
To set your practice up to use the Booking Site for virtual appointments, we recommend taking the following two actions:
1
If the Practice Location offers both in-person and virtual appointments, set up two versions of the Practice Location - one for each.
Adjust the Practice Location of any provider offering virtual appointments to match the provider's time zone.
2
Save each patient's preferred time zone in their Patient Demographics.
This ensures that Providers see their calendar in the Provider's own time zone and patients receive communications in the patient's preferred time zone.
### Why can I only set Availability Start and End times in 15-minute increments?
The Start Time and End Time pickers in Availability settings snap to 15-minute marks. This is separate from the **Appointment Time Block Intervals** setting under **Settings** → **Calendar & Booking** → **Calendar view**, which controls how granularly appointment slots display on the Calendar. See [Calendar and Booking Settings](/articles/calendar-and-booking-settings#managing-the-calendar-view) for more on that setting.
### Can I enter availability that changes week to week?
Yes, but not with an automatic "every other week" rule. You can configure a recurring weekly template and then adjust specific dates on the calendar.
For a detailed example, see the[Configuring Rotating or Irregular Schedules](#configuring-rotating-or-irregular-schedules)section above.
### If I am also using Elation's Workspaces feature, what Time Zone will the Availability on my Calendar display in?
If you are using Elation's [Workspaces](/articles/workspaces-guide) feature, the Availability will display based off of the Time Zone your Workspace is configured for.
## Related Articles
* [Calendar Guide- How to set up the provider calendar](/articles/calendar-and-booking-settings)
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Practice Locations Guide- Listing your service locations](/articles/adding-a-second-practice-location)
# Calendar Guide - Checking patients in for their appointment
Source: https://help.elationhealth.com/articles/Calendar-Guide-Checking-patients-in-for-their-appointment
This guide will describe the steps you can take to check a patient in for their appointment.
## Overview
### What is patient check-in?
Patient check-in is the process of updating a patient's appointment status when they arrive at your practice. Elation provides several status options—**Checked In**, **In Room**, **In Room - Vitals Taken**, and **With Doctor**—to help you track where patients are throughout their visit.
### Why should I check patients in?
Checking patients in for their appointment allows you to:
* Properly record the patient's journey as they are being seen in your practice
* Trigger actions in Elation, such as a Medication History Download for walk-in patients
* Verify patient demographics upon arrival
* Track patient location if you have multiple triage areas or exam rooms
## Workflow Instructions
### Updating the appointment status
For each appointment in the Calendar, clicking on the colored space in the appointment will display a pop-up box with the patient's appointment status.
#### Verifying demographics with the 'Checked In' status
When you update the **Status** of the appointment to **Checked In**, the patient's demographics will open for you to review the accuracy of the information with the patient upon check-in. If any changes are made, click **Save & Close** to save your changes.
For walk-in patients, the demographics verification will assist with triggering a [Medication History Download](/articles/retrieving-previous-medication-history-for-your-patients) for the patient.
#### Indicating patient location throughout the appointment
The following appointment statuses allow you to record the physical location of the patient throughout their appointment, especially if you have multiple triage areas or exam rooms:
* **In Room**
* **In Room - Vitals Taken**
* **With Doctor**
[Click here for instructions on how to edit your exam rooms](/articles/calendar-and-booking-settings#Exam_Rooms).
### Collecting payment
It is important to collect payment for services rendered from patients when they are in the office with you. Studies show that the chance of collecting from a patient drops almost 20% as soon as the patient leaves the office. We recommend collecting payment from patients upon check-in (or check-out if preferred) using Elation's secure payment collection feature or a method of your own.
Review our [Patient Payments Guide](/articles/using-elation-to-securely-collect-patient-payments) to learn more about the secure patient payment collection feature in Elation.
### Recording payment details
Once you have collected payment information from patients, you can record the payment details in the appointment as one way of sharing the information with your biller.
For customers using the secure payment collection feature, the biller can reference the **Patient Payment Report** under the **Reports** button at the top of Elation to locate patient payment information.
To record payment details in the appointment:
| **1** | Click on the colored space in the appointment. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Edit** to open the **Edit Patient Appointment** box. |
| **3** | Enter any payment collected in the **Patient payment** field and enter any notes related to the payment (e.g., method of payment) in the **Billing notes** field. |
| **4** | Click **Save** to save the payment details. |
When the biller looks at the billing information for that day's visit, they will see the payment information and notes.
![Edit Patient Appointment dialog showing Patient payment field set to 20.00 and Billing notes "Copaid paid by check" (highlighted), alongside the Billing Report displaying the same 20.00 and note for Donald James Jones's visit.]()
## Frequently Asked Questions (FAQ)
**Can I use Elation as a kiosk?**
Elation does not currently provide a dedicated kiosk user interface. However, you can simulate the process by doing the following:
* Using **Patient Forms** on a clinic-owned tablet for intake (demographics, questionnaires, consents).
* Manually updating check-in status in the **Calendar**.
* Collecting copays with **Patient Payments**.
For a more robust intake experience with patient self-identification, consider a third-party intake partner such as Updox or IntakeQ. See the [Patient Intake & Check-In Options](/articles/Patient-Intake-Check-In-Options) article for recommended patterns and partner integrations.
## Related Articles
* [Medication History Download Introduction](/articles/retrieving-previous-medication-history-for-your-patients)
* [Patient Payments Guide - Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Billing Guide - Creating a Super Bill and coding for your visit](/articles/billing)
* [Calendar and Booking Settings](/articles/calendar-and-booking-settings)
* [Patient Intake & Check-In Options](/articles/Patient-Intake-Check-In-Options)
# Calendar Guide - Managing cancellations, no-shows, overbooking, and recalls
Source: https://help.elationhealth.com/articles/Calendar-Guide-Managing-special-appointment-use-cases
This article explains how to handle common appointment disruptions in Elation—including planned cancellations, unplanned no-shows, overbooking scenarios, and patient recall workflows—so your practice can maintain an efficient schedule and ensure patients receive timely follow-up care.
## Overview
**Full Name (a.k.a. preferred name) used in cancellation emails.** When a patient has a Full Name (preferred/actual name) set in their demographics, that name—not their legal name—is used in the cancellation email patients receive after canceling through a reminder. See the [Patient Demographics Guide](/articles/Patient-Demographics-Guide) for more on the Legal Name vs. Full Name fields.
### How do I manage special appointment use cases?
You can use appointment statuses and appointment reminders to keep your schedule accurate, reduce no-shows, and make it easier for your team to handle cancellations, overbooking, and follow-up work.
### Why is managing appointment statuses important?
Appointment statuses track where a patient is in their visit journey. Accurate status tracking helps your practice:
* Identify patients who need follow-up after missed appointments.
* Generate reports to analyze cancellation and no-show trends.
* Ensure billing workflows proceed correctly.
* Maintain visibility into provider schedules for the entire care team.
Elation supports the following appointment statuses:
| Appointment status | Meaning |
| -------------------------------- | ------------------------------------------------------ |
| Scheduled | Appointment is booked but the patient has not arrived. |
| Confirmed | Patient has confirmed the appointment via a reminder. |
| Checked In | Patient has arrived and demographics were verified |
| In Room / In Room - Vitals Taken | Patient is in an exam room. |
| With Doctor | Patient is with the provider. |
| Checked Out | Visit is complete. |
| Canceled | Appointment was canceled. |
| No Show (Not Seen) | Patient did not attend. |
| Billed | Billing has been processed. |
### Why is using appointment reminders important?
Automated appointment reminders ensure patients have the information they need to attend their visit. Reminders can also allow patients to confirm, reschedule, or cancel appointments directly—updating your calendar in real time.
For complete setup instructions, delivery options, and troubleshooting, see the [Calendar Guide - Using automated appointment reminders](/articles/appointment-reminders) article.
## Workflow Instructions
### Handling appointment cancellations
When a patient notifies you in advance that they need to cancel, you can update the appointment status and optionally reschedule using [Quick Reschedule](#quick_reschedule).
#### Canceling from the Calendar
| 1 | Click in the shaded area of the appointment to open the appointment popover box. |
| - | -------------------------------------------------------------------------------- |
| 2 | Update the Status to Canceled . |
| 3 | If the patient prefers to reschedule, use the Quick Reschedule workflow below. |
#### Using Quick Reschedule
Quick Reschedule streamlines moving appointments by letting you instantly select a new date and time without leaving your current workflow.
| 1 | Click in the shaded area of the appointment to open the appointment popover box. |
| - | ----------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Click Show suggested times next to Quick Reschedule . |
| 3 | Select a new appointment time from the list of the next six available options, based on the appointment's Location , Duration , and the provider's Availability . |
| 4 | Click Save new time . |
The Location field must be filled in to use Quick Reschedule.
#### When patients cancel via appointment reminders
If you have enabled the Allow patients to cancel their appointments online setting, patients can cancel directly from their appointment reminder.
When a patient cancels through a reminder:
* The appointment status updates to Canceled
* The patient receives a follow-up text or email
* If you use the Patient Booking Site, the patient will be prompted to book a new appointment
* The time slot becomes available for other patients to book
For complete setup instructions and configuration options, see the [Calendar Guide - Using automated appointment reminders](/articles/appointment-reminders) article.
### Handling unplanned no-shows
When a patient misses their appointment without prior notice, update the status and use reports to track patterns and follow up.
#### Setting the status to No Show
| 1 | Click in the shaded area of the appointment to open the appointment popover box. |
| - | -------------------------------------------------------------------------------- |
| 2 | Update the Status to No Show . |
The **No Show** status may appear as **Not Seen** in some reports.
#### Tracking no-shows with reports
Use the Appointment Report or Appointment Dashboard to identify no-show patterns.
##### Appointment Report
| 1 | Click Reports → Appointment Report at the top of any page in Elation. |
| - | ------------------------------------------------------------------------------------------ |
| 2 | Select the provider and date range. |
| 3 | Click Update List . |
| 4 | Download as CSV to sort by appointment status and group all no-show appointments together. |
[Click here for more information about the Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments).
##### Appointment Dashboard (Premium EHR Only)
The dashboard displays a graph of **Appointments by Status** with quick-view counts for:
* Total Appointments
* Canceled Appointments
* No Show Appointments
* Canceled Ratio
* No-Show Ratio
[Click here for more information about the Appointment Dashboard](/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting#appointment_dashboard).
#### Following up with no-show patients using Patient List
Use the Patient List Report to generate contact lists for appointment recalls.
| 1 | Click Reports → Patient List in the blue bar at the top of Elation. |
| - | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| 2 | Apply filters such as: Last Appointment – to find patients who haven't been seen recently • Next Appointment – to identify patients without upcoming visits • Patient Status – to filter for active patients |
| 3 | Click Generate List . |
| 4 | Use the results to contact patients and schedule follow-up appointments. |
The Patient List Report is useful for patient outreach—generate contact lists for preventive care reminders or appointment recalls.
For more details, see the [Patient List Report Guide - Searching your patient panel](/articles/find-patients-with-elations-patient-list) article.
#### Using Office Messages for recall workflows
You can use Office Messages to create internal reminders for patient follow-up.
| 1 | Send an Office Message about the patient to the appropriate staff member. |
| - | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Use the Pd (post-date) field to schedule the message for a future date as a reminder. |
| 3 | Use the Recall patient Quick Reply option, which sends the message: **Please call the patient in for appointment.** For more information, see the [Office Message Feature Guide - The enhanced inter-office communications tool](/articles/Office-Message-Feature-Guide) article. |
### Overbooking and double-booking procedures
#### Double-booking appointments
Elation allows you to book multiple appointments in the same time slot when scheduling manually.
To book multiple appointments in the same time slot, click on the white space to the right of the time slot. The most recently booked appointment will appear on top.
#### Booking Site limitation for double-booking
Each appointment slot on the Patient Booking Site can only be booked by one patient. Elation does not allow double-booking the same time slot through the Booking Site.
If a provider is already booked for another appointment or event, the availability for that provider will be automatically updated on the Booking Site to avoid double-booking.
#### Maintaining a manual waitlist
Elation does not currently have a native waitlist feature.
To manage patients waiting for earlier appointments, consider:
* Maintaining a manual list (spreadsheet or Office Message thread)
* Using the Patient List Report to identify patients who need rescheduling
* Contacting patients directly when cancellations occur
### Using appointment reminders and Booking Site configurations
Appointment reminders and Booking Site settings directly impact how your practice handles cancellations, no-shows, and rescheduling. Understanding these configurations helps you optimize your workflows.
#### Using appointment reminders to reduce no-shows
Automated appointment reminders ensure patients are notified of their upcoming appointment in a timely manner.
For complete setup instructions, delivery options, and troubleshooting, see the [Calendar Guide - Using automated appointment reminders](/articles/appointment-reminders) article.
#### Booking Site cancellation and rescheduling behavior
When patients cancel through an appointment reminder:
* The appointment status updates to Canceled
* The time slot becomes available for other patients to book
* If Booking Site is enabled, patients are prompted to reschedule immediately
You can also share a cancellation policy message in your Booking Site settings.
Elation displays the cancellation policy but does not enforce it.
For full configuration options, see the [Patient Booking Site Guide](/articles/Patient-Booking-Site) article.
#### Checking reminder status for an appointment
To verify whether a patient received their reminders:
| 1 | Click in the shaded area of the appointment in the Calendar. |
| - | --------------------------------------------------------------------- |
| 2 | Select Edit . |
| 3 | Review the Activity Log section at the bottom of the appointment box. |
![]()
## Frequently Asked Questions
### How do I see all no-show appointments for a time period?
Download the Appointment Report as a CSV file and sort by the **Status** column to group all no-show appointments together.
### Can patients reschedule their own appointments?
Patients can confirm or cancel appointments via the appointment reminder and can then reschedule through the Booking Site, if the Booking Site is enabled. If they need to reschedule before receiving a reminder, they must call the office.
### What happens when a patient cancels through the Booking Site or reminder?
The time slot becomes available for other patients to book.
### Can I create a waitlist for patients who want earlier appointments?
Elation does not have a native waitlist feature. You will need to manage this manually and contact patients when openings occur.
### Why didn't my patient receive an appointment reminder?
If the patient only has **Work**, **Night**, **Fax**, or **Other** phone number types in their demographics, Elation will not send reminders. Ensure patients have a **Mobile** phone (opted in to SMS), email address, or **Home**/**Main** phone number on file.
### How do I track patients who are overdue for follow-up visits?
Use the Patient List Report with filters like Last Seen and Patient Status to identify patients who haven't been seen recently and need to schedule appointments.
## Related Articles
* [Calendar Guide - Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar)
* [Calendar Guide - Using automated appointment reminders](/articles/appointment-reminders)
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Patient List Report Guide - Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Calendar Guide - Searching for appointments using the Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments)
* [Office Message Feature Guide - The enhanced inter-office communications tool](/articles/Office-Message-Feature-Guide)
# Calendar Guide- Searching for appointments using the Appointment Report
Source: https://help.elationhealth.com/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments
This article describes how you can utilize the Appointment Report to view appointments for specific providers and/or appointments within a given time frame.
## What is an Appointment Report?
The Appointment Report feature in Elation allows you to generate a report of all of a practice's or provider's appointments as recorded in their Elation calendar within a given time frame. The report contents include:
* Appointment date & time
* Patient Full Name, Date of Birth & primary phone number
* Appointment type
* Appointment reason
* Appointment status
* Any patient payment information recorded
* Patient's insurance details
## Use cases for an Appointment Report
The Appointment Report is a good administrative report for tracking patient appointments over a period of time. Here are some common uses cases we have seen from various customers:
1. Generating a report to follow up on patients who are due for recurring visits (ex. annual exams, recurring procedures/tests, chronic conditions follows ups)
2. Generating a total amount for payments collected from patients at the end of the day to **close out** your day
3. Generating a report to understand business trends and patient needs
4. Generating a report for [a provider who is leaving the practice](/articles/User-Accounts-Guide-Best-practices-for-deactivating-accounts) to reassign appointments to an active provider.
## Generating an Appointment Report
To generate an Appointment Report, follow these steps:
1. Click **Reports** >> **Appointment Report** at the top of any page in Elation
* By default, the Appointment Report will show your own appointments (if you are a provider level user) or the appointments of a staff member's default physician (if you are a staff level user)
* By default, the report will show the appointments for the last 7 calendar days
2. Select **All Providers** or another provider's name if you would like to change the provider filter for the report
3. Select a different **From:** or **To:** to filter for a different time frame
4. Click **Update List** to update the report after changing any filters
5. Click the **Download List of Appointments as CSV** button if needed to download the Appointment Report as a CSV file and view the results in a spreadsheet software application where you have [advanced customization options](#custom_sort)
**Note:** A disabled provider won't appear in this report's provider dropdown, but their appointments are still included when you run the report with **All Physicians** selected — no need to re-enable their account. Re-enabling is only necessary if you want to filter the report specifically by that provider's name. See [Best practices for disabling accounts](/articles/User-Accounts-Guide-Best-practices-for-deactivating-accounts#i-already-disabled-a-providers-account-how-do-i-see-which-patients-they-saw-or-get-their-past-appointment-history) for the full steps.
### Important Report Tips
#### Generating Appointment Reports With Future Dates
If you need to filter for a date in the future, type in the date manually in the MM/DD/YYYY format instead of using the Calendar picker
![The From date field highlighted with a red border, showing 10/25/2022 typed manually, with the October 2022 calendar picker open below showing 10/21 as the current date.]()
#### Generating Appointment Reports- Time Constraints
* If you filter for a timeframe that is greater than 14 calendar days, you will not be able to see the report contents in Elation. You will need to click the **Download List of Appointments as CSV** button to view the results in a spreadsheet software application.
* If you need to filter for a timeframe that is larger than 6 months, you will need to break up the time frame into multiple reports, download the reports to your computer as a CSV file and then combine the data in a spreadsheet software application. For example, if you would like to see all appointments from 2020, you will need to run 3 reports; each with the following time frames:
* 01/01/2020 to 05/31/2020
* 06/01/2020 to 10/31/2020
* 11/01/2020 to 12/31/2020
#### Custom Sorting In CSV Files
* Downloading reports as CSV files allows you to further customize your report. CSV files can be viewed in spreadsheet software applications, such as Google Sheets and Microsoft Excel. You can use the advanced spreadsheet capabilities of these applications to best fit your practice’s needs. For example, to see an Appointment Report of **no show** appointments, you can sort the column of \[appointment] **Type** in the spreadsheet application so that all **no show** appointments are grouped together.
* For specific instructions on how to sort columns in Microsoft Excel or Google Sheets, please reference these links below.
* [Microsoft Excel](https://support.microsoft.com/en-us/office/sort-data-in-a-range-or-table-62d0b95d-2a90-4610-a6ae-2e545c4a4654#OfficeVersion=Windows)
* [Google Sheets](https://support.google.com/docs/answer/3540681?hl=en\&co=GENIE.Platform%3DDesktop)
## Related Articles
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Calendar Guide- How to set up the provider calendar](/articles/calendar-and-booking-settings)
* [User Accounts Guide- Best practices for disabling accounts](/articles/User-Accounts-Guide-Best-practices-for-deactivating-accounts)
# California Data Exchange Framework (DxF) and Elation
Source: https://help.elationhealth.com/articles/California-Data-Exchange-Framework-DxF-and-Elation
How Elation supports California practices meeting their Data Exchange Framework (DxF) data sharing requirements through the Carequality integration.
This article is written by Elation Health for informational purposes only. It is intended as a summary of how Elation's tools relate to the California Data Exchange Framework and should not be relied upon to ensure compliance. Each practice is responsible for understanding and meeting its own DxF obligations. For official DxF requirements, contact [CalHHS](https://dxf.chhs.ca.gov/) directly.
## Overview
The California Data Exchange Framework (DxF) is a statewide initiative established under AB 133 and SB 660 that requires California healthcare entities to exchange health data electronically. The framework is administered by the California Health and Human Services Agency (CalHHS).
As part of the DxF, healthcare entities must sign a Data Sharing Agreement (DSA) and establish a method for electronic health data exchange. The DxF allows participants to fulfill their data exchange obligations through several pathways, including connecting through a Qualified Health Information Organization (QHIO), through an agreement with another entity that provides data exchange, or through their own technology.
**Elation provides the tools and integrations to facilitate data exchange, but compliance with the DxF — including signing the DSA and understanding your practice's specific obligations — is the responsibility of each individual practice.**
## How Elation supports your data exchange requirements
### Carequality integration
Elation's [Carequality integration](/articles/Carequality-Integration-Introduction) enables your practice to exchange patient data bidirectionally across the national Carequality network. This includes sharing and receiving Continuity of Care Documents (CCDs/C-CDAs) with other Carequality-enabled EHRs, health systems, and Health Information Exchanges (HIEs).
Carequality is a recognized data exchange pathway that can help satisfy the DxF's technical requirements for health data exchange.
To enable Carequality in your practice:
Go to **Settings > Security & Privacy**.
Toggle **Patient Data Sharing with Outside Care** to **ON** and agree to the terms.
For full setup instructions, consent management, and usage details, see [Elation-Carequality Integration Introduction](/articles/Carequality-Integration-Introduction).
### USCDI support
The DxF requires USCDI v2 at a minimum for data exchange. Elation supports the USCDI standard for data exchanged through the Carequality integration. For details on USCDI data classes and how they map to Elation data, see [21st Century Cures Act Guide - Patient CCDAs and U.S. Core Data for Interoperability (USCDI)](/articles/Cures-Act-Patient-Data-and-USCDI).
## Recommended next steps
If your California practice needs to comply with the DxF:
Review the DxF requirements that apply to your practice through the [DxF participant portal](https://dxf.chhs.ca.gov/for-participants/). Requirements vary based on entity type and size.
If you have not yet signed the DSA, you can do so through the [DxF participant portal](https://dxf.chhs.ca.gov/for-participants/).
If Carequality is not yet enabled in your Elation account, follow the setup instructions in the [Carequality Integration Introduction](/articles/Carequality-Integration-Introduction) to turn it on.
## Frequently asked questions
### Does enabling Carequality satisfy the DxF data exchange requirement?
The DxF allows participants to meet their data exchange obligations through several pathways. Carequality is a bidirectional data exchange framework that can serve as one of those pathways. Your practice should review the specific DxF requirements that apply to your entity type to confirm.
### Is Elation responsible for my practice's DxF compliance?
No. While Elation provides the tools and integrations to facilitate data exchange, each practice is responsible for its own DxF compliance. This includes signing the DSA, understanding applicable deadlines, and ensuring your practice meets the framework's requirements. For compliance questions about the DxF, contact [CalHHS](https://dxf.chhs.ca.gov/) directly.
### What about Manifest MedEx?
Elation integrates with Manifest MedEx, a California-based Health Information Exchange. However, the Manifest MedEx integration is inbound-only (receiving data) and does not support bidirectional exchange. If the DxF requires bidirectional data exchange for your practice, the [Carequality integration](/articles/Carequality-Integration-Introduction) is the recommended pathway.
### Where can I get help with technical configuration?
If you have questions about enabling Carequality or configuring your Elation account for data exchange, contact [Elation Support](https://app.elationemr.com/support/). For questions about DxF compliance requirements, contact [CalHHS](https://dxf.chhs.ca.gov/).
## Related articles
* [Elation-Carequality Integration Introduction](/articles/Carequality-Integration-Introduction)
* [Data Sharing Guide - Sharing data outside Elation via CCDA, Carequality, Direct messaging, Connect and Patient Passport](/articles/Sharing-data-outside-Elation)
* [Patient Consent Regulations Guide](/articles/Patient-Consent-Regulations-Guide)
* [21st Century Cures Act Guide - Patient CCDAs and U.S. Core Data for Interoperability (USCDI)](/articles/Cures-Act-Patient-Data-and-USCDI)
# Elation-Carequality Integration Introduction
Source: https://help.elationhealth.com/articles/Carequality-Integration-Introduction
This article introduces Elation's Carequality integration.
## Overview
### What is Carequality?
Carequality is a national interoperability framework utilized to enable health information exchange across health platforms and vendors. Carequality connects different health data networks under a common set of nationwide legal, technical, and policy rules with the goal of promoting trusted and patient-consented data exchange. Carequality does not store information, but enables exchange between and among health information networks and service platforms through the Carequality framework to ensure they are upholding data exchange policies.
Carequality enables practices with the Outside Care integration to receive data and share data with other EHRs, data repositories and Health Information Exchanges (HIEs) also utilizing the Carequality framework. The Carequality framework connects more than 600,000 providers, 50,000 clinics, and 4,200 hospitals in the United States. The full database of Carequality-enabled providers can be found [here](https://carequality.org/active-sites-search/).
### What is Elation’s Carequality integration?
With the Elation’s Carequality integration, you can share data with any [Carequality-enabled provider](https://carequality.org/active-sites-search/) and query for data from any [Carequality-enabled provider](https://carequality.org/active-sites-search/) with mutual patients. Elation’s Carequality integration unlocks access to data available via Commonwell, and eHealth Exchange as well as data from other EHRs and data repositories connected to Carequality. You can query for files, such as Continuity of Care Documents (CCDs), visit notes and results in various formats (PNGs, PDFs, TIFFs, etc.) as long as the patient’s affirmative consent to query and share their data from or to outside care entities has been obtained and recorded.
Queries should only be launched when the provider and patient have a relationship and the patient consents. For this reason, if a patient has not consented to have their data shared or specific data shared through an outside entity, this data may not be available. Entities can choose what data is shared and the specific format in which data is shared.
Elation also makes patient data available to providers on other networks connected to Carequality via a comprehensive Continuity of Care (CCD) file. Documentation in the form of images will not be shared.
### Is my practice the right fit for Elation's Carequality integration?
The current Carequality experience does not have data filtering or patient filtering capabilities. For this reason, it is a good fit for practices that do not have 42 CFR Part 2 (controlled substance abuse treatment) data or psychotherapy notes within Elation. If your practice has psychotherapy notes, are controlled substance abuse treatment providers and/or provides treatment for controlled substance abuse in any way, your practice can use the Carequality integration but you must never share data for patients with these criteria via Carequality.
Psychotherapy notes, by HIPAA definition, are notes recorded by a health care provider who is a mental health professional documenting or analyzing the contents of a conversation during a private counseling session or a group, joint or family counseling session, and that are separate from the rest of the patient’s medical record.
## Setup
### Configuring access
To enable the Carequality integration:
| **1** | Go to **Settings** > **Security & Privacy** . |
| ----- | ---------------------------------------------------------------------------- |
| **2** | Toggle Patient Data Sharing with Outside Care **ON** and agree to the terms. |
To turn off access, toggle Patient Data Sharing with Outside Care **OFF.**
### Preparing your practice for the Carequality integration
In order to ensure a compliant and smooth experience with the Carequality integration, please take the following actions before you begin using the integration:
1. **Update your practice’s Privacy Policy** - To ensure patients are informed that their data is being shared through the Carequality integration, update your practice’s Privacy Policy to reflect the patient information health information exchange (HIE) activity facilitated by the Carequality integration. Our Carequality partner suggests adding the following to your Privacy Policy:
* *‘We may make your protected health information available electronically through an electronic health information exchange to other health care providers that request your information for their treatment purposes. In all cases the requesting provider must have or have had a treating relationship with you. Participation in an electronic health information exchange also lets us see other provider’s information about you for our treatment purposes.’*
2. **Train your staff** around appropriate use of the Carequality integration.
* In order to access data through the Carequality integration, all users in your practice must understand and comply that queries should only be initiated for patients with whom your practice has a relationship with. By using the Carequality integration, you agree to uphold the permitted purposes, query only when appropriate, and record patient consent to access their information from other healthcare facilities.
* In order to comply with Carequality regulations, all users should be trained to never share data for patients with the following criteria via Carequality. These patients must always have their [Consent](#manage_patient_consent) set to ‘No, patient does not consent’.
* psychotherapy notes
* controlled substance abuse treatment notes
* other documentation for treatment for controlled substance abuse
3. **Verify patient demographics are up to date** in Elation EHR.
* Carequality uses the patient demographics stored in your patient’s chart in Elation EHR to query the Carequality network for the patient’s data. The proprietary Carequality algorithm qualifies patient matches by comparing the patient demographics (name, gender, date of birth, address, phone number, and email) included in the query against the patient demographics available in Elation. The Carequality integration will only return any data found through qualified patient matches. Always review and update the patient’s address, phone number, and email for best matching results as patient name, date of birth, and sex at birth may not be enough to return a qualifying match.
## Workflow Instructions
### Accessing Carequality data
Once the Carequality integration is enabled you will see an **Outside Care** button at the top of the patient’s Clinical Profile. To query for Carequality data:
**1**
Click the **Outside Care** button. ![Patient chart for Frankie Everyman showing the Outside Care button highlighted with a red border in the Profile toolbar, indicating where to click to initiate a Carequality query.]()
**2**
Patients with any documentation of psychotherapy or controlled substance abuse treatment in their chart **must** always have their Consent set to **No, patient does not consent**.
First the patient (and/or patient’s legal guardian or representative) must consent to querying and sharing the data in their chart. You should follow applicable state and federal laws regarding minor consent. If a consent has not been recorded in the Patient’s Demographics, you will be prompted to record one before we query for patient data:
1. If the patient consents, select **Yes, patient consents** and then click **Next**.
2. You will be able to query and share patient data through the Carequality integration.
3. If the patient denies consent, select **No, patient does not consent** and then click **Next**.
4. You will not be able to query or share patient data through the Carequality integration.
5. You will not be able to remove a patient’s consent once you choose a Consent option. You can only adjust the consent from **Yes** to **No** or **No** to **Yes**.
6. To remove a patient consent response from their chart, click the **I need help** -> **Contact Elation Support** button from the patient’s chart and ask our Support Team to remove the response for you. A member of the Elation Support Team will assist you with this action.
**3**
If the patient’s affirmative consent is on record, the Carequality integration search will attempt to match the patient in the network with demographic information and any documents available for the patient will display in the Outside Care document viewer. ![Outside Care modal for Frankie Everyman showing 63 records, with "Surescripts Location Summary" selected and its details displayed on the right, alongside Sign Off and Sign Off & Import buttons.]()
1. You can select and view Continuity of Care Documents (CCDs) in the document viewer and can import CCDs into the patient chart.
* Click **Sign Off** to add the document to the patient chart without importing discrete data
* Click **Sign Off & Import** to add the document to the patient chart and select specific data within the CCD for import.
2. Other types of documents, such as PDFs or images, will be visible in the document viewer but cannot be imported into the patient chart from the document viewer. To save a copy of other document types in the patient’s chart:
3. Download the document to your computer/laptop.
4. Drag and drop the document into the patient’s chart to upload it to the chart as a Report. Afterwards, you can assign a Report Category and Title of your choice to the document as you would for other uploaded documents. [Click here to learn more about the drag-and-drop feature.](/articles/filing-documents-to-a-patient-chart)
Elation has no control over what data is available in query results. Data pulled from the Carequality network is solely dependent on what data is made available by Carequality-enabled providers based on the following conditions for mutual patients: The patient’s demographics within your practice and that of other Carequality-enabled providers matches.
The patient granted other Carequality-enabled providers permission to share their data in the Carequality network.
### Managing patient consent for the Carequality integration
Patient consent for the Carequality integration can be recorded when initiating a query for data (as outlined above) or can be manually recorded in the patient’s demographics. To store, view or update the patient’s consent for the Carequality integration within their demographics:
![Patient demographics dialog open to the Consents tab, showing "Yes, does consent" selected with consent recorded on 02/10/2022 at 11:44 am, highlighted with a red border.]()
1. Click the patient’s name in their chart to open the demographics dialog.
2. Go to the Consents section to select, view or update the patient’s recorded consent response.
You cannot remove a patient consent response (i.e. change the patient’s consent response from **Yes** to **No** response or from **No** to **Yes** response). To remove a patient’s consent response from their chart, click the **I need help** -> **Contact Elation Support** button from the patient’s chart and ask our Support Team to remove the response for you. A member of the Elation Support Team will assist you with this action.
### Sharing your patient’s data via the Carequality integration
When other Carequality-enabled providers query for your patient’s data via Carequality then Carequality will pull a [CCDA file](/articles/import-patient-information-from-another-ehr-c-cda-format) of your patient’s data and share it with the provider. The proprietary Carequality algorithm qualifies patient matches by comparing the patient demographics (name, gender, date of birth, address, phone number, and email) included in the query against the patient demographics available in Elation. The exact minimum required information to constitute a qualified match is not defined, and CCDA’s will only be shared when there is high confidence (i.e. a qualified match) that the patient records match.
Elation will not share a patient’s data with Carequality if the patient consent on file states that the patient does not consent to sharing their health data with outside care networks.
## Frequently Asked Questions
### How do I prevent Carequality from sharing patient charts that have sensitive data such as reproductive health data or substance abuse data, etc?
To prevent Carequality from sharing patient charts that have sensitive data such as reproductive health data or substance abuse data, you must set the patient’s [Consent status](#manage_patient_consent) to **No, patient does not consent**. Any charts where Consent is not granted by the patient will not be exposed to Carequality.
### What type of data does Elation share in the Carequality network?
Elation shares a patient’s CCDA data which includes the following:
* Reason for Referral
* Allergies, adverse reactions, alerts
* History of medication use
* Problem List
* Encounters
* Immunizations
* Vital Signs
* Social History
* History of Procedures
* Implantable Devices
* Relevant diagnostic tests and/or laboratory data
* Functional Status
* Mental Status
* Assessments
* Plan of Care
* Goals
* Health Concerns
### What type of data can Elation receive from the Carequality network?
Elation can receive CCDA, PDF and TIF files from the Carequality network. The actual types of files retrieved and the actual data received depends on how other EHRs have set up their Carequality Integrations.
### What does Carequality look for when querying for patient data?
Carequality uses the patient demographics stored in your patient’s chart in Elation EHR to query the Carequality network for the patient’s data. The proprietary Carequality algorithm qualifies patient matches by comparing the patient demographics (name, gender, date of birth, address, phone number, and email) included in the query against the patient demographics available in Elation. The Carequality integration will only return any data found through qualified patient matches.
* If there is no qualifying match at all then you will not see any results.
* If the patient’s demographics does not match across all [Carequality-enabled providers](https://carequality.org/active-sites-search/) then you may see only a portion of the patient’s results.
Always review and update the patient’s address, phone number, and email for best matching results as patient name, date of birth, and sex at birth may not be enough to return a qualifying match.
**Exception:** Elation has no control over what data is available in query results. Data pulled from the Carequality network is solely dependent on what data is made available by Carequality-enabled providers based on the following conditions for mutual patients: The patient’s demographics within your practice and that of other Carequality-enabled providers matches.
The patient granted other Carequality-enabled providers permission to share their data in the Carequality network.
### How does patient consent work in relation to Carequality?
Patients must consent to sharing their data for all [Carequality-enabled providers](https://carequality.org/active-sites-search/) in order for the patient’s data to be accessible in the Carequality network. For example, if a patient is associated with two Carequality-enabled providers then they must grant consent to both Carequality-enabled providers to share their data via the Carequality network.
### I queried for a patient’s data but there’s information/records missing, why?
Data pulled from the Carequality network is solely dependent on what data is made available by [Carequality-enabled providers](https://carequality.org/active-sites-search/) with mutual patients. Some reasons for why patient data might be missing are:
* Elation is only able to find qualifying matches for some Carequality-enabled providers based on the patient’s demographics within your practice and that of their practice because not all Carequality-enabled providers have matching demographics.
* The patient did not grant consent to share their data across all Carequality-enabled providers.
* Other EHRs may not support a certain file type in their integration which prevents that information/record from appearing in the Carequality network.
### Another Carequality-enabled provider is trying to pull my data into their EHR but there is information missing, why?
Elation only shares patient data via [CCDA](/articles/Supported-Elation-CCDA-types) files in the Carequality network. Other file types such as PDFs or images of reports are not shared by Elation. Other reasons for why patient data may not be visible to other [Carequality-enabled providers](https://carequality.org/active-sites-search/) are:
* The patient’s demographics within your practice and that of other Carequality-enabled providers does not match.
* The patient did not grant you consent to share their data with other Carequality-enabled providers.
### The Carequality integration is showing me documents (PDFs & images) from other Carequality-enabled providers. Can I pull these into the patient’s chart in Elation?
Yes, you can save a copy of PDFs or images in the patient’s chart by following these instructions:
1. Download the document to your computer/laptop.
2. Drag and drop the document into the patient’s chart to upload it to the chart as a Report. Afterwards, you can assign a Report Category and Title of your choice to the document as you would for other uploaded documents. [Click here to learn more about the drag-and-drop feature](/articles/filing-documents-to-a-patient-chart).
### Can I see the date the Carequality integration was activated for my practice?
Currently, Elation does not display an activation date or historical log of when the Carequality integration was enabled for your practice.
## Related Articles
* [Patient Chart Guide- Importing patient information from another EHR (CCD/CCDA Format)](/articles/import-patient-information-from-another-ehr-c-cda-format)
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
# Colorado State- CIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Colorado-State-CIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Colorado Immunization Information System [CIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Colorado State Immunization Registry known as CIIS.
## What is the CIIS Immunization Registry Interface?
The CIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to CIIS; the Colorado Immunization Information System. Practices can also query CIIS for vaccination history or forecast.
## Why is the CIIS Immunization Registry Interface valuable?
With the CIIS Immunization Registry Interface, practices no longer need to separately log in to CIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to CIIS. You can also pull vaccination history for specific patients from CIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & CIIS
The Elation Team will assist you with initiating interface with CIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. Confirmation that you have a Colorado Public Health Reporting (CoPHR) account.
* If you do, you should be able to login [here](https://cophr.com/emrlogin.asp). If you do not have an account, you will need to register [here](https://cophr.com/eregister1.asp) before interfacing can begin.
2. Send us your 4 letter CIIS facility ID
3. Tell us if your practice administers COVID vaccines
4. Who will be the point of contact with CIIS for testing?
## How to submit vaccination data to CIIS using Elation
When submitting data for vaccines administered by your practice, *do not* choose **Other Manufacturer** as this is not allowed by CIIS. You must select a manufacturer from Elation's database. If you do not see the manufacturer you are looking for, [click here to contact support](https://help.elationemr.com/s/contactsupport) or use the **I need help** button from your Elation account to notify us.
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to CIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using CIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide.](/articles/Vaccination-Form-Guide#query_IR)
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
*'Managing querying errors' section of the Vaccination Documentation Guide.*
## Related Articles
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
# Complying with CMS' Appropriate Use Criteria (AUC) Program
Source: https://help.elationhealth.com/articles/Complying-with-CMS-Appropriate-Use-Criteria-AUC-Program
Starting on January 1st, 2021, providers must consult a clinical decision support mechanism before placing an advanced imaging order to ensure the service adheres to CMS' appropriate use criteria.
In this article, you will learn more about CMS' Appropriate Use Criteria (AUC) requirements and how to create advanced imaging orders that adhere to the AUC.
1. [Background on PAMA and AUC](#background)
2. [Choosing a Clinical Decision Support Mechanism (CDSM)](#CDSM)
3. [How to create an advanced imaging order in Elation to meet requirements](#creating-order)
4. [Advanced imaging CPT® codes requiring CDSM consultation](#CPT-codes)
5. [Reporting requirements for CDSM consultations](#consulting-cdsm)
## Background
The Protecting Access to Medicare Act (PAMA) of 2014, Section 218(b), established the appropriate use criteria (AUC) program to ensure advanced imaging orders (CT, PET, nuclear medicine, and MRI) for Medicare patients that will be reimbursed by CMS are appropriate.
**What does this mean for your practice?** Starting on January 1st, 2021, providers will need to consult an AUC program for all advanced imaging orders for Medicare patients and provide furnishing provider information or the claim will not be reimbursed by CMS. Many imaging centers will not accept imaging orders for tests impacted by this program unless the proper AUC consultation information is provided.
The AUC consultation must occur when the advanced imaging is ordered and can be delegated to clinical staff. Please note that providers whose ordering patterns are considered by CMS to be outliers could be subject to prior authorization before future orders.
**Who does this impact?** This program impacts all physicians and practitioners (1861(r) or 1842(b)(18)(C)) “that order advanced diagnostic imaging services and physicians, practitioners and facilities that furnish advanced diagnostic imaging services in a physician’s office, hospital outpatient department (including the emergency department), an ambulatory surgical center or an independent diagnostic testing facility (IDTF) and whose claims are paid under the physician fee schedule, hospital outpatient prospective payment system, or ambulatory surgical center payment system.” ([From CMS AUC Program page](https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program).)
**Are there any exceptions?** Yes - AUC does not need to be consulted before ordering advanced imaging in the following situations:
* Emergency services
* Inpatients and Medicare part A payments
* Providers with significant hardship
### Choosing a Clinical Decision Support Mechanism (CDSM)
CMS has approved many clinical decision support mechanisms (CDSMs) to consult AUC, which can be reviewed [here](https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program/CDSM). Your practice may consult any of these CDSMs in order to retrieve the information necessary to include on imaging orders to meet CMS program requirements. Free CDSMs are marked with an asterisk on this list.
### How to create an advanced imaging order in Elation to meet requirements
To easily meet CMS AUC requirements for imaging orders placed in Elation, please follow the steps below. Note that this process only needs to be followed for advanced imaging tests (see the set of relevant test codes in the section below).
1. Create an imaging order by clicking on the Orders>Imaging Orders button in the grep action bar within a patient's chart
2. Fill out the required fields in the Imaging Requisition Form, including: Test, Reason, Imaging Center
3. Consult your clinical decision support mechanism (CDSM).
* Have the following information readily available:
* Patient age and gender
* Requested advanced imaging service (e.g. MRI spectroscopy head/brain w/o contrast), and
* Indication (e.g. headache, infection suspected).
* The CDSM will report an appropriateness score (1-9) for the selected imaging service and will suggest other imaging services based on the patient demographics and indication. Select an imaging service.
* The CDSM will then generate a Decision Support Number, with a summary of the appropriateness score, adherence results (e.g. adheres to AUC), G-code (e.g. CDSM CareSelect’s is G1004), and modifier (e.g. ME).
4. Back in the Elation Imaging Requisition Form, click **more…** and copy and paste the AUC information into Instr/Notes of the imaging order.
5. Click Print & Close and send the Imaging Order to the imaging center. Read more about faxing an imaging order or referral.
### Advanced imaging CPT codes requiring CDSM consultation per the January 2020 CMS AUC imaging bulletin, the advanced imaging CPT codes requiring AUC review include:
| Advanced Imaging test | CPT Codes |
| --------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CT | 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 71250, 71260, 71270, 71275, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72191, 72192, 72193, 72194, 73200, 73201, 73202, 73206, 73700, 73701, 73702, 73706, 74150, 74160, 74170, 74174, 74175, 74176, 74177, 74178, 74261, 74262, 74712, 74713, 75571, 75572, 75573, 75574, 75635, 76380, 76497 |
| MRI | 70336, 70540, 70542, 70543, 70544, 70545, 70546, 70547, 70548, 70549, 70551, 70552, 70553, 70554, 70555, 71550, 71551, 71552, 71555, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72159, 72195, 72196, 72197, 72198, 73218, 73219, 73220, 73221, 73222, 73223, 73225, 73718, 73719, 73720, 73721, 73722, 73723, 73725, 74181, 74182, 74183, 74185, 75557, 75559, 75561, 75563, 75565, 76498, 77046, 77047, 77048, 77049 |
| **Nuclear Medicine** | 78012, 78013, 78014, 78015, 78016, 78018, 78020, 78070, 78071, 78072, 78075, 78099, 78102, 78103, 78104, 78110, 78111, 78120, 78121, 78122, 78130, 78135, 78140, 78185, 78191, 78195, 78199, 78201, 78202, 78215, 78216, 78226, 78227, 78230, 78231, 78232, 78258, 78261, 78262, 78264, 78265, 78266, 78267, 78268, 78278, 78282, 78290, 78291, 78299, 78300, 78305, 78306, 78315, 78350, 78351, 78399, 78414, 78428, 78429, 78430, 78431, 78432, 78433, 78434, 78445, 78451, 78452, 78453, 78454, 78456, 78457, 78458, 78459, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, 78499, 78579, 78580, 78582, 78597, 78598, 78599, 78600, 78601, 78605, 78606, 78608, 78609, 78610, 78630, 78635, 78645, 78650, 78660, 78699, 78700, 78701, 78707, 78708, 78709, 78725, 78730, 78740, 78761, 78799, 78800, 78801, 78802, 78803, 78804, 78811, 78812, 78813, 78814, 78815, 78816, 78830, 78831, 78832, 78835, 78999 |
| **SPECT** | 76390 |
### Reporting requirements for CDSM consultations
All Medicare claims for advanced imaging orders (CT, MRI, Nuclear Medicine, and SPECT, see CPT codes below) must report:
1. HCPCS code (G-code): Code for the CDSM consulted.
2. Decision Support Number (DSN): unique number for AUC consultation.
3. HCPCS modifier (M-code): Code for CDSM AUC determination.
* MA: Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
* MB: Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
* MC: Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
* MD: Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances
* ME: The imaging service ordered would adhere to specified applicable AUC
* MF: The imaging service ordered would not adhere to specified applicable AUC
* MG: The order for this service does not have appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
* QQ: Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
The name and NPI of the ordering provider who consulted the AUC if different from furnishing provider.
*CPT copyright 2019 American Medical Association. All rights reserved.*
# Connecticut State- CT WiZ- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Connecticut-State-CT-WiZ-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Connecticut State Immunization Registry [CT WiZ] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Connecticut State Immunization Registry known as CT WiZ.
## What is the IRIS Immunization Registry Interface?
The CT WiZ Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to CT WiZ, the Connecticut State Immunization Registry. Practices can also query CT WiZ for vaccination history or forecast.
## Why is the CT WiZ Immunization Registry Interface valuable?
With the CT WiZ Immunization Registry Interface, practices no longer need to separately log in to CT WiZ to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to CT WiZ. You can also pull vaccination history for specific patients from CT WiZ to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & CT WiZ
The Elation Team will assist you with initiating interface with CT WiZ. To notify us of your interest, [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the \*\*Request Type \*\* and notify us who in your practice will be administering and ordering vaccinations.
## How to submit vaccination data to CT WiZ using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to CT WiZ. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
If you are sending a vaccination record for a Medicaid patient, make sure 'Medicaid' is selected in the **Coverage** field in the patient's demographics. CT WiZ requires this field in order to receive the patient's Medicaid Plan ID for the vaccination record.
![Insurance, Payment, & Membership dialog with the Coverage dropdown highlighted, showing "Medicaid" selected for patient Sally Smith's primary insurance.]()
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using CT WiZ
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide.](/articles/Vaccination-Form-Guide#query_IR)
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
*'Managing querying errors' section of the Vaccination Documentation Guide.*
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Visit Note Documentation Guide- Care Plans
Source: https://help.elationhealth.com/articles/Creating-and-Viewing-a-Care-Plan
This article describes the Care Plan visit note category and the Care Plan section of the visit note.
## What is a Care Plan?
The Care Plan is a patient-centered planning tool that focuses on your patient’s specific needs, goals, and preferences. It represents a **snapshot** of care at a single point in time to be easily shared with other providers and teams to ensure continuity of care.
Each [Visit Note Format](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) has a **Care Plan** section except for the **Simple Note**. You can also create a [Visit Note Category](/articles/visit-note-categories) specifically for care plans if care plans are frequently needed for a patient.
Care Plans usually consist of:
* any treatment prescribed to a patient
* any testing orders that you would like a patient to complete
* any recommendations for care after the visit
## Creating a **Care Plan** visit note category
**For Admins Only:** To edit visit note categories, you must have administrator (Admin) level privileges. If you do not see the **Report & Visit Note Categories** option in your Settings page, then you are not an Admin. To become an Admin, you must ask an existing Admin level user in your practice (most likely a primary provider level account holder) to grant you privileges via this [Manage Accounts](https://app.elationemr.com/settings/allaccounts/) settings page.
If you wish you categorize specific patient encounters as **Care Plan** visits in your patient’s chart, add a **Care Plan** visit note category to your Practice Settings.
Click **Settings** >> **Report & Visit Note Categories**
Scroll to the bottom of the page and click the **+ Add Visit Note Category** button
Type **Care Plan** in the text field
Update the toggle for **Count for MIPS?** as needed
Click **Save**.
This visit note category will also allow you to export Care Plans via [C-CDA (CCDA) exports](/articles/Supported-Elation-CCDA-types).
## Building a Care Plan within a visit note
Any records within the **Plan** section of your visit note will be part of the care plan whether it is
* assessments or directions that you typed for the patient to follow
* [referrals](/articles/letter-and-referral-introduction) to another provider
* [medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) you prescribed
* [tests](/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients) you ordered for the patient to complete
* [vaccinations](/articles/Vaccination-Form-Guide) administered
## Creating a new "Care Plan" visit note
To create a new visit note with the \*\*Care Plan \*\* category:
Click the **Visit Note** button at the top of the patient’s chart
At the top of the new visit note, change the visit note category dropdown to **Care Plan**
Populate [care plan details](#inside_visit_note) in the visit note.
Click **Sign Visit Note** to complete the **Care Plan** visit note.
To view **Care Plans** that you have documented for your patient, type the keyword “Care Plan” into the Chronological Record’s search bar.
## Creating a new Care Plan from an existing visit note
When you are updating a patient’s Care Plan, Elation allows you to copy forward an existing Care Plan or signed Visit Note from the patient’s chart to minimize duplicative work.
Find the signed **Care Plan** in your patient’s Chronological Record. You can also type the keyword “Care Plan” into the Chronological Record’s search bar.
Click on the **Actions** >> **Export to Note** on the **Care Plan** you found
The contents of existing **Care Plan** will copy forward into a new visit note.
At the top of the new visit note, change the visit note category dropdown to **Care Plan** as needed
Populate [care plan details](#inside_visit_note) in the visit note.
Click **Sign Visit Note** to complete the **Care Plan** visit note.
## Sharing Care Plans
Care Plans can be shared:
* automatically with your patients through [Elation Patient Passport](/articles/elation-patient-passport-an-introduction) once a patient has registered for a Passport account and you sign any visit notes with **Care Plan** details
* with other collaborating providers or healthcare professionals by attaching the **Care Plan** to a [Letter or Referral](/articles/letter-and-referral-introduction) and sending the **Care Plan** to them
* by generating a [C-CDA (CCDA) export](/articles/Supported-Elation-CCDA-types) of a **Care Plan** and sharing it securely with someone else
## Related Articles
* [Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Visit Note Categories Guide](/articles/visit-note-categories)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Letters & Referrals Introduction- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types)
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
* [Prescription Form Guide- ePrescribing & Ordering Medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Order Forms Introduction- Ordering medical tests for your patients](/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients)
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Orders Guide - Creating tests for Order Forms
Source: https://help.elationhealth.com/articles/Creating-tests-for-Order-Forms
## Overview
### What are user-created tests?
For our [5 order forms](/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients#value) (lab, imaging, cardiac, pulmonary, and sleep), all users can create additional tests with custom names. These user-created tests are saved in the respective compendium of each order type and can be ordered for any patient.
Please note, if you are eOrdering labs (i.e. you have a bidirectional interface with a lab vendor), you’ll be required to use their proprietary compendium and won’t be able to include user-create tests.
### What is the purpose of user-created tests?
User-created tests give you more flexibility when placing an order - it means you’re not constrained to the tests that are in Elation’s generic compendium. After a test is created, anyone in your practice can select the test when creating a lab order for any patient.
## Workflow Instructions
The instructions for creating a lab test are different from the instructions for creating an imaging, cardiac, pulmonary or sleep. Follow the instructions below carefully when creating the test you need.
### Creating a lab test
To create a lab test:
Take caution when adding new lab tests to your test database. User-created lab tests cannot be edited or deleted.
### Creating an imaging, cardiac, pulmonary or sleep test
To create an imaging, cardiac, pulmonary or sleep test:
Take caution when adding new lab tests to your test database. User-created tests cannot be edited or deleted.
## Frequently Asked Questions
### I noticed I misspelled a test after I added it to my test database. Is there a way for me to edit it?
User-created tests cannot be edited or deleted. You will need to create the test again using the correct spelling.
### How many lab tests can I add to a single lab order?
You can add up to 40 lab tests per lab order.
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Using the regular Lab Order Form](/articles/Regular-Lab-Order-Form)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Lab Orders & Results - Managing lab order sets](/articles/Managing-lab-order-sets)
# 21st Century Cures Act Guide- Patient CCDAs and U.S. Core Data for Interoperability (USCDI)
Source: https://help.elationhealth.com/articles/Cures-Act-Patient-Data-and-USCDI
The 21st Century Cures Act (“Cures Act”) is a set of healthcare-related regulations.
## Overview
For more information on the Information Blocking provisions please read[21st Century Cures Act: Staying compliant with Information Blocking Provisions](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions).
## What information will be shared with patients in Elation CCDA files?
From April 5, 2021 to October 6, 2022, shared EHI is limited to the data classes represented in the US Core Data for Interoperability (USCDI) v1 standard. There are 16 data classes of the USCDI v1 standard, and all elements within each class will be incorporated in Elation’s CCDAs.
After October 6, 2022, read the [21st Century Cures Act: Staying compliant with Information Blocking Provisions](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions) article to learn how to comply with the updated definition for electronic health information (EHI).
## How USCDI v1 data classes map to Elation Data
[USCDI v1 data classes, definitions, and how they map to Elation](/files/uscdi-v1-elation-mapping.pdf).
* The listed USCDI v1 data classes are used to define EHI from April 5, 2021 to October 6, 2022.
[Read more about the USCDI standard here](https://www.healthit.gov/isa/united-states-core-data-interoperability-uscdi).
## Additional Resources
* [United States Core Data for Interoperability Information Sheet](https://www.healthit.gov/cures/sites/default/files/cures/2020-03/USCDI.pdf)
## Related Articles
* [21st Century Cures Act Introduction](/articles/21st-Century-Cures-Act-and-Elation-EHR)
* [21st Century Cures Act: Staying compliant with Information Blocking Provisions](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions)
# 21st Century Cures Act Guide- Staying compliant with Information Blocking Provisions
Source: https://help.elationhealth.com/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions
The 21st Century Cures Act (“Cures Act”) is a set of healthcare-related regulations.
## 21st Century Cures Act- Information Blocking Provisions Overview
Information Blocking is a practice that
1. is likely to interfere with access, exchange, or use of electronic health information (unless required by law or covered by an [exception](#exceptions)) and
2. if conducted by a health IT developer of certified health IT, health information network or health information exchange, such developer, network or exchange knows, or should know, that such practice is likely to interfere with access, exchange, or use of electronic health information; or
3. if conducted by a health care provider, such provider knows that such practice is unreasonable and is likely to interfere with access, exchange, or use of electronic health information.
The [21st Century Cures Act](/articles/21st-Century-Cures-Act-and-Elation-EHR) (**Cures Act**) Information Blocking provision took effect April 5th, 2021. The Information Blocking provision states that healthcare providers are required by law to make a core set of clinical data available to patients in a timely fashion to encourage interoperability and portability of Electronic Health Information (EHI).
* Electronic Health Information is defined as “the electronic protected health information (ePHI) in a designated record set (as defined in the Health Insurance Portability and Accountability Act (HIPAA) regulations) regardless of whether the records are used or maintained by or for a covered entity” ([§170.401](https://www.healthit.gov/condition-ccg/information-blocking)).
* **From April 5, 2021 to October 6, 2022**, EHI is limited to the data classes represented in the US Core Data for Interoperability (USCDI) v1 standard. ([Read more about the USCDI v1 dataset here.](/articles/Cures-Act-Patient-Data-and-USCDI))
* **From October 6, 2022 onward**, EHI includes all ePHI in the designated record set that is transmitted in any electronic media or maintained in any electronic media.
## How your practice can stay compliant
1. Establish practice policies to provide Patient access to their health information in a timely manner upon patient request. You can use Elation’s Patient Passport feature to easily meet this requirement. [Read more about Patient Passport here](/articles/elation-patient-passport-an-introduction).
* Once Patients have activated their Patient Passport account, they will have access to their EHI via a combination of individually attached records AND a CCDA file.
*
Due to the expanded definition of EHI **after October 6, 2022** , Elation’s CCDA files with USCDI v1 data elements will NOT include all ePHI as defined in the 21st Century Cures Act. Data elements not included in USCDI v1 will need to be [shared as attachments via Patient Letters](/articles/letter-and-referral-introduction#Patient) . Examples of data elements not included in USCDI v1 are test orders & referral letters.
Elation CCDAs will not include non-visit notes or visit notes with dates of service **prior to April 5, 2021**. Non-visit notes and visit notes **prior to April 5, 2021** can be shared with patients via a Patient Letter.
2. Ensure patient information is shared with the authorized individuals according to your state guidelines.
3. Establish practice policies to exercise information blocking only when certain exceptions have been met.
* [Read more about the 8 exceptions](#exceptions)
* [Instructions on how to use the confidential section to store exceptions](/articles/confidential-items-in-your-patient-chart)
## Information Blocking Exceptions
The Cures Act established 8 exceptions that may be applied to Information Blocking provisions. There are specific conditions that must be met for the Exception to apply. We encourage you to [read more about the Exceptions here](https://www.healthit.gov/cures/sites/default/files/cures/2020-03/InformationBlockingExceptions.pdf) and to consult with a legal resource regarding how the Cures Act may impact your practice and whether the Information Blocking Exceptions may be applicable.
Exceptions that involve not fulfilling requests to access, exchanges, or use electronic health information (EHI):
* **Preventing Harm Exception**: It is necessary and reasonable to prevent harm to a patient or another patient.
* **Privacy Exception**: It is necessary to protect an individual’s privacy.
* **Security Exception**: It is necessary to protect the security of EHI.
* **Infeasibility Exception**: It is not possible due to infeasibility of the EHI request.
* **Health IT Performance Exception**: If it is not possible due to health IT temporarily being unavailable or if the request would degrade health IT’s performance.
Exceptions that involve procedures for fulfilling requests to access, exchange, or use EHI:
* **Content and Manner Exception**: The content of the request may be limited as long as the required EHI elements are present and the actor may use an alternative method to fulfill the request if the manner requested is not technically possible or not possible in agreeable terms.
* **Fees Exception**: Charging fees is acceptable within a reasonable profit margin.
* **Licensing Exception**: Interoperability elements to access, exchange, and use EHI may be licensed
To block patient data from being shared with patients, in accordance with the exception scenarios above, use the Confidential section of the Clinical Profile. [Instructions on how to use the confidential section to store exceptions](/articles/confidential-items-in-your-patient-chart).
## Additional Resources
* [21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program Final Rule in the Federal Register](https://www.federalregister.gov/documents/2020/05/01/2020-07419/21st-century-cures-act-interoperability-information-blocking-and-the-onc-health-it-certification)
* [ONC Information Blocking FAQs](https://www.healthit.gov/curesrule/resources/information-blocking-faqs)
* [Information Blocking Exceptions Information Sheet](https://www.healthit.gov/cures/sites/default/files/cures/2020-03/InformationBlockingExceptions.pdf)
## Related Articles
* [21st Century Cures Act Introduction](/articles/21st-Century-Cures-Act-and-Elation-EHR)
* [21st Century Cures Act Guide- Patient CCDAs and U.S. Core Data for Interoperability (USCDI)](/articles/Cures-Act-Patient-Data-and-USCDI)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
* [Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
# Decision Support Interventions Regulatory Documentation
Source: https://help.elationhealth.com/articles/Decision-Support-Interventions-Regulatory-Documentation
Elation Health offers a certified EHR technology platform to meet regulations per the ASTP ONC for all CEHRT.
## Overview
Elation AI product functionality includes multiple product features leveraging AI in the application. The information included in this page includes requirements for the Certified EHR Technology Program for Predictive Decision Support Interventions which are defined as AI utilization in the product and which Elation Health certified to. Requirements for AI in the product include a summary of Elation Health’s AI Risk Management Practices and predefined Source Attributes included in this page.
To turn off Elation AI functionality, contact Elation Health Support ([support@elationhealth.com](mailto:support@elationhealth.com)). You can find more information on [Elation’s AI Data Use Policy](https://www.elationhealth.com/ai-data-use-policy/). *It is important for You to understand some of the limitations of AI and LLMs generally to utilize the Services safely and responsibly. Because AI technology is still evolving, Outputs may be generated that are factually incorrect.*
The following Elation Health Help Center Articles describe Product Functionality that include AI:
* [Elation Analyst](/articles/Elation-Analyst)
* [Medication Reconciliation](/articles/Reconciling-active-medications)
* [Note Assist](/articles/Note-Assist-Guide)
* [Wordsmith](/articles/Auto-drafting-letters-and-referrals-with-Wordsmith)
## Decision Support Interventions Regulatory Documentation
### Introduction to Decision Support Interventions
Elation Health offers a certified EHR technology platform to meet regulations per the ASTP ONC for all CEHRT. There are multiple requirements for the CEHRT required criteria Decision Support Interventions (b)(11). All required documentation can be found here.
* Predictive Decision Support Interventions (Developer Supplied Source Attributes)
* Predictive Decision Support Interventions (Developer Supplied Risk Management Framework Summary)
* Evidence-based Decision Support Interventions (Source Attributes)
* Predictive Decision Support Interventions (User Supplied Source Attributes)
### Predictive Decision Support Interventions: Elation AI which includes Note Assist
Elation Health offers use of artificial intelligence (AI) in our application as the product feature Note Assist. Note Assist is Elation’s AI-powered scribing and visit note generation solution. This tool is thoughtfully embedded in the visit workflow, seamlessly incorporating ambient scribing capabilities into your encounter documentation process. After [purchasing Note Assist](/articles/Note-Assist-Guide#purchase), anyone who has a [Provider Level User account](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges) (e.g. physicians, non-prescribing providers) can use Note Assist. Note Assist will create detailed content for your Visit Note and intelligently identify the appropriate fields to fill based on your transcription. Related information will be organized into their respective sections, reflecting how you would document an encounter. More information on the product feature of Note Assist can be found in [this Help Center Article](/articles/Note-Assist-Guide). All content that is transcribed from Note Assist can be edited or deleted before signing the visit note, with all visit note signers maintaining content ownership of the visit note.
As part of the requirements for Predictive Decision Support Interventions, Source Attributes for Note Assist are included in the table below, and the Risk Management Summary is included in this page as well. To record and change source attributes users can leverage the feedback form in the application to document those changes and record new source attributes.
#### Source Attributes for Elation AI which includes Note Assist
| **Source Attributes to be Published and Available to End Users** |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 1. Details and output of the intervention, including: Name and contact information for the intervention developer; [Elation Health](https://www.elationhealth.com/) **530 Divisadero St, #872,** **San Francisco, CA 94117** **415-231-5164** Funding source of the technical implementation for the intervention(s) development; • **Same as the intervention developer.** • Description of value that the intervention produces as an output; and **[Visit Note Templates](/articles/Note-Assist-Guide#supported_visit_note_templates)** Whether the intervention output is a prediction, classification, recommendation, evaluation, analysis, or other type of output. |
| 4. Description of tasks, situations, or populations where a user is cautioned against applying the intervention; and Known risks, inappropriate settings, inappropriate uses, or known limitations Exclusion and inclusion criteria that influenced the training data set; • Use of variables in paragraph (b)(11)(iv)(A)(5)-(13) as input features; • Description of demographic representativeness according to variables in paragraph (b)(11)(iv)(A)(5)- (13) including, at a minimum, those used as input features in the intervention; • Description of relevance of training data to intended deployed setting. **Elation Health uses a contracted Large Language Model (LLM) training data set and then employs that for speech to text transcription. Elation Health does not own the LLM and can not describe the training data set including training the data set.** **The USCDI data classes and elements that are captured in Note Assist are Patient Demographics for the patient’s preferred gender to be consistent with in the summary provided.** |
| 7. Quantitative measures of performance, including: Validity of intervention in test data derived from the same source as the initial training data; • Fairness of intervention in test data derived from the same source as the initial training data; • Validity of intervention in data external to or from a different source than the initial training data; • Fairness of intervention in data external to or from a different source than the initial training data; • References to evaluation of use of the intervention on outcomes, including, bibliographic citations or hyperlinks to evaluations of how well the intervention reduced morbidity, mortality, length of stay, or other outcomes. **The Note Assist will write a transcript that would be the same source as initial training data. Additional testing includes manual review before editing discrepancies between accuracy of verbal recordings and transcriptions then editing in test data.** |
#### AI Risk Management Summary
Elation Health has implemented suitable risk management controls in place to ensure AI use in the product is fair, appropriate, valid, effective, and safe (FAVES). Our implemented risk management controls align with the NIST RMF, specifically, section Govern 6.0.
We have implemented specific controls to meet the requirements set forth by the ASTP/ONC for certification of Predictive Decision Support Interventions. Included in this documentation is a summary of policies, procedures, and actions taken to maintain this efficacy.
Elation Health has built a product using an established LLM and does not control the LLM training data, nor is data used in Elation contributing to training the LLM. AI as Note Assist in the Elation Health product is subject to the same internal rigor as other privacy and security controls that interact with patient health information (PHI). Note Assist as a feature is able to be turned on or off easily as a system wide feature or as a product feature for user accounts.
**1. Auditability of AI Systems** We have mechanisms to document the development process of each AI system, from sourcing of training data to deployment. This includes:
* Detailed development logs that track the creation and modification of algorithms as part of the SDLC processes.
* Outcome logs capturing both the positive and negative impacts of AI decision-making, which enables continuous evaluation and audit.
**2. Third-Party AI Systems and Explainability** When acquiring AI systems from third parties, we ensure a level of explainability through:
* Contractual obligations that include vendors to provide documentation on the underlying logic and reasoning of their AI models.
* Post-deployment testing to assess model interpretability and transparency as noted above in source attributes.
* Ongoing internal reviews to validate the clarity of AI outputs and verify system behavior under different scenarios.
**3. Vulnerability and Bias Reporting by Third Parties** Our organization has developed a clear and accessible process for users to report potential vulnerabilities or biases in the AI system. This includes:
* The required feedback form mechanism for end users and other stakeholders to submit potential issues.
* Regular risk assessments based on feedback, with corrective actions documented and communicated back to stakeholders as part of the SDLC process.
* A monitoring group that actively tracks reports of biases and proposes interventions when necessary.
**4. Comprehensive Risk Management Plan** We have developed a risk management plan that addresses key risks associated with AI system acquisition, procurement of software, and operational infrastructure. This includes:
* Vendor risk assessments to evaluate third-party software, ensuring compliance with cybersecurity and AI ethics standards.
* Cybersecurity controls that safeguard the integrity of computational infrastructure, as well as regular updates to patch vulnerabilities.
* System failure contingency planning, including fail-safe mechanisms and redundancy in critical AI applications.
**Summary of Policies and Procedures**
**1. Development Policy**
* All AI projects must maintain a comprehensive development log, including details on algorithm design, data usage, and system updates. This ensures a clear lineage for all AI systems.
**2. Procurement and Vendor Management Procedure**
* Prior to AI acquisition from third parties, all vendors must undergo a risk assessment to evaluate the explainability, transparency, and security of their AI products. Vendors must also provide ongoing access to audit trails for independent third-party review.
**3. AI Vulnerability and Bias Reporting Procedure**
* External stakeholders, including users and vendors, are encouraged to report any issues related to AI system performance, vulnerabilities, or biases via a secure online portal. All reports will be addressed by our development team using our normal development feedback process (SDLC).
The summary of these policies and practices are part of our broader governance framework, which aligns with industry standards and resources such as the **NIST AI Risk Management Framework**. We are committed to fostering responsible AI practices that prioritize transparency, accountability, and ethical considerations in all our AI initiatives.
### Source Attributes for Evidence Based Decision Support Interventions
#### Introduction
Evidence Based Decision Support Interventions in Elation’s product use the electronic clinical reminders functionality that remind providers and relevant staff users of clinical interventions that are related and applicable to electronic clinical quality measures (eCQMs). Use of eCQM reminders can be enabled by both the practice and the clinical user in their settings and additional configuration details can be found in this [Help Center Article](/articles/clinical-reminders-for-clinical-quality-measures). Each eCQM is developed by an outside recognized agency, such as CMS or NCQA, and each eCQM has specifications which dictate what data and how each are included in each measure including data related to USCDI. To find all relevant information (referred to as source attributes by ASTP/ONC), such as developer information and use of USCDI elements, you may find the information associated in the table below with additional details in each of the individual Help Center Articles.
Source Attributes associated to each eCQM reminder can be found in eCQI specifications:
* Bibliographic citation of the intervention (clinical research or guideline)
* Developer of the intervention (translation from clinical research or guideline)
* Funding source of the technical implementation for the intervention(s) development
* Release and, if applicable, revision dates of the intervention or reference source
* Use of USCDI Data
| **eCQM** | **Source Attributes** |
| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| [\[CMS69v12\] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan](/articles/CMS69v12-Preventive-Care-and-Screening-Body-Mass-Index-BMI-Screening-and-Follow-Up-Plan) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0069v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[CMS], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS122v12\] Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%) (MIPS 2024)](/articles/CMS122v12-Diabetes-Hemoglobin-A1c-Poor-Control-MIPS-2024) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0122v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS124v12\] Cervical Cancer Screening (MIPS 2024)](/articles/CMS124v12-Cervical-Cancer-Screening-MIPS-2024) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0124v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS125v12\] Breast Cancer Screening](/articles/CMS125v12-Breast-Cancer-Screening) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0125v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS130v14\] Colorectal Cancer Screening](/articles/CMS130v14-Colorectal-Cancer-Screening) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0130v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS131v12\] Diabetes: Eye Exam (MIPS 2024)](/articles/CMS131v12-Diabetes-Eye-Exam-MIPS-2024) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0131v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS139v12\] Falls: Screening for Future Fall Risk (MIPS 2024)](/articles/CMS139v12-Falls-Screening-for-Future-Fall-Risk-MIPS-2024) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0139v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS149v12\] Dementia: Cognitive Assessment (MIPS 2024)](/articles/CMS149v12-Dementia-Cognitive-Assessment-MIPS-2024) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0149v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[American Academy of Neurology], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS155v12\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2024)](/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2024) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0155v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
| [\[CMS165v12\] Controlling High Blood Pressure (MIPS 2024)](/articles/CMS165v12-Controlling-High-Blood-Pressure-MIPS-2024) | [Electronic Clinical Quality Improvement Measure Specification](https://ecqi.healthit.gov/ecqm/ec/2024/cms0165v12?qt-tabs_measure=measure-information) (this measure specification provides information on the measure developer, steward \[NCQA], annual revision updates, and use of USCDI data in the measure specification. The Help Center Article linked also describes how Elation Health has built the product to the measure specification. |
### Source Attributes for User Supplied Predictive Decision Support Interventions
User Supplied Predictive Decision Support Interventions are associated with Elation Health’s Caregaps API functionality. This functionality allows a user with subscription access to the Developer Platform to establish and load into Elation their own predictive decision support interventions and create a clinical intervention for users in their instance to meet a specific care gap. Source attributes, definitions of the interventions, are all established by the user. Users that create the Caregap are responsible for identifying the source attribute information required for Predictive Decision Support Interventions, including accessing, recording, and changing source attributes related to the predefined PDSI. All of these source attributes can be included in loading information into the API and additional details on the functionality, including accessing the functionality can be [found here](https://help.elationhealth.com/articles/rest/care-gaps-api/caregaps/create-caregap).
# Delaware State- DelVAX- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Delaware-State-DelVAX-Immunization-Registry
This article will describe how you can submit vaccination data to the Delaware State Immunization Registry [DelVAX] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with Delaware State's Immunization Registry (DelVAX).
## What is the DelVAX Immunization Registry Interface?
The DelVAX Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to DelVAX; a web based, database-driven immunization registry system. Practices can also query DelVAX for vaccination history or forecast.
## Why is the DelVAX Immunization Registry Interface valuable?
With the DelVAX Immunization Registry Interface, practices no longer need to separately log in to DelVAX to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to DelVAX. You can also pull vaccination history for specific patients from DelVAX to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & DelVAX
The Elation Team will assist you with initiating interface with DelVAX. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. Is your practice owned by a large health organization (e.g. Bayhealth, Christiana Care)?
2. Does your practice participate in Vaccines for Children (VFC)? If so, can you please send your VFC pin?
3. Can you please list the providers in your practice who order immunizations?
4. Can you please list the providers and/or staff members in your practice who administer immunizations?
## How to submit vaccination data to DelVAX using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to DelVAX. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using DelVAX
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide.](/articles/Vaccination-Form-Guide#query_IR)
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
*'Managing querying errors' section of the Vaccination Documentation Guide.*
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# District of Columbia - DOCIIS - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/District-of-Columbia-DOCIIS-Immunization-Registry-Interface-User-Guide
This article provides information on Elation's electronic interface with the District of Columbia Immunization Registry known as DOCIIS.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the District of Columbia Immunization Registry known as DOCIIS.
## What is the DOCIIS Immunization Registry Interface?
The DOCIIS Immunization Registry Interface allows connected practices to
**send**
vaccination information from their Elation EHR directly to DOCIIS; District of Columbia Immunization Information System.
## Why is the DOCIIS Immunization Registry Interface valuable?
With the DOCIIS Immunization Registry Interface, practices no longer need to separately log in to DOCIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to DOCIIS. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & DOCIIS
The Elation Team will assist you with initiating an interface with DOCIIS. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry would you like to connect to?
* Is your practice a VFC and/or COVID vaccine provider? If so, please provide the facility PIN.
* Is your facility part of a larger organization? If so, please share the name of the organization and the organization address.
* Who is your primary clinical contact and what is their title, phone number, and email?
* Who is an alternate clinical contact if the primary contact is not available?
* Who is overseeing data entry for your practice and what is their title, phone number, and email?
* Do you have multiple locations (“branch facilities” administering vaccines? If so, what are the facilities and their addresses?
* Will all vaccine inventory be stored at, managed at, and shipped to one central location?
* Will vaccines be transferred from a central location to branch facilities?
* Will your facility have mobile clinics? If so, will mobile clinics manage/store/order their own vaccine inventory, separate from the main facility location?
* How frequently is your facility administering vaccines throughout the week?
* What is your weekly vaccination throughput (i.e. how many are you vaccinating in one week)?
* Are there particular days of the week that your facility administers vaccines (e.g. only on Monday and Wednesday)?
* Do you have periodic large vaccination clinics (e.g. three events throughout the year, located in different locations in the community)?
* Are you administering COVID-19 vaccines only, routine/other vaccines only, or both COVID-19 and routine vaccines?
* Does your facility document vaccines directly into an EHR during or shortly after patient visits, or does your facility use paper copies that are backlogged/entered into the electronic medical record system? DC Health will assess providers’ capabilities to report vaccines to DOCIIS within 24 hours after administration.
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to send vaccination data to DOCIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit the data to DOCIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## Frequently Asked Questions (FAQ)
### Can I retrieve immunization history from DOCIIS in Elation?
You can only send vaccination history from Elation to DOCIIS using this current interface. In the future Elation will work with DOCIIS to also allow you to retrieve immunization history from DOCIIS.
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
## Related Articles
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
# Prescriptions Guide- Documenting medications administered by your practice
Source: https://help.elationhealth.com/articles/Documenting-Clinic-Administered-Medications
This guide describes how to document clinic administered medications in the patient's chart.
## What is a clinic administered medication?
A clinic administered medication is a medication or injection that was dispensed to or administered to the patient during the patient’s visit by your practice. If you wish to prescribe a medication to be dispensed by a pharmacy, reference
[this Prescription Form Guide](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
.
## Why is it important to document clinic administered medications?
It is important to document any medication and injection given to the patient during the visit to ensure that the patient’s chart record is complete, comprehensive, and up to date.
## How to document clinic administered medications
Documenting clinic administered medications can be done through the
[Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
in Elation, and can be done through the same workflow as ePrescribing, with one small change. Instead of selecting one of the options to ePrescribe, simply select **Sign & Close** to file the medication into the patient chart. You may add additional information on the prescription form to clarify how the medication was provided to the patient.
1. Open up the Prescription Form by clicking the **Rx** --> **Prescription Form (Rx/OTC/CS)** in the gray navigation bar at the top of the patient's chart.
2. Complete the required (\*) areas of the form.
3. Document that the medication was administered in the clinic in the **Instructions to Pharmacy** field.
* The **Instructions to Pharmacy** field can also be used to store additional information such as Manufacturer Name, Lot # or expiration dates, as needed.
4. Click **Sign & Close**.
### Chronological Record
Once the information is entered through either medication form, it will display in the Chronological Record of the chart as shown below:
![Patient chart Chronological Record showing two Sep 15 2022 prescriptions, each with "Instr: Administered in clinic" highlighted by red arrows indicating where clinic administration is documented.]()
## Related Articles
* [Medication List Management Guide](/articles/medication-history)
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Prescriptions Guide- Frequently Asked Questions](/articles/Prescriptions-Guide-Frequently-Asked-Questions)
# Medication List Management Guide - Documenting injected medications (Beta)
Source: https://help.elationhealth.com/articles/Documenting-injected-medications
This article describes how you can use the Document Injected Medication form to document injected medications.
**Beta feature:** The feature described in this article is part of a beta release and is only available to a select number of practices.
## Overview
### What is the Document Injected Medication form?
Elation’s injection form allows users to fully document a medication that was injected for a patient, including how and when the injection was administered, the details of the medication, and all appropriate procedure and diagnosis codes.
Practices can document injections newly administered by the practice and historical injections reported by the patient, another provider, or another source.
### What are the benefits of the Document Injected Medication form?
The **Document Injected Medication** form allows you to record the action of administering an injected medication and the details surrounding the medication itself, such as the NDC number, Lot number, expiration date, and manufacturer. These injected medications, like the other medications the patient is actively taking, will remain part of the patient’s medication list for ongoing reference.
## Workflow Instructions
### Documenting an injection
![Document Injected Medication form opened via the Rx button dropdown menu, with "Document Injected Medication" highlighted. The form shows New Injection tab selected, filled with Hydroxocobalamin Acetate 1000 MCG/ML, NDC 00591-2888-30, Lot 23413515, expiration 12/12/2025, dose 1 mg, Intramuscular method, R Deltoid site, Permanent toggle selected, and proc codes 96372 and I3420 listed.]()
1. Use **any of the three methods** below to open the **Document Injected Medication** form:
2. **Rx** button at the top of the patient’s chart.
3. **Injected Medications** button within a visit note draft.
4. **Actions** menu within the Clinical Profile’s Permanent Rx Meds, Permanent OTC Meds, or Scripts Since Last 6 Visits.
5. At the top of the injection form, use the **toggle** to select whether this is a **New Injection** that you’ve just administered or a **Historical Injection** that was performed in the past. The form’s **required fields** (i.e. fields with an asterisk \*) will update according to your selection.
6. Fill out the **required fields** (\*) and any optional fields regarding the injected medication. For clarification:
7. **Medication name and strength**: Start typing the name of the medication to search through Elation’s database. If you’re unable to find a match, you can create a custom medication.
8. **NDC#**: If a medication is selected from our database, the **NDC #** will auto-populate from our database.
9. **Unit**: mL is the default unit but the following units are accepted: dL, g, kg, kL, L, mCi, mg, mL, ug, and uL.
10. Use the **toggle** to indicate whether this injection is **Permanent** or **Temporary**.
* If **Permanent** is selected, this injection will appear under the Permanent Med List in the patient’s Clinical Profile.
* If **Temporary** is selected, this injection will only appear if you open the patient’s full Medication History.
5. In the **Proc Codes** field, specify the procedure code(s) related to the injection. Then, in the **Dx For All** field, specify the diagnosis code(s) you wish to associate with all the listed procedure code(s).
* If you are using the Premium EHR [Injection Coding Automation](/articles/vaccines-and-injections-coding-templates) feature, the codes may be automatically populated once you select a coded medication.
* At this time, the Procedure and Diagnoses codes will not transfer to any other parts of the chart\*\*.\*\*
6. You must select the **Ordered by** and **Given by** user from your practice’s list of active users for new injections. For historical injections, these fields are optional and do not have to be members of your practice.
7. The **Reaction** field will default to **No Reaction**. Click on the dropdown to select other reactions as needed and to describe the reaction.
8. Click **Save** to complete.
Once the injection form is saved, you will not be able to make edits. Please make sure all entries are accurate before saving.
### Creating a custom medication for the injection form
If you cannot find a medication within Elation’s database, simply add it by following these steps:
1. Type out the name of the medication in the **Medication name and strength** field of the **Document Injected Medication** form then select **Add a new med…** at the bottom of the dropdown.
2. Verify the **Name** of the new medication, and optionally fill out the **Strength**.
3. Select whether it is a **Prescription**, **OTC**, or **Controlled** medication type.
4. Click **Create Medication & Continue**. You will be brought back to the injection form to continue the workflow.
### Viewing recorded injections
The workflow that was used to document an injection will determine where Elation saves it in the patient’s chart.
* If the injection was documented while a **visit note draft was** **open**, it will appear within the Plan of the note.
* If the injection was documented while **a visit note draft was** **not open**, it will appear as a standalone item in the Chronological Record.
* If the injection was marked as **Permanent**, the injection will appear under the Permanent Med List in the patient’s Clinical Profile and the patient’s full Medication History list.
* If the injection was marked as **Temporary**, the injection will only appear in the patient’s full Medication History list.
Click on the injection hyperlink from any of these locations to view its details. If an injected medication is documented multiple times, the entries will be grouped into a single thread to improve tracking.
## Frequently Asked Questions
### Who can view and save injections?
All users (providers and staff) are able to view and save injections.
### Does the injection form “remember” and autofill certain details about each medication? (ex. the manufacturer, lot number, expiration from the last saved record)
It does not currently remember and autofill details about each medication.
### Can you edit the injection details once it’s been saved?
Saved injections cannot be edited. If edits need to be made, please re-document the injection and delete the incorrect version.
### If you chose Historical Injection, are you able to free hand the Ordered by and Given by fields (rather than be limited to users within the practice)?
Yes, you can freely enter text in the **Ordered by** and **Given by** for historical injections.
### Who shows up in the Ordered by field if an injection form is opened by a staff user?
The staff’s assigned provider will appear in the **Ordered by** field, and the staff user’s name will be in the **Given by** field.
### What happens if the provider I want to select has been deactivated?
Only active users are available for selection for new injections. For historical injections, any individual can be documented as the **Ordered by** and **Given by** provider.
## Related Articles
* [Medication List Management Guide- Documenting, discontinuing or merging medications](/articles/medication-history)
# Coding Guide - Searching for ICD-10 codes using the Dx Code Navigator (Premium)
Source: https://help.elationhealth.com/articles/Dx-Code-Navigator
## Overview
### What is the DX Code Navigator?
By default, all ICD-10 fields (e.g. in the Lab Order Form, Problem List, Referral, Visit Note) include built-in search functionality for ICD-10-CM codes, allowing users to quickly look up and select the appropriate codes. As users type search terms, matching results appear automatically to simplify selection. To narrow the results, users can add more specific search terms. When a diagnosis involves a code combination, selecting it will automatically add all related codes to the entry.
Premium EHR users can utilize the **Dx Code Navigator**, a tool that streamlines the process of searching for and applying ICD-10 codes and code combinations. Users start by entering a broad search term for a diagnosis category, then refine their results using suggested modifiers to identify more specific or secondary codes.
* Premium EHR users can also request an optional setting that separates code combinations into individual line items within the **Assessment** section of visit notes, improving organization and clarity.
* This setting **does not** separate code combinations into individual line items in the **Problem List**.
### What are the benefits of the Dx Code Navigator?
The Dx Code Navigator allows you to quickly search for and apply specific, detailed, and accurate diagnosis codes directly to your documentation. This is particularly valuable for practices participating in quality programs that calculate a patient’s [Risk Adjustment Factor (RAF)](/articles/what-is-risk-assessment), as it enables thorough documentation of chronic conditions, comorbidities, and illness severity—leading to more accurate risk scores, equitable reimbursement, and a more accurate representation of the patient population’s clinical complexity.
### Which features support the Dx Code Navigator?
Dx Code Navigator can be used to document **Assessments** in the visit note and problems in the **Problem List**.
## Setup
The **Dx Code Navigator** feature is part of Elation's [Premium EHR](/articles/Premium-EHR-Features-Guide) offering. To request the feature, click **I need help**-> **Contact Elation Support** and specify which version of the feature you prefer.
* **Option 1**: *Please enable the Dx Code Navigator feature. I want code combinations to appear as a single line item in the***Assessment***section of my visit notes.*
* **Option 2**: *Please enable the Dx Code Navigator feature. I want code combinations to appear as separate line items in the***Assessment***section of my visit notes.*
Once the feature is enabled you can use it immediately.
## Workflow Instructions
### Using the DX Code Navigator in the Assessment section of visit notes
Elation’s Dx Code Navigator is available in any visit note format that includes structured **Assessment** fields, including the 1-column, 2-column, and Pre-Op formats.
| **1** | Go to the **Assessment** section of your visit note and enter a keyword to search for the diagnosis code you need. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Matching code categories will appear at the top of the search results. Click on the closest match to open the **Dx Code Navigator**. ![Assessment section search field with "diabetes" typed, showing a dropdown of matching code categories including "Diabetes" highlighted at top, and basic search results below with ICD-10 codes E11.9 and E13.9.]()
If the code already appears in the basic search results, simply click on it as usual. |
| **3** | Narrow your search by selecting a matching modifier using the radio buttons or by typing additional keywords into the search box. ![Dx Code Navigator showing search terms "Diabetes," "type 2," "with long term use," and "with kidney complications" applied. Left panel shows three checked modifiers. Right panel shows "type 2" and "with long term use" selected, filtering results to Type 2 diabetes with kidney disease ICD-10 codes (E11.21+, E11.22+) with 0.2 risk scores.]()
As you refine your search, the diagnosis codes listed at the bottom of the Dx Code Navigator automatically narrow to show the most relevant matches. Specific modifiers can also be accessed quickly by selecting options in the left-hand column. |
| **4** | Click on the desired codes in the **Dx Code Navigator** to add them to the visit note. To preview the diagnosis codes that will be added to the note, hover over the ICD-10 code in the search results. A plus sign (**+**) at the end of an ICD-10 code indicates that it’s part of a code combination and must be used with additional related codes. ![Dx Code Navigator showing E11.21+ selected for "Type 2 diabetes mellitus with diabetic nephropathy, with long-term current use of insulin." A tooltip reveals the two codes in the combination: E11.21 and Z79.4. Risk score 0.2 shown in orange.]()
You’ll also see the associated CMS-HCC risk adjustment weight, shown in orange. |
| **5** | The selected code(s) will appear as a single line item in the **Assessment** section, unless you are using the feature that separates primary and secondary codes into individual line items. Click **Add Problem** to add any relevant problems to the Problem List. |
### Using the Dx Code Navigator in the Problem List
| **1** | Go to the **Problem List** and click + Add Problem. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Enter a keyword to search for the diagnosis code you need. |
| **3** | Matching code categories will appear at the top of the search results. Click on the closest match to open the **Dx Code Navigator**. If the code already appears in the basic search results, simply click on it as usual. |
| **4** | Narrow your search by selecting a matching modifier using the radio buttons or by typing additional keywords into the search box. As you refine your search, the diagnosis codes listed at the bottom of the Dx Code Navigator automatically narrow to show the most relevant matches. Specific modifiers can also be accessed quickly by selecting options in the left-hand column. |
| **5** | Click on the desired codes in the **Dx Code Navigator** to add them to the visit note. To preview the diagnosis codes that will be added to the note, hover over the ICD-10 code in the search results. A plus sign (**+**) at the end of an ICD-10 code indicates that it’s part of a code combination and must be used with additional related codes. You’ll also see the associated CMS-HCC risk adjustment weight, shown in orange. |
| **6** | The selected code(s) will appear as a single line item in the **Problem List**. |
## Related Articles
* [Problem List Guide](/articles/managing-your-problem-list)
* [Risk Assessment Introduction- Risk Assessment Factors (RAF) and Hierarchical Condition Categories (HCC)](/articles/what-is-risk-assessment)
# Electronic Health Information (EHI) Export Criteria
Source: https://help.elationhealth.com/articles/EHI-Export-Criteria
## What is the Electronic Health Information Export Requirement?
The 21st Century CURES updates to 2015 Certified EHR Technology (CEHRT) update requires criteria § 170.315 (b)(10) Electronic Health Information Export to be met in 2023 by Health IT. The requirement states that all certified Health IT must be able to export Electronic Health Information (including payment data, imaging, and any data stored in the module at time of export) for both a single patient, as requested by the patient, and the patient population, as requested by the provider.
To fulfill this requirement for both the single patient and patient population exports, the data must be exported electronically and in a computable format by Elation within a reasonable request of time. This Help Center Article will act as the publicly accessible hyperlink of the export’s format that must be included in the export file as outlined by the criteria.
## How Elation will help you stay compliant
To export EHI data for a single patient:
1. Open the patient’s chart in Elation.
2. Click the **More** button in the navigation bar and then click **Data Exchange**.
3. Click **Export Entire Health Information (EHI)** .
4. Afterwards click **Export Patient EHI** in the confirmation box.
5. You will receive two emails at the email listed in the confirmation box. The emails will have the subject line ***ACTION REQUIRED: Elation Data Export***. One email will contain a download link for the export and the other email will contain the password to unlock the file after you download it. You will have 6 days to download the file before the download link expires. If the download link expires before you download the file, repeat these steps to generate a new export with a new download link and password.
* You can optionally choose to email a copy of the export to the patient by checking off the **Also share with patient** box. We recommend verifying the patient’s email address before sending them the export.
In order to export EHI for individual patients, you must have Admin level privileges. To become an Admin, you must ask an existing Admin level user in your practice (most likely a primary provider level account holder) to grant you privileges via the [Manage Accounts](/articles/managing-user-accounts) Settings page.
Providers can also request that Elation completes an EHI export for their entire patient panel at their request. For additional support regarding Electronic Health Information Exports, including expedited exports and customized exports which may include a cost for customized reports, [please submit a request here](https://help.elationemr.com/s/contactsupport).
Integrators with Elation can reach out to Elation for EHI export requests using [this Contact Support form](https://help.elationemr.com/s/contactsupport).
## Additional Regulatory Information
Elation Health facilitates Customers’ ability to comply with information disclosure obligations in its exporting of electronic patient health information. It is the Customer’s responsibility to understand applicable laws, rules and regulations applicable to its practice and to comply. By default, the Elation Health EHI does not include information identified as **Confidential Notes** (defined below) in exports. It is Customer’s responsibility to ensure that psychotherapy notes as defined in 45 CFR 164.501, information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding, or data regarding a person who has been deceased for more than 50 years or other information that may not subject to disclosure are included in these Confidential Notes areas of the EHI. In accordance to the EHI Export certification criterion, all electronic patient information will be exported, except for the following subsets of data:
Confidential Notes Features:
* Files in Elation that can be tagged as ‘Keep this Confidential’ (e.g., orders and visit notes) or **Mark Confidential** (e.g., reports)
* Free text in the **Notes and Chart Management** section in the Demographic Dialog
* Free text in the **Notes** section of our Elation Billing product
For single patient exports requested by the patient, Confidential Notes will always be withheld.\* For bulk exports requested by a provider or practice, users will have the option to include or exclude Confidential Notes.
\*Additional information: In alignment with the HIPAA Privacy Rule, it is the provider’s responsibility to include any information that would otherwise be disclosable to a patient under applicable state and federal healthcare laws. For single export requests by a patient where the Confidential Notes are requested, [please reach out to Elation Support](https://help.elationemr.com/s/contactsupport) to fulfill this request. Confidential Notes features are intended to help providers restrict access to information that qualifies for an information blocking exception under applicable law; however it is the provider’s responsibility to ensure its compliance with applicable laws, rules and regulations related to information disclosure.
## Elation’s Designated Record Set
In accordance with the Electronic Health Information Export criteria, Elation must provide information about the export format to facilitate the interpretation of the electronic health information. The Elation Health Designated Record Set contains the electronic health information available in a patient's Elation Health record in a computable, pdf, xml, or image file format. Some electronic health information might not be available in an xml or pdf format, such as rich text documents or images. This information might be referenced from the EHI Tables, but the actual files can be reviewed in a separate download in the export. Information may not be available based on the configuration of modules from Elation Health the practice, provider, or integrations in use.
The content included in the export might vary based on a variety of factors, including:
* The software applications in use at the practice or provider that generated the files.
* The documentation and software use practices in place at the practice or provider that generated the files.
* Configuration decisions made by the practice or provider that generated the files.
* The practice or provider includes materials not sourced from Elation Health.
### Data
The data elements listed in Elation's Designated Record Set are the identified data elements in Elation’s system which store EHI. The formats of data exported are associated with the relative datum.
[Click here to download a copy of Elation's Data Resource Table and its export formats](/files/ehi-data-resource-table.pdf).
## Frequently Asked Questions (FAQs)
### My practice has multiple instances on Elation. Will I receive a separate export for each instance?
At this time, Elation does not support cohorting or filtering of patient data to fulfill this requirement. The § 170.315 (b)(10) Electronic Health Information Export criteria states that filtering and the ability to create subsets are not required for certification.
### How do I export data for a single patient?
To export EHI data for a single patient:
1. Open the patient’s chart in Elation.
2. Click the **More** button in the navigation bar and then click **Data Exchange**.
3. Click **Export Entire Health Information (EHI)** .
4. Afterwards click **Export Patient EHI** in the confirmation box.
5. You will receive two emails at the email listed in the confirmation box. The emails will have the subject line ***ACTION REQUIRED: Elation Data Export***. One email will contain a download link for the export and the other email will contain the password to unlock the file after you download it. You will have 6 days to download the file before the download link expires. If the download link expires before you download the file, repeat these steps to generate a new export with a new download link and password.
* You can optionally choose to email a copy of the export to the patient by checking off the **Also share with patient** box. We recommend verifying the patient’s email address before sending them the export.
### How do I export EHI data for my entire practice?
Providers can also request that Elation completes an EHI export for their entire patient panel at their request. For additional support regarding Electronic Health Information Exports, including expedited exports and customized exports which may include a cost for customized reports, [please submit a request here](https://help.elationemr.com/s/contactsupport).
Integrators with Elation can reach out to Elation for EHI export requests using [this Contact Support form](https://help.elationemr.com/s/contactsupport).
### How do I export the data for all patients assigned to a specific Provider?
Providers can also request that Elation completes an EHI export for their entire patient panel at their request. For additional support regarding Electronic Health Information Exports, including expedited exports and customized exports which may include a cost for customized reports, [please submit a request here](https://help.elationemr.com/s/contactsupport).
Integrators with Elation can reach out to Elation for EHI export requests using [this Contact Support form](https://help.elationemr.com/s/contactsupport).
### Does the EHI export include a patient's appointment history?
No, appointment history is not currently included in the EHI export. If a patient needs this information, take a screenshot of the appointment list from the patient's chart and email it directly to the patient, or upload it into the patient's chart so it's included in a future export.
### I can't open the password-protected ZIP file from my export. What should I do?
Windows 10's built-in extraction tool does not support password-protected AES256-encrypted ZIP files, which is a common cause of this issue. Use a third-party extraction tool such as [7-Zip](https://www.7-zip.org/), WinZip, or WinRAR instead. Once extracted, the export contains several file types: PDFs (viewable with any web browser or PDF reader), CSVs (best opened with a spreadsheet application), and XML/CCDA files (intended for import into EHR systems, but can be opened with a text editor if needed).
## Related Articles
* [21st Century Cures Act Introduction](/articles/21st-Century-Cures-Act-and-Elation-EHR)
* [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types)
# User Accounts Guide- Setting up Elation EHR accounts and Provider account authentication
Source: https://help.elationhealth.com/articles/EHR-account-setup-and-Provider-account-authentication
The Elation Team is excited to welcome you to our user community! Please complete your account details to fully set up your new Elation EHR account.
## What is EHR Account Setup?
All users must set up a password for their Elation EHR account in order to gain access to their EHR account. In addition to creating a password, [Provider Level Users](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges) must also complete account authentication, verify their credentials and set up their electronic signature.
## How to complete EHR Account Setup
A small subset of customers may still be seeing the legacy EHR Account Setup workflow. Both workflows will allow you to register for an Elation Account. If you have any questions about the experience you are seeing, [click here to contact Elation Support](https://help.elationemr.com/s/contactsupport) .
To complete EHR account Set Up:
1. Go to your email inbox and look for an email from '[sysadmin@elationemr.com](mailto:sysadmin@elationemr.com)' with the Subject Line ***Welcome to Elation! Quickly complete your account setup.***
\_\_ ![Elation Health welcome email in Gmail inbox with subject "Welcome to Elation! Quickly complete your account setup." showing a "Get Started" button in the email body.]()
2. Click the **Get Started** button in the body of the email.
3. Choose a password for your account and enter it in the **Password** field. The requirements for your password are as follows:
* At least 12 characters long
* At least 1 capital letter (uppercase letter)
* At least 1 number
* At least of the following special characters @ # \* ( ) + = / ? \~ ; , . - \_
![Elation password setup form with all four requirements checked in green: 12+ characters, 1 capital letter, 1 number, and 1 special character.]()
4. Re-enter the same password in the **Retype Password** field.
5. Click **Set Password** to complete account set up.
6. \*\*\[PROVIDER LEVEL USERS ONLY]\*\* Go to the ['How Provider Level Users complete Account Authentication' section](#CompleteAccountAuthentication) of this article to proceed with the next step, Account Authentication. Staff Level Users have complete EHR account setup and have no additional steps.
## What is Provider Level User Account Authentication?
Account Authentication is the process Elation takes to verify a [Provider Level User's](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges) identity and credentials before we give Provider Level Users full access to tools that grant them access to all Protected Health Information (PHI) features; especially e-Prescribing.
## Why is Account Authentication required for Provider Level Users?
Account Authentication is required for [Provider Level Users](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges) because Elation must make sure the correct **person** is granted access to Protected Health Information (PHI) and related features and interfaces. It is a shared responsibility to make sure your patients' PHI is accessed by the correct individuals. Account Authentication is also required for each Provider Level User before Elation can grant them prescribing privileges.
**Exception:** A Provider Level User account is permanently tied to the identity that completed Account Authentication and can't be edited or re-verified to represent a different person. If a new provider joins your practice, invite them to set up their own account rather than updating an existing provider's profile with the new provider's information. Doing so can leave the account improperly provisioned, associating the new provider with the wrong provider identification — such as an SPI number — for prescribing and other regulated activity. If your practice has already updated an existing account with a different provider's details, [contact Elation Support](https://app.elationemr.com/support/) to get the account properly re-provisioned.
## How Provider Level Users complete Account Authentication
A small subset of customers may still be seeing the legacy Provider Account Authentication workflow . Both workflows will allow you to complete Account Authentication. If you have any questions about the experience you are seeing, [click here to contact Elation Support](https://help.elationemr.com/s/contactsupport) .
To complete Account Authentication, [Provider Level Users](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges) must complete the following steps:
1. After you, the Provider Level User, set up your password, you will be brought to the Identify Verification page. Click the \*\*Verify Identity \*\* button to verify your identity with our identity verification service provider, Stripe. [Click here for step by step instructions on the identity verification process](/articles/how-to-complete-identity-proofing).
![Elation account setup step 2 of 4 (Identity Verification) active, showing the Verify Identity button and requirements: government-issued ID and webcam or phone for a selfie.]()
2. Click the **Continue Set Up** button after you complete identity verification.
3. Review your account information in the Credential Verification page & select your timezone in the **Timezone** field.
![Credential Verification page (step 3 of 4) showing pre-filled contact info for Jane Smith and credentials including NPI 9999999999, MD, CA license, with "I have an NPI" selected and timezone set to US - Pacific.]()
* **Important Note:** If you do not have an NPI, select the **I do not have an NPI** option to proceed with credential verification.
**Exception:** The **Timezone** field is not editable from Settings once you complete Account Authentication. If you need to change your timezone afterward, contact Elation Support.
4. Click **Yes, looks correct** once all the information on the Credential Verification page is accurate.
5. Lastly, you will set your electronic signature for your EHR account. To set your signature:
* Use your mouse or touchpad to draw your signature in the signature box OR
* Click the **Use a separate device** button to scan a QR code with a mobile device to draw your signature using the mobile device.
6. Click **Save & Complete** to save your electronic signature.
7. You will now have access to your EHR account and should see a ‘Congratulations….” box. This means you have successfully completed Provider Account Authentication.
8. Next, go to the ['Provider Level User Profile Fields' section](#provider_fields) below to see if you need to store any additional, optional identifiers in your EHR Profile. You can also edit your profile information in this section of your account at any time.
### Email confirmation
After your account is authenticated and credential verification is complete, Elation sends a confirmation email to the email address associated with your account. Depending on whether you had a valid DEA number on file prior to authentication, the email may include additional information on how to sign up for [ePrescribing Controlled Substances (EPCS)](/articles/how-to-complete-the-epcs-sign-up-process).
If you do not receive this email within several business days, check your spam or junk folder. The email is sent from [support@elationhealth.com](mailto:support@elationhealth.com).
If you experience any issues with the Provider Account Authentication process and need assistance, [please click here to contact the Elation Team](https://help.elationemr.com/s/contactsupport).
## Profile Level User Profile Fields
To view your account profile:
1. Click on your email address (username) at the time right corner of your EHR account
2. Click **Settings**
3. Click **Edit profile** in the Account Details page
The Provider Level User profile fields are divided into the following sections:
* [Account Details](#account_details)
* [Credentials](#credentials)
* [Authentication Documents](#authentication_documents)
* [Electronic Signature](#electronic_signature)
* [Lab Identifiers](#lab_identifiers)
### Account Details
* Profile picture
* Your profile picture appears in the Elation Provider Directory.
* **First name***and **Last name***
* This is how your name will display on all Elation records.
Do not include credentials in these fields. You must enter your legal name. You can enter your credentials in the **Credentials**\* field.
* **Email**\*
* This is the email address that you will use to log in to Elation and Elation will use this email to contact you.
* **Credentials**\*
* Your credentials will appear after your name on all Elation records.
* Tax ID Number (**TIN**)
* **NPI**\*
### Credentials
* Medical License **State**\*
* Medical License Number\**\**\**\**\* (Next to the **State**\* field)
* **DEA Number**
* Enter your Drug Enforcement Administration (DEA) registration number. Your DEA number is a unique identifier assigned by the DEA that authorizes you to prescribe controlled substances.
Your DEA number is necessary for [ePrescribing controlled substances](/articles/how-to-complete-the-epcs-sign-up-process) through Elation. If you do not have a DEA number or do not prescribe controlled substances, you may leave this field blank.
**Account authentication and your DEA number:**
* If your DEA number is **not** entered prior to being authenticated, your authentication email will only provide instructions for prescribing non-controlled substances.
* If your DEA number **is** entered prior to being authenticated, your authentication email will also include instructions on how to sign up for ePrescribing Controlled Substances (EPCS).
* **Supervising Provider**
* Your Supervising Provider must have their own Elation Provider Level User account. Afterwards you can select their name of this dropdown.
* **Rx Authorization** Number
* **Rx Authorization** number is an optional field for NPs who have additional license numbers for ePrescribing.
* If you have a supervising provider, invite them to create their own [Provider Level User](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges) account in Elation. Afterwards, you only need to select their name in the **Supervising Provider** field. This will ensure their prescribing information (DEA number, etc.) is included on the prescriptions you prescribe.
* **XDEA/NADEAN**
* **XDEA/NADEAN** is an optional field for Providers who have additional license numbers for prescribing controlled substance medications.
### Authentication Documents
* Identity Verification
* You may need to click **Verify identity through Stripe ID Proofing** again if you did not pass identity proofing the first time. [Click here for detailed information about the identity proofing process.](/articles/how-to-complete-identity-proofing)
* **Medical License**
* Click the **Upload photo** buttons under Medical License to store a copy of your medical license if preferred.
* You can remove and re-upload it yourself until Elation Support reviews and marks it complete. After that, contact Elation Support to make changes.
### Electronic Signature
Click on your wet signature to update your wet signature on your account. \*
* Click **Save & Close** after drawing your signature to save it.
* Elation will attach an image of the wet signature for providers whenever provider-signed records are printed or shared from their Elation account.
* If you prefer to use an alternative device to draw your signature, such as a tablet or phone, click the **Use a separate device for my signature** button to scan a QR code with the alternative device.
### Lab Identifiers
Enter your lab identification numbers for Quest or Labcorp if applicable.
## Staff Level User Profile Fields
To view your account profile:
1. Click on your email address (username) at the time right corner of your EHR account
2. Click **Settings**
3. Click **Edit profile** in the Account Details page
Staff Level Users can store the following information in their account profile:
* Profile picture
* **First name**
* **Last name**
* **Email** (username)
* **Default physician**
*© 2023 Experian. All rights reserved.© 2023 Stripe, Inc.*
\*\*Excited to get started with Elation? We invite you to explore the \*\*[On-Demand Courses on Elation University](https://www.elationhealth.com/elation-university/#on-demand) **to learn more about Elation EHR.**
## Related Articles
* [How to Complete Identity Proofing with Elation](/articles/how-to-complete-identity-proofing)
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
# Elation-AdvancedMD Integration Guide
Source: https://help.elationhealth.com/articles/Elation-AdvancedMD-Integration
This article details the integration between Elation and AdvancedMD and how information syncs between the systems.
## What is AdvancedMD?
AdvancedMD® is a Practice Management software that practices can use alongside Elation. Practices most commonly use AdvancedMD to submit claims to Payers for services rendered and track the progress of claim payments.
## What is the Elation-AdvancedMD Integration?
The Elation-AdvancedMD integration allows practices to send claims-related data from Elation to AdvancedMD for practices to submit claims to Payers (through AdvancedMD) for services rendered in Elation. The Elation-AdvancedMD integration reduces the need for double documenting in two softwares and allows practices to store all their clinical data in Elation while using AdvancedMD side-by-side to manage their revenue.
## How do I get started?
You must first have an account with AdvancedMD before you can use this integration. Elation will work with AdvancedMD to set you up on AdvancedMD and turn on the integration if you do not have an AdvancedMD account yet. You can send Elation a request to turn on the AdvancedMD integration by:
* emailing [implementation@elationhealth.com](mailto:implementation@elationhealth.com) if you are being onboarded to Elation
* emailing [integrations@elationhealth.com](mailto:integrations@elationhealth.com) after you exited the onboarding phase
## What information is synchronized?
| Data | Sync Direction |
| -------------- | -------------------- |
| Patient Charts | AdvancedMD → Elation |
| Demographics | AdvancedMD → Elation |
| Insurance | AdvancedMD → Elation |
| Appointments | AdvancedMD → Elation |
| Bills | Elation → AdvancedMD |
## Mapping Data
Follow these instructions to map the following data between Elation & AdvancedMD:
1. **Providers**- notify Elation and/or AdvancedMD if new providers are added to both systems. Additional actions have to be taken on the backend to connect new providers to each other across systems.
2. **Practice Locations**- notify Elation and/or AdvancedMD if new Practice Locations (Service Locations) are added to both systems. Additional actions have to be taken on the backend to connect the new locations to each other across systems.
3. **Payers**- new insurance Carriers need to be added to the AdvancedMD Insurance Carriers list and to a patient chart in AdvancedMD in order to be pushed to Elation. Do not create new insurance carriers in Elation.
4. You can manage insurance carriers in AdvancedMD under **System Settings >> Carriers >> Carriers**.
5. **Appointment Types**- Appointment Types are automatically synced from AdvancedMD to Elation.
6. **CPT Codes**- You can freely add CPT Codes in Elation and those will be automatically pushed to AdvancedMD.
7. Add the CPT Code to your Fee Schedule in AdvancedMD (with an associated charge) if you have a default billed amount you want to assign to the CPT Code for your claims. You can find your Fee Schedule in AdvancedMD under **System Settings >> Fee Schedule**.
8. While any CPT code entered in a bill will transfer from Elation to AdvancedMD, the CPT code and additional details will need to be added directly in your AdvancedMD Chart Code database if you require these details for your claims (ex. NDC information). You can add CPT Codes in AdvancedMD by going to **System Settings >> Transaction Codes >> Charge Codes**.
## Patient Charts
### Creating Charts
All patient charts must be created in AdvancedMD in order for the patient's chart to be created in Elation. See the
[Patient Demographics section](#demographics)
for details about managing demographics information after charts are created in Elation.
### Merging Charts
Each chart can only have a one to one connection between Elation and AdvancedMD and this connection is established upon chart creation. If you happen to see a duplicate chart for the same patient in Elation, please make sure you find the chart that is connected between the two systems and keep the connected chart after performing a merge.
* We recommend making a small demographic change in AdvancedMD to see which Elation chart the change occurs in. Once you locate the connected chart in Elation, you will merge the duplicate, not-connected chart into the connected one by following the steps detailed below.
Here are the proper merge steps for Elation charts:
1. Open the duplicate chart that is not connected to the integration
2. Click on the patient's name to open their Demographics
3. Click on the **Merge Chart** button
4. Find & select the chart you want to keep (the one that is connected to the integration)
5. Click **Merge Chart**
6. Confirm you understand the transfer of data and then click **Yes, merge charts**
### Deleting Charts
Deleting a chart in Elation will not delete the chart in AdvancedMD and vice versa. Please take caution when deleting charts in Elation while using the AdvancedMD integration as charts have a one to one connection via the integration. If the patient is still active in your practice, the deleted chart must be restored in order for the patient's information to sync properly across the two systems.
You can restore a deleted patient chart yourself using the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice). Go to **Reports** > **User Activity Log**, filter by the patient or by the **Delete** action, and click the **Restore** button next to the deleted chart. [Admin Level Users](/articles/administrative-privileges) can view and restore activity for all users in the practice.
## Patient Demographics
The synchronization of Patient Demographics is unidirectional from AdvancedMD to Elation. Any changes or updates to demographics information must occur in AdvancedMD. The following table shows a mapping of the Patient Demographics fields that are shared between Elation and AdvancedMD and their matching field names.
| Elation Field Name | AdvancedMD Field Name |
| -------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Legal First Name | Patient Name \**When creating charts in AMD, the patient’s name must be entered as: Last name, First name Middle name* |
| Legal Last Name | Patient Name \**When creating charts in AMD, the patient’s name must be entered as: Last name, First name Middle name* |
| Date of birth | Date of Birth |
| Sex at Birth | Sex |
| Primary Phone “Cell” from AdvancedMD will display as **Mobile** in Elation | Preferred Phone The following phone number types will sync to Elation: |
| Secondary Phone | Work Phone *or* Other |
| Email | Email |
| Address | Address |
| Ste or apt # | Apt / Ste # |
| City | City |
| State | State |
| Zip | Zip Code |
| Provider assigned in practice | Provider Profile \**A patient’s assigned provider will automatically be the first provider listed in Elation if the provider from AdvancedMD is not properly mapped between Elation and AdvancedMD.* |
## Insurance
The synchronization of insurance information is unidirectional from AdvancedMD to Elation. Practices must enter insurance information in AdvancedMD in order for the insurance information to push to Elation.
The following table lists the insurance related fields that are pushed from AdvancedMD to Elation and show how the AdvancedMD fields map to the Elation demographic fields for insurance. Fields that are not listed are not shared between Elation and AdvancedMD:
*
Only Primary Insurance and Secondary Insurance will sync between AdvancedMD and Elation.
| Elation Field Name | AdvancedMD Field Name |
| ---------------------- | --------------------- |
| Insurance carrier name | Carrier |
| Group ID | Group # |
| Member ID | Subscriber ID |
### Carriers
Insurance Carrier details should only be maintained in AdvancedMD as AdvancedMD is the source of truth for insurance. It is most important for you to create Carriers in AdvancedMD to avoid creating duplicate Payers in Elation. Best practice is to create a unique Carrier in AdvancedMD for each unique Payer (with a unique Payer ID). You can manage insurance carriers in AdvancedMD under
**System Settings >> Carriers >> Carriers**
.
*
Elation ‘Plan’ level details are not supported by the integration. If it is important to distinguish between different coverage plans under different Payers, create a separate AdvancedMD **Carrier** for each coverage plan.
## Appointments
The synchronization of appointments is unidirectional from AdvancedMD to Elation. Practices must create new appointments in AdvancedMD for the appointment to push to the corresponding Provider calendar in Elation. After new appointments are created in AdvancedMD, you may update appointment details in AdvancedMD and the updates will push to Elation.
The following table lists the Appointment fields that are pushed from AdvancedMD to Elation and show how the AdvancedMD fields map to the Elation fields. Fields that are not listed are not shared between the Elation and AdvancedMD:
| Elation Field Name | AdvancedMD Field Name |
| -------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------- |
| Patient name | Last name, First name \**Displayed at the top of the appointment window* |
| Date | Date |
| Start Time | Time |
| Duration | Duration |
| Status \*Only the following statuses are supported at this time: Checked In • Checked Out • Canceled • No show | Status Indicator \**Displayed in the left hand column of the appointment window* |
| Provider | Provider |
| Appointment type | Appointment Type |
Deleting an appointment in AdvancedMD will also delete the appointment in Elation. Best practice is to update the status of cancelled appointments to **Canceled** instead of deleting it.
## Bills
The synchronization of bills is uni-directional from Elation to AdvancedMD. Once a provider signs a visit note in Elation, the billing information in the visit note will be pushed to AdvancedMD as a Superbill. Once a bill is pushed to AdvancedMD, edits must be made in both Elation and AdvancedMD if needed. If you are missing any CPT and ICD-10 codes upon signing your visit note, Elation will notify you and prompt you to update your billing information before sending it to AdvancedMD.
*
The **Delayed Billing** feature is supported by the AdvancedMD integration. Learn more about the feature [here](/articles/How-to-set-up-Delayed-Billing) .
The following table lists the fields that are pushed from Elation to AdvancedMD and show how the Elation fields map to the AdvancedMD fields. Fields that are not listed are not shared between Elation and AdvancedMD:
| Elation Field Name | AdvancedMD Field Name |
| ------------------ | ---------------------- |
| Procedure | Procedure |
| + Add Dx | ICD-10 Diagnosis Codes |
| Place of Service | POS |
*
If the bill is sent successfully from Elation to AdvancedMD, a billing reference number from AdvancedMD will be sent to Elation. This reference number will be stored in [Billing Home](/articles/Billing-Home) and in the corresponding signed visit note/bill in the patient’s chart.
## Getting Support
### AdvancedMD
If you need assistance with your AdvancedMD configuration or have questions about the AdvancedMD Application, contact AdvancedMD by clicking on **Help** >> **Contact Support** in the black bar at the top of your AdvancedMD account.
### Elation
If you need assistance with Elation or the Elation-AdvancedMD integration, contact Elation using the **I need help** >> **I need help from an Elation Team Member** button at the top of your Elation account.
## Related Articles
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
# Hosted Database Guide - Using Elation Analyst
Source: https://help.elationhealth.com/articles/Elation-Analyst
## Overview
### What is Elation Analyst?
Elation Analyst is a self-service, AI-powered chat app that uses natural language to generate analytical reporting within your [Hosted Database account](/articles/Hosted-Database-Introduction). You can explore your data, ask analytical questions, and view generated reports directly within Snowflake.
### What are the benefits of using Elation Analyst?
Elation Analyst gives you access to advanced analytics without the need for custom reports or a dedicated data analyst. It’s built to help you work more efficiently, improve patient outcomes, and move beyond basic reporting. Whether you're in a small practice or a larger organization, you’ll get advanced analytics at your fingertips - no custom reports or extra development required.
### What kinds of data can I explore with Elation Analyst?
While you can explore all your Hosted Database data, we’ve fine-tuned Elation Analyst to be especially smart at analyzing these types of information:
* Appointment
* Billing Codes
* Diagnoses
* Medications
* Orders
* Vitals
* Patient Tags
[Click here for a list of sample questions you can ask around the topics listed above](#resources).
Elation Analyst is best at answering clear, data-based questions—things you could pull from a database, like patient counts or appointment trends. It won’t generate open-ended insights or big-picture takeaways, such as **What trends do you notice?**.
## Setup
**Beta feature:** The feature described in this article is part of a beta release and is only available to a select number of practices using Elation’s Hosted Database.
### Do you need to install Elation Analyst?
That depends on the type of Snowflake account you use for your Hosted Database. Most practices use an Elation-provided reader account, where Elation Analyst is already installed and no setup is required.
| Your Snowflake account | How to tell | What to do |
| ----------------------------------- | -------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Elation-provided reader account** | Elation sent you your Snowflake URL, username, and password. Your Snowflake role is **USERADMIN**. | Elation Analyst is already installed. Go to [Asking questions](#asking-questions). Do not run the installation script. |
| **Standalone Snowflake account** | Your organization purchased the account directly from Snowflake, and you have the **ACCOUNTADMIN** role. | Install Elation Analyst yourself. Follow [Installing Elation Analyst in a standalone Snowflake account](#installing-elation-analyst-in-a-standalone-snowflake-account). |
### Installing Elation Analyst in a standalone Snowflake account
A standalone Snowflake account is your own Snowflake account — one your organization purchased directly from Snowflake and manages itself.
These steps apply only to standalone accounts. The script uses the **ACCOUNTADMIN** role to create a database and install the app, so it returns an error in an Elation-provided reader account. If Elation sent you your Snowflake login, skip this section and go to [Asking questions](#asking-questions).
To install the Elation Analyst App:
| **1** | Go to **Projects** -> **Worksheets** . |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click the plus **+** icon to open a new SQL Worksheet. |
| **3** | Open [this SQL code](/files/elation-analyst-sql.txt) in a new browser tab, copy the entire script, and paste it into the worksheet. |
| **4** | At line 2, update target\_database |
| **5** | At line 3, update target\_schema |
| **6** | At line 4, update warehouse\_name |
| **7** | Click **Run** . |
| **8** | You will now see the Elation Analyst App in the **Apps** section. |
Elation updates the script when:
* A new semantic model is added.
* An existing semantic model changes.
* The listing name changes.
## Workflow Instructions
### Asking questions
| **1** | Open Snowflake. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Catalog** -> **Apps** . |
| **3** | In the **Installed Apps** section, click the **Elation Analyst (Beta)** App. ![Snowflake Apps page showing the Installed Apps section with Elation Analyst (Beta) listed, owned by ACCOUNTADMIN, version v0.1, installed 2 weeks ago. A submenu shows Catalog > Apps navigation path.]()
|
| **4** | Select the type of Analyst you want to use from the dropdown. |
| **5** | Type a question and then click the **>** icon or **Return**/**Enter** key on your keyboard to submit the question. Your questions should be clear and specific. If the response isn’t quite right, try rewording your prompt slightly or adding additional context to the question. • [Click here for a list of sample questions you can ask.](#resources) |
![Select Analyst dropdown expanded showing options: Appointment, Billing Code, Diagnosis, Medication, Orders, and Vitals, with an arrow pointing to the question input field below.]()
### Viewing results
The answer to your question (i.e. the results after analyzing your data) will appear below the question in the App. You will first see the **SQL** query used to generate the results followed by the **Results** table.
![Elation Analyst chat showing the query "Top 10 appointment type last month" with AI interpretation for July 2025, SQL Query section, and Results table with Follow-Up (3,634) and None (2,077) as top appointment types.]()
#### Providing feedback about the results
If the results are inaccurate, send us the feedback so that we can continue improving on the App’s skills.
| **1** | Select **Query Feedback** . |
| ----- | ------------------------------------------------------------------------------------------------------ |
| **2** | Select **thumbs up** if the answer met expectations • **thumbs down** if the answer needs improvement. |
| **3** | Enter feedback in a message if needed. |
| **4** | Click **Submit** . |
![Query Feedback panel expanded showing thumbs up selected, an optional feedback message field, and a Submit button, overlaying appointment type results data.]()
#### Downloading results
| **1** | Hover over the **Results** section some icons appear. |
| ----- | ----------------------------------------------------------------- |
| **2** | Hover over the download icon and then click **Download as CSV** . |
![Results table showing top appointment types for July 2025, with the download icon circled in orange and "Download as CSV" tooltip visible. Follow-Up leads with 3,634 appointments.]()
#### Copying the SQL Query
| **1** | Expand the **SQL Query** by clicking the down arrow. |
| ----- | ----------------------------------------------------------------------------------------------- |
| **2** | Place your cursor over the query to surface the copy icon & then click on it to copy the query. |
![Elation Analyst chat showing the query "Top 10 appointment type last month" with the AI interpretation and an expanded SQL Query panel. The copy icon in the top-right corner of the SQL panel is highlighted with an orange circle.]()
### Leveraging the results data
#### Building your analytics library
Keep track of the searches that give you the answers you need, and easily update them as your priorities change. Over time, you’ll build a go-to set of insights that grow with your practice—always just a click away.
| **1** | Expand the **SQL Query** . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Place your cursor over the query to surface the copy icon & then click on it to copy the query. |
| **3** | Go to **Projects** -> **Worksheets** . |
| **4** | Click the plus **+** icon to open a new SQL Worksheet. ![Snowflake Worksheets page with the "+" button dropdown open, showing options: SQL Worksheet, Python Worksheet, and Folder. An arrow points to SQL Worksheet.]()
|
| **5** | Paste the **SQL Query** into the worksheet & then click the run icon. |
| **6** | The query is now saved to your Worksheets and can be accessed any time. |
| **7** | Double click the name of the query to rename it as needed. |
### Creating a dashboard from a query
Quickly create a dashboard to keep an eye on what matters most to your practice—all in one place. Whether it’s appointments, prescriptions, conditions, or patients, you can track it all in just a few clicks.
| **1** | Expand the **SQL Query** . |
| ----- | ----------------------------------------------------------------------------------------------- |
| **2** | Place your cursor over the query to surface the copy icon & then click on it to copy the query. |
| **3** | Go to **Projects** -> **Dashboard** . |
| **4** | Click **+ Dashboard** |
| **5** | Name your dashboard. |
| **6** | Click **Create Dashboard** . |
| **7** | Click **New Tile** -> **From SQL Worksheet** . |
| **8** | Paste the SQL query into the worksheet. |
| **9** | Click **Run** . |
![Snowflake Appointment Dashboard showing two tiles: "Top 10 Appointments by Type" bar chart with 1st Visit Primary Care highest at 6,224, and "No Show Count" tile displaying 15.]()
## Resources
### Sample questions for Elation Analyst
#### Appointment Analyst
* Who has missed their appointments this year?
* List of appointments by type most to least in 2025
* List of patients who canceled appointments
* Show me appointment data from last month
* Total appointments created vs Patient seen
#### Billing Code Analyst
* What is the distribution of billing statuses for all bills created year to date?
* I want a list of patients who have not had a flu vaccine in 2025, include contact info and dob, exclude anyone under age 10
* What are the top 5 most frequently billed CPT per month for the last 3 months
* I want to know what is unbilled this year
* How many AWV have we billed this year?
#### Diagnosis Codes Analyst
* I want to find patients by Diagnosis X (e.i.Diabetes)
* I want to see patients diagnosed with 46635009 (SNOMED Code)
* I want to see patients diagnosed with E08 (CPT for Diabetes mellitus due to an underlying condition)
* I want to find patients with Risk Scores between 2-5. Above 5.
* What is the average risk score, for provider X? For practice Z?
#### Medications Analyst
* I want to see all open med orders, include patient info and medication details
* I want to see total open med orders by provider, most to least
* How many medications were discontinued last month? By Provider. By Practice.
* I want to know who is on medication X
* I want to know who is on depression meds and group by age, most to least
#### Orders Analyst
* I want to see open orders grouped by provider and type, include a count
* I want to know how many open referrals there are and the patients associated to them
* I want to know how many open \[Imaging, Cardiac, Colonoscopy, Lab, Pulmonary, Mammogram, Sleep] Orders there are and the patients associated to them
* Show me patients and their tests and results that show abnormal cardiac conditions
* I want to find patients with an A1C result above 9. Between 5-6
#### Vitals Analyst
* I want to know the last vitals for patient X
* I want to know who has a blood pressure reading of 130/80 mm Hg or higher and what diagnosis they have, include medication list
* I want to see all patients with a bmi between 30 and 35. Above 30.
* I want to know average patient BMI for patients over 65
* I want to see patients with an oxygen level below 90 percent, include oxygen level, grouped by provider
#### Patient Tags Analyst
* I want to create a list of all patients with X tag.
* I want to find all patients who have X tag but not Y tag.
* I want to count the number of patients who have X tag.
## Frequently Asked Questions
### Why do I get an error when I run the installation script?
The installation script only runs in a standalone Snowflake account. It uses the **ACCOUNTADMIN** role to create a database and install an application, and an Elation-provided reader account permits neither action.
If Elation sent you your Snowflake login, you have a reader account and Elation Analyst is already installed — go to [Asking questions](#asking-questions) instead of running the script. For details on what a reader account can do, see [What kind of Access/Permissions do I get with my Snowflake Account?](/articles/hdb/what-kind-of-accesspermissions-do-i-get).
### Will Elation fine-tune Elation Analyst to be especially smart at analyzing other types of information?
Yes, we will, please send us the feedback so that we can continue improving on the App’s skills.
| **1** | Select **Query Feedback** . |
| ----- | ----------------------------------------------------------------------------- |
| **2** | Enter the type of information you want us to analyze in the feedback message. |
| **3** | Click **Submit** . |
### What happens if the information I am looking for is unavailable?
Please send us the feedback so that we can continue improving on the App’s skills.
| **1** | Select **Query Feedback** . |
| ----- | ----------------------------------------------------------------------------- |
| **2** | Enter the type of information you want us to analyze in the feedback message. |
| **3** | Click **Submit** . |
### What happens if Elation Analyst is wrong?
If the results are inaccurate, send us the feedback so that we can continue improving on the App’s skills.
| **1** | Select **Query Feedback** . |
| ----- | ------------------------------------------------------------------------------------------------------ |
| **2** | Select **thumbs up** if the answer met expectations • **thumbs down** if the answer needs improvement. |
| **3** | Enter feedback in a message if needed. |
| **4** | Click **Submit** . |
### Can Elation Analyst use results from previous questions?
Elation Analyst can see your previous questions, but it doesn’t have access to the answers. For example, if you first ask, **Which appointment types had more than 5 cancellations last month?** and then follow up with, **Give me the name of the patients for the second one?**, it won’t know what “the second one” is. You’ll need to ask the second question more specifically, like: **Give me the name of all the patients that cancelled with the Annual Wellness Exam appointment type**.
### What should I do if Elation Analyst seems confused after multiple questions?
If you ask many questions in a row or change topics often, Elation Analyst may have trouble keeping up with your requests. When this happens, it’s best to start a new conversation by clicking **Clear Chart History** and ask your question again.
## Related Articles
* [Hosted Database Introduction (Add-On)](/articles/Hosted-Database-Introduction)
* [Accessing Your Hosted Database](/articles/hdb/accessing-your-hosted-database)
* [What kind of Access/Permissions do I get with my Snowflake Account?](/articles/hdb/what-kind-of-accesspermissions-do-i-get)
# Elation Billing- Using Elation's all-in-one billing solution to manage your claims
Source: https://help.elationhealth.com/articles/Elation-Billing-All-in-One
This article describes Elation's all-in-one billing solution.
### What is Elation Billing?
Elation Billing is Elation’s all-in-one solution for managing your claims and revenue. Elation Billing reduces the need for double documenting in two softwares and allows practices to store all their clinical data in the EHR while using Elation Billing to manage their revenue.
### Why is Elation Billing valuable?
Using an all-in-one solution, like Elation Billing, to manage your clinical and financial workflows allows you to simplify billing workflows, eliminates integration challenges, and reduces time spent on duplicate claim entries. This in turn allows you to focus more time on patient care.
### Elation Billing Help Articles
For detailed guides on using Elation Billing, see the articles below:
* [Getting to Know Elation Billing](/articles/getting-to-know-the-software)
* [Filing a Claim in Elation Billing](/articles/filing-a-claim)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
* [Running Eligibility in Elation Billing](/articles/running-eligibility)
* [Elation Billing FAQs](/articles/elation-billing-faqs)
### What information is synchronized?
| Data | Sync Direction |
| -------------- | ----------------------------- |
| Patient Charts | Elation EHR → Elation Billing |
| Demographics | Elation EHR → Elation Billing |
| Insurance | Elation EHR → Elation Billing |
| Bills | Elation EHR → Elation Billing |
### How do I get started?
If you are interested in using Elation Billing click **I need help** -> **Contact Elation Support** to notify us and your customer service representative will reach out to you to further discuss your interests.
#### Mapping Data
Follow these instructions to map the following data between Elation EHR & Elation Billing:
1. Providers- Provider mapping is automatic between Elation EHR & Elation Billing.
2. Practice Locations- Practice Location is automatic between Elation EHR and Elation Billing. You must still select a default Place of Service code in Elation EHR for each Practice Location.
3. Payers/Carriers- Payer/Carriers are automatically mapped between Elation EHR and Elation Billing.
4. CPT Codes- You can freely add CPT Codes to a visit note in Elation EHR and those will be automatically pushed to the Superbill in Elation Billing.
### Patient Charts
#### Creating Charts
All patient charts must be created in Elation EHR in order for the patient's chart to be created in Elation Billing. See the [Patient Demographics section](#demographics) for details about managing demographics information after charts are created in the EHR.
#### Merging Charts
Each chart can only have a one to one connection between Elation EHR and Elation Billing and this connection is established upon chart creation. If you happen to see a duplicate chart for the same patient in the EHR, please make sure you find the chart that is connected between the EHR and Elation Billing and keep the connected chart after performing a merge.
* For example, patient John Smith has one chart in Elation Billing but two charts in the EHR. The best way to find out which of the two charts in the EHR is connected to Elation Billing is by clicking on the **Elation EHR Record** button for the chart in Elation Billing to see which EHR patient chart is tied to the Elation Billing chart.
Here are the proper merge steps for EHR charts:
1. Open the duplicate chart that is not connected to the integration
2. Click on the patient's name to open their Demographics
3. Click on the **Merge Chart** button
4. Find & select the chart you want to keep (the one that is connected to the integration)
5. Click **Merge Chart**
6. Confirm you understand the transfer of data and then click **Yes, merge charts**
#### Deleting Charts
Deleting a chart in Elation EHR will not delete the chart in Elation Billing and vice versa. Please take caution when deleting charts in the EHR as charts have a one to one connection to Elation Billing. If the patient is still active in your practice, the deleted chart must be restored in order for the patient's information to sync properly from the EHR to Elation Billing.
You can restore a deleted patient chart yourself using the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice). Go to **Reports** > **User Activity Log**, filter by the patient or by the **Delete** action, and click the **Restore** button next to the deleted chart. [Admin Level Users](/articles/administrative-privileges) can view and restore activity for all users in the practice.
### Patient Demographics
The synchronization of Patient Demographics is uni-directional from Elation EHR to Elation Billing. Any changes or updates to demographics information must occur in the EHR. The following table shows a mapping of the Patient Demographics fields that are shared between Elation EHR and Elation Billing and their matching field names.
| Elation EHR Field Name | Elation Billing Field Name |
| -------------------------------------------------------------------------------------------------------------------------------- | ---------------------------- |
| Legal First Name | First Name |
| Legal Last Name | Last Name |
| Date of birth | DOB (Age) |
| Sex at Birth | Gender |
| SSN | Social Security |
| Mobile Phone If Mobile Phone does not exist then the phone number in the primary phone field in Elation is pushed to LightningMD | Best Phone |
| Email | Best Email |
| Address | Address 1 |
| Ste or apt # | Address 2 |
| City | City |
| State | State |
| Zip | Zip |
| Guarantor First Name | Responsible Party First Name |
| Guarantor Last Name | Responsible Party Last Name |
| Guarantor Phone # | Responsible Party Best Phone |
| Guarantor Address | Responsible Party Address 1 |
| Guarantor City | Responsible Party City |
| Guarantor State | Responsible Party State |
| Guarantor Zip | Responsible Party Zip |
| Link to Elation Chart | Elation EHR RECORD |
### Patient Insurance
The synchronization of insurance information is uni-directional from Elation EHR to Elation Billing. Practices must enter insurance information in the EHR in order for the insurance information to push to Elation Billing.
The following table lists the insurance related fields that are pushed from Elation EHR to Elation Billing and show how the EHR fields map to the Elation Billing fields. Fields that are not listed are not shared between Elation EHR and Elation Billing:
| Elation EHR Field Name | Elation Billing Field Name |
| ---------------------------------- | -------------------------- |
| Insurance Carrier Name | Insurance Payer |
| Group ID | Group Number |
| Member ID | Member ID |
| Patient's relation to policyholder | Relationship |
#### Carriers
Insurance Carrier details should only be maintained in Elation EHR as Elation EHR is the source of truth for insurance. Best practice is to select the patient’s Insurance from the drop-down options that appear.
If you are adding a NEW Insurance to your EHR, this new insurance will automatically be mapped to a Payer in Elation Billing.
Elation EHR ‘Plan’ level details are not shared with Elation Billing. If it is important to distinguish between different coverage plans under different Payers, create a separate Elation EHR Carrier for each coverage plan.
### Bills
The synchronization of bills is uni-directional from Elation EHR to Elation Billing. By default, once a provider signs a visit note in the EHR, the billing information from the visit note is pushed to Elation Billing as a Superbill. As best practice, review your bill to make sure coding is accurate and complete before signing your visit note because once a bill is pushed to Elation Billing, edits must be made in both the EHR and Elation Billing if needed. We recommend turning on the [Billing Guidance](/articles/billing-settings---service-locations--procedure-codes#billing_guidance) feature which will notify you if you are missing any CPT codes or ICD-10 codes upon signing your visit note.
If you prefer your bills are pushed independent of signing a visit note, we recommend turning on the Delayed Billing feature. The Delayed Billing feature allows you to hold your bills in [Billing Home](/articles/Billing-Home) for review until you are ready to send them to Elation Billing. [Learn more about the Delayed Billing feature](/articles/How-to-set-up-Delayed-Billing).
The following table lists the fields that are pushed from Elation EHR to Elation Billing and show how the EHR fields map to the Elation Billing fields. Fields that are not listed are not shared between Elation EHR and Elation Billing:
| Elation EHR Field Names | Elation Billing Field Names |
| ----------------------- | --------------------------- |
| CPT Code | CPT |
| Modifier | MOD |
| Dxs\* | DX |
| Service Location (POS) | Location |
| Charge | CHG |
| Unit | UNIT |
| Referring Provider | Referring Provider |
| Rendering Provider | Rendering Provider |
\***Important Notes**: While you can enter more than 12 diagnosis codes on a bill in the EHR, Elation Billing automatically selects a maximum of 12 diagnosis codes for claim submission. You do not need to manually reduce the number of diagnoses before submitting. Elation Billing does not support automatic claim splitting at this time. Each charge line item on the claim supports up to 4 diagnosis pointers (the top 4 diagnosis codes from each procedure code on the bill will be used). If you encounter a claim rejection related to diagnosis code pointers, reach out to Elation Support using **Help** → **Contact Elation Support**.
The charges associated with your **Popular CPT Codes** settings in the EHR will serve as your fee schedule for Elation Billing. Store the default charge for each CPT Code you bill for in the **Popular CPT Codes** settings of your EHR to readily populate the charge in your bill.
If your Billing Settings has a **Fee Schedules** section, manage your charges there instead. Your existing **Popular CPT Codes** appear as custom rates on your Default fee schedule. The charges for each code will cross over once a bill is sent to Elation Billing. See [Fee Schedules Guide — Setting charges in the EHR](/articles/fee-schedules-in-the-ehr).
#### Additional billing fields
You can enable additional incident-to billing fields and synchronize these fields from Elation EHR to Elation Billing. The fields include **Supervising Provider** , **Billing Provider** , **Ordering Provider** and **Prior Authorization** and the mapping is shown below. To enable any of these fields:
1. Go to Elation EHR
2. Click on your email at the top of your account and then click **Settings**
3. Click **Billing** to open the Billing settings
4. Scroll down to the Billing Fields section
5. Click on the toggle to configure the fields you want to include on your bills - green is ON (enabled) and gray is OFF (disabled)
6. Once a field is enabled, it will appear at the top of the bill in your EHR visit notes
* Data stored in enabled fields will also push to Elation Billing when you push the bill over.
| Elation EHR Field Names | Elation Billing Field Names |
| ---------------------------------------------------------------------------------------- | ------------------------------------------ |
| Ordering Provider | Ordering Provider |
| Supervising Provider | Supervising Provider |
| Prior Authorization | Auth/Referral Number (Prior Authorization) |
| Billing Provider (appears after you check off the **Mark as incident-to encounter** box) | Billing Provider |
* **Ordering Provider**: This field is used when services provided require a referral or order from another healthcare provider such as durable medical equipment, diagnostic imaging, laboratory tests, specialist consultations, and certain medical procedures. This is not a common field for Primary Care.
* **Billing Provider**: This field is commonly used for incident-to billing.
### Getting Support
If you need assistance with Elation Billing, contact Elation by clicking on the blue chat box at the bottom right of your Elation Billing account or visit our [Help Center](/).
## Related Articles
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
* [Billing Guide- Creating a superbill & coding for your visit](/articles/billing)
* [Billing Guide- Navigating Billing Settings](/articles/billing-settings---service-locations--procedure-codes)
* [Getting to Know Elation Billing](/articles/getting-to-know-the-software)
* [Filing a Claim in Elation Billing](/articles/filing-a-claim)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
* [Running Eligibility in Elation Billing](/articles/running-eligibility)
* [Elation Billing FAQs](/articles/elation-billing-faqs)
# Elation-Dock Health- Task Management Integration Guide
Source: https://help.elationhealth.com/articles/Elation-Dock-Health-Integration-Guide
This article describes the Elation integration with Dock Health, a HIPAA compliant task management and collaboration platform.
## What is Dock Health?
Dock Health is a HIPAA compliant task management and task collaboration platform. Dock Health allows practices to generate follow up tasks tied to specific patients that are assigned to different members of your practice for follow up.
The Elation to Dock Health integration can automatically generate follow up tasks in Dock Health after a clinical action is completed in Elation. These follow up tasks can:
* Facilitate new patient onboarding
* Streamline patient intake
* Assist with prior authorization management
* Prompt evaluations and testing
* Trigger post-discharge follow-up
Some common use cases are:
* Creating an appointment in Elation -> Follow up task generated in Dock Health to send patients visit instructions
* Signing a Lab Order in Elation -> Follow up task generated in Dock Health to follow up on lab results in 2 weeks
* Signing a Referral in Elation -> Follow up task generated in Dock Health to follow up with referred provider on results of consultation
The Dock Health Team will work with Elation customers to configure actions in Elation to corresponding tasks in Dock Health after the Elation customer signs up for the Dock Health integration.
![Dock Health task list showing "New Patient Onboarding Workflow" for patient Bella Smith, with 5 of 10 subtasks completed, due 05/31, status In Progress.]()
## What is the Elation-Dock Health integration?
The Elation to Dock Health integration will improve the efficiency of your practice and reduce the administrative burden that often comes with managing downstream tasks that support patient care. With automated task creation and the ability to collaborate as a team, your office will be able to effectively manage all tasks related to delivering high quality patient care and in turn improve patient outcomes and satisfaction.
## How do I get started?
If you are interested in using the Elation to Dock Health integration, send Elation an email using [integrations@elationhealth.com](mailto:integrations@elationhealth.com) and a member of the Elation Team will reach out to you on next steps for setting up the Dock Health integration and connect you with a Dock Health representative to set up custom workflows.
Dock Health will charge you separately for using their software.
## What information is synchronized?
The Elation to Dock Health integration is unidirectional from Elation to Dock Health. By default, only patient demographics are pushed from Elation to Dock Health. Additional information like patient insurance and appointments can be customized to push from Elation to Dock Health.
As part of this integration, certain events in Elation can trigger task creation in Dock Health. The action itself does not transfer data exactly like Patient Demographics, Insurance and Appointments do but the action can relay certain information into the task. For example, when you sign a lab order in Elation for a patient, it can generate a task in Dock Health tied to the patient’s name. The task can also have details about the lab vendor and a due date of two weeks to remind your office to follow up with the lab vendor in two weeks to make sure the lab results are returned.
### Patient Demographics & Insurance
Default behavior is that Elation is the source of truth and Dock Health pulls basic patient demographic fields like First Name, Last Name, Date of Birth, Chart ID, and contact info such as email, phone and address. Other demographics fields from Elation can be pushed to Dock Health during the initial configuration as discussed with Dock Health..
The following chart will show you how the demographic fields in Elation map to Dock Health:
![Field mapping from Elation to Dock Health for patient demographics: First Name/Middle Name/Last Name, Date of Birth, Sex at Birth, SSN, Address, Phone Type and Number, and Email all sync directly.]()
Per your request, the patient insurance synchronization can easily be enabled on demand by the Dock Health Team and mapped to the right fields in Dock Health. After the custom configuration is set up by the Dock Health Team, you can create and update insurance plans in Elation and the fields below will sync from Elation to Dock Health.
![Field mapping table showing Elation insurance fields (Rank, Carrier, Member ID, Group ID, Address, Copay, Deductible, Insured Person details, Relationship to Insured) syncing to identical Dock Health fields.]()
### Appointments
Per your request, appointment synchronization can easily be enabled on demand by the Dock Health Team and mapped to the right fields in Dock Health. After the custom configuration is set up by the Dock Health Team, you can create and update appointments in Elation and the fields below will sync from Elation to Dock Health.
The following chart will show you how the appointment fields in Elation map to Dock Health:
![Appointment field mapping from Elation to Dock Health: Scheduled date, Duration, Reason, Status, Patient, Physician, Practice, and Recurring Event Schedule all sync directly.]()
# Support Guide- Elation Downtime Recommendations
Source: https://help.elationhealth.com/articles/Elation-Downtime-Recommendations
If you encounter intermittent delays in site performance, here’s our recommendations on how to see your patients with the least amount of disruption.
## Status Page
If you notice that the
app.elationemr.com
website is not functioning as normal, check our status page to see if we are experiencing any service disruptions:
[https://elation.status.io](https://elation.status.io)
. If our status page indicates everything is
*Operational*
but you are still experiencing issues, notify our Support Team of the issues you are experiencing.
You do not need to reach out to the Elation Team if our Status Page indicates service issues as this means our engineers are already investigating and fixing the issues. The status page will be updated whenever our engineers make significant improvements. Read below to see what actions you should take when experiencing service disruption to ensure you can still see your patients with the least amount of disruption.
![Elation status page at elation.status.io showing all core services marked "Operational" in green, with a note to access read-only Elation at app-ro.elationemr.com during emergencies.]()
For your convenience, Elation will also post periodic updates in the EHR using the yellow banner you often see at the top of your account. The banner will reflect any status changes from the Status Page.
## Notifying Elation
To notify Elation of service disruption that is not visible on our [Status Page](https://elation.status.io), submit an Urgent support ticket to our Support Team by following [these instructions](https://help.elationemr.com/s/contactsupport). You do not need to reach out to the Elation Team if our Status Page indicates service issues as this means our engineers are already investigating and fixing the issues. The status page will be updated whenever our engineers make significant improvements.
**For Providers & Admins Only:** To submit an urgent request, you must have a Provider Level User account or have administrator (Admin) level privileges. If you do not see the\*\*\*\*Urgent\*\* checkbox in the Support form, then you are not a Provider or an Admin. To become an Admin, you must ask an existing Admin level user in your practice (most likely a primary provider level account holder) to grant you privileges via this [Manage Accounts settings page](https://app.elationemr.com/settings/allaccounts/).
!["How can we help?" support form with "Report an issue" selected and the "Urgent: a patient cannot receive care" checkbox checked, showing the required Details field.]()
We will commit to responding back to you within 30 minutes - regardless of what day or time it is.
* We will first attempt to reach you by phone. If we are unable to reach you by phone, then a response to your request will go directly to your email inbox for the email address tied to your Elation account (your Elation login email).
When submitting a support ticket to the Elation Support Team, we always recommend
1. submitting the request directly within Elation (and directly within the relevant patient's chart if the issue is tied to a particular patient). This provides context to the Support Team in regards to where you were in Elation when you ran into an issue.
2. providing the Support Team with a best call back number if different from your main office phone number. This allows the Support Team to reach you even when you do not have access to your main office phone number.
3. providing the Support Team as much details and context about the issue as possible. This allows the Support Team to investigate the issue immediately upon receipt of your request and reduces the need to reach out to you for additional details.
## Read Only website
The Read-Only website is [app-ro.elationemr.com](http://app-ro.elationemr.com). Your regular Elation credentials will provide you access to a read-only version of your patient charts. When using the Read-Only site, you can access, read and print existing data in any existing charts, but will not be able to enter or edit information in the charts. You will also have access to your Elation Calendar to see scheduled visits and start any integrated video visits.
We recommend using the Read Only website to complete your patient encounters and document outside of Elation while our engineers work on restoring our site performance.
## Documentation
In case you experience service disruption issues, be prepared to document encounters and notes outside of Elation (on paper or a digital text documentation software) during that time frame.
If you document any visits notes outside of Elation, you will be able to upload the documentation back to the patient's chart as a **New Visit Note** document type for future reference. Use our [drag & drop feature](/articles/filing-documents-to-a-patient-chart) to accomplish this.
## Orders
If you have prescriptions or orders to fill, plan for a situation where you may need to call the facility to authorize the prescription or order or use an external fax method to send the prescription or order to the facility. If the orders are not urgent, make note of the requests on a notepad and complete them once the EHR is back to normal service.
## Virtual visits
If you are seeing patients virtually using [Elation Integrated Video](/articles/Elation-Telehealth-powered-by-Zoom), you will be able to access the **Start Video** button for appointments already on your Elation Calendar through our read-only site ([app-ro.elationemr.com](http://app-ro.elationemr.com)).
If you are experiencing any issues with accessing the Read Only website or the **Start Video** button, please [reach out to the Support Team](#notify_Elation) who will be able to assist you.
## Integrations
Integrations will remain functional (unless a specific integration is down) during an EHR service disruptions but you may experience some delay in certain features of the integration. The integration will return to normal once the EHR is back to normal service. If you need urgent data from a specific integration while the EHR is down, try to access or contact the vendor directly for the information.
Read additional instructions below if a specific integration is down.
### Faxes
* Inbound- Inbound faxes will be automatically be routed to your **Fax Inbox** once the integration returns to normal. For urgent faxes, ask the recipient to send it to an external or personal fax number if available.
* Outbound- Draft the Letter/Referral and click **Save as draft & close**. Afterwards, wait until the integration is back to normal to sign the Letter/Referral to fax it out of Elation. For urgent faxes, use an external or personal fax number if available or ask the recipient for an email address to send the Letter/Referral via the [secure online portal](/articles/secure-Provider-Portal).
### E-prescribing
* For urgent scripts- call the pharmacy to give a verbal order to the pharmacist
* For non-urgent scripts- draft the prescription order and click **Save as draft & close**. Afterwards, wait until the integration is back to normal to sign the prescription order to send it to the pharmacy
### Controlled Substance E-Prescribing (EPCS)
* For urgent scripts- call the pharmacy to give a verbal order to the pharmacist if allowed. If it is not allowed, draft the prescription order and click **Save as draft & close**. Afterwards, wait until the integration is back to normal to sign the prescription order to send it to the pharmacy
* For non-urgent scripts- draft the prescription order and click **Save as draft & close**. Afterwards, wait until the integration is back to normal to sign the prescription order to send it to the pharmacy
### Electronic lab ordering
* For urgent labs- use the **Other** vendor option to generate lab orders for the lab vendor and fax the order to the lab vendor using our [fax feature](/articles/efaxing-lab-and-radiology-orders).
* For non-urgent labs- draft the lab order and click **Save as draft & close**. Afterwards, wait until the integration is back to normal to sign the order to send it to the lab vendor.
### Electronic lab results
* For urgent results- call the lab vendor and ask them to fax you the results
* For non-urgent results- the results will appear in your Elation account once the integration is back to normal
### Practice Management Systems (PMS)
* Patient data- Make note of any patient data changes needed while the integration is down and make those changes once the integration resumes to ensure the data is synchronized between Elation and the PMS
* Appointments- Make note of any new appointments or appointment data changes needed while the integration is down and make those additions and changes once the integration resumes to ensure the data is synchronized between Elation and the PMS
* Bills- Have providers hold off on signing visit notes while the integration is down and resume signing visit notes once the integration is back to normal.
* If you are using the [Delayed Billing](/articles/How-to-set-up-Delayed-Billing) feature, do not click the **Send all queued bills to PMS** button until the integration is back to normal.
## Frequently Asked Questions (FAQ)
### How long will it take for the site service to return to normal?
Whenever Elation experiences a service disruption, Elation engineers will work as diligently as possible to restore the site to normal service. Check the Elation [Status Page](https://elation.status.io) as well as look for the yellow banners at the top of your Elation account for updates on our service disruption.
### I submitted an urgent request but I have not heard back from Elation yet. Why?
Due to the volume of urgent tickets that may flow in during service disruptions, the Elation Team may not be able to call every user back. Please check our status page to look for updates on the service disruption: [https://elation.status.io](https://elation.status.io). The status page will be updated whenever our engineers make significant improvements.
For your convenience, Elation will also post periodic updates in the EHR using the yellow banner you often see at the top of your account. The banner will reflect any status changes from the Status Page.
## Related Articles
* [Support Guide- How to get help on Elation](https://help.elationemr.com/s/contactsupport)
# Elation EHR Quick Start Training Resources
Source: https://help.elationhealth.com/articles/Elation-EHR-Quick-Start-Training-Resources
This article lists all Help Center Resources referenced during the Elation EHR Quick Start Training.
This article lists all Help Center Resources referenced during the Elation EHR Quick Start Training. Feel free to reach out to Elation if you have any questions about any of the resources. Elation hosts Office Hours daily and you can register for attendance here: [https://www.elationhealth.com/elation-university/](https://www.elationhealth.com/elation-university/)
## Elation Website
* [https://app.elationemr.com](https://app.elationemr.com)
## Help Center Articles
| | **Settings** [Provider vs. staff level account privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges) • [Managing Elation accounts for providers and staff](/articles/managing-user-accounts) • [Administrative privileges](/articles/administrative-privileges) • [How to set up the provider calendar](/articles/calendar-and-booking-settings) • [Listing your service locations](/articles/adding-a-second-practice-location) • [Managing practice letterheads](/articles/print-headers) • [Visit Note Categories Guide](/articles/visit-note-categories) • [Report Category Guide](/articles/report-types) • [Labs Settings Guide](/articles/labs-settings) • [Setting up CPT Codes and Place of Service](/articles/billing-settings---service-locations--procedure-codes) • [Managing Patient Insurance](/articles/Managing-Insurance) • [Patient Forms](/articles/Getting-Started-with-Patient-Forms) | **Charting** [Patient Demographics](/articles/Patient-Demographics-Guide) • [Clinical Profile](/articles/clinical-profile-record-patient-medical-history) • [Visit Note Documentation](/articles/Visit-Note-Documentation-Introduction) • [Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) • [Electronic Prescribing of Controlled Substances](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs) • [Test Order Forms](/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients) • [Letters & Referrals](/articles/letter-and-referral-introduction) |
| - | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
## Related Content
* [Elation EHR Quick Start Training Registration Form](https://elationhealth.zoom.us/webinar/register/8016587824069/WN__5mHwWZoQHiUauVx171rBA)
# Elation-Fullscript Integration Guide - Using Fullscript to manage supplement dispensing
Source: https://help.elationhealth.com/articles/Elation-Fullscript-Integration-Guide
This article describes how you can use the Elation-Fullscript integration to manage supplement plans for your patients.
## Overview
### What is Fullscript?
Fullscript is a supplement dispensing platform that empowers practitioners to dispense personalized treatment plans and high-quality supplements directly to patients.
### What is the Elation-Fullscript Integration?
The Elation-Fullscript Integration enables you to create treatment plans in Fullscript and store data on dispensed supplements within Elation.
### What are the benefits of the Elation-Fullscript Integration?
The Elation-Fullscript Integration demonstrates Elation’s commitment to supporting holistic patient care while empowering practitioners to deliver personalized treatment plans. You can see all of a patient’s medications and supplements in their Medication History in Elation.
### What information is synchronized?
#### Overall
| **Data** | **Sync Direction** |
| ------------------------- | -------------------- |
| Patient Chart Creation | Elation → Fullscript |
| Patient Demographics | Elation → Fullscript |
| Medications (Supplements) | Fullscript → Elation |
#### Patient Charts
The synchronization of patient demographics information is uni-direction from Elation to Fullscript. Only charts created in Elation will be synchronized with Fullscript.
| **Elation Field Name** | **Fullscript Field Name** |
| ----------------------------- | ------------------------- |
| Legal First Name | First name |
| Legal last name | Last name |
| Date of birth | Date of birth |
| Email | Email |
| Provider Assigned in Practice | Practitioner |
#### Medications
The synchronization of medications is uni-directional from Fullscript to Elation. Supplement plans will push to Elation as a Documented Medication.
| **Fullscript Field Name** | **Elation Field Name** |
| ------------------------- | ---------------------- |
| Ingredient | Med |
| Dosage | Dosage |
| Plan Date | Documented date |
| Practitioner | Documented by |
## Set-up
### 1. Obtaining a Fullscript account
To use the Elation-Fullscript integration each Provider must first have a Fullscript account and sign a consent with Fullscript.
* To register for a Fullscript account [click here](https://us.fullscript.com/practitioner-signup/elation-health).
* If you already have a Fullscript account move on to the next step.
#### Multi-provider practices
To use the Elation-Fullscript integration each Provider must first have a Fullscript account and sign a consent with Fullscript.
* If you own a Fullscript account and you want other providers in your practice to work under your account:
1. Add the other Providers as sub-practioners under your Fullscript store.
2. [Connect your Fullscript account to Elation](#connect_to_integration).
3. [Sign the BAA](#connect_to_integration) as the Fullscript account owner.
* If each Provider in your practice has their own Fullscript account, each Provider must:
1. [Connect your Fullscript account to Elation](#connect_to_integration).
2. [Sign the BAA](#connect_to_integration) in their Fullscript account.
### 2. Authorizing the Elation-Fullscript integration
1. Sign in to your Fullscript account.
2. Click on your name at the bottom left corner of your account to open the practitioner menu & then click **Integrations**.
3. Select **Elation**.
4. Click **Get Started Now**.
5. Sign your **Authorization and Consent (A\&C) form** and click **Send**.
After the **Authorization and Consent (A\&C) form** is received by Fullscript, Fullscript will acknowledge receipt of the form, provide you with a copy, and inform Elation to authorize the application on your Elation account. Please allow 3-5 business days to process your request. Fullscript will send you an email once Elation has informed us the interface has been authorized.
### 3. Connecting your Elation account to Fullscript & signing a Business Associate Agreement (BAA) for the integration
After the integration is turned on, you must connect your Elation account to Fullscript. Afterwards, you must sign a BAA before using the integration. To do this:
1. Navigate to a patient’s chart in Elation.
2. Click **Fullscript** in the upper-left corner of the patient’s Clinical Profile.
3. Log in with your existing Fullscript credentials.
4. Select the Elation Provider Level User account you want connected to your Fullscript account.
Once you select the Elation Provider Level User account you want connected to your Fullscript account, it cannot be changed.
1. If there is no Business Associate Agreement (BAA) on file for your account, you will be asked to sign a BAA document. Click **Start Signing** to begin.
2. After signing the BAA you can begin using the Elation-Fullscript integration.
## Workflow Instructions
### Pushing supplement plan information from Fullscript to Elation
1. Navigate to a patient’s chart in Elation.
2. Click **Fullscript** in the upper-left corner of the patient’s Clinical Profile.
3. Log in with your existing Fullscript credentials.
4. If Fullscript is able to find the patient’s Fullscript profile based on the email address in their Elation chart, then you will see that patient’s profile open in Fullscript.
* If Fullscript is unable to find a matching patient:
* Verify the patient’s email matches between Elation and Fullscript and then click **Fullscript** in the upper-left corner of the patient’s Elation Clinical Profile again.
* If the patient does not have a Fullscript profile yet, click **Create patient** in Fullscript.
5. [Create a plan](https://support.fullscript.com/articles/the-plan-building-tool/) for the patient.
6. When you are ready, click **Send to patient** to send the plan to the patient.
7. Once you return the patient chart in Elation, any recommended supplements that were in the plan will be listed under the **Chronological Record** and **Permanent OTC Meds**.
## Frequently Asked Questions
### Set Up
#### Is there a cost to use the Elation-Fullscript integration?
No, Elation’s integration with Fullscript is available to all Elation members at no additional cost, and a Fullscript account is free.
#### Is there a cost to use Fullscript as an Elation member?
No, your Fullscript account is free if you are using the Elation-Fullscript integration.
#### What is the Elation Authorization & Consent (A\&C) form and how do I submit it?
The Authorization and Consent form is a requirement from Elation to enable a 3rd-party integration such as Fullscript. Simply review and complete it here, then wait for the Fullscript team to let you know that the integration is enabled. The Fullscript team will send an email confirming receipt and a follow-up email once approved and the integration is enabled on the Elation end.
Once enabled, the Fullscript app will be available under patient information in the patient chart in Elation. You’ll need to have a Fullscript account and execute a Business Associate Agreement (BAA) in order to use the integration, if you don’t already have one on file under your account.
#### Why do I need a Business Associate Agreement (BAA) with Fullscript to enable the Elation-Fullscript integration?
All Elation marketplace partners are required to execute BAA with accounts wanting to access their integrations. We have a standard BAA that you’ll sign when redirected to Fullscript via the Elation integration for the first time.
#### I’m a practitioner who shares an Elation account with other providers but we don’t all operate under the same Fullscript store. Can we still utilize this integration?
Yes! This integration allows one Elation account to be connect with multiple Fullscript stores. Please note the account owner of each Fullscript account must initiate the integration process within their account. If you’re an account owner, you can begin this process by clicking here.
### Account Management
#### Can I change the Elation practitioner that I assigned to my Fullscript account when I first signed in?
You cannot change the Elation practitioner account that was initially selected. Please contact [elationintegration@fullscript.com](mailto:elationintegration@fullscript.com) for additional assistance.
#### I’m trying to sign in to Fullscript after clicking the Fullscript button from Elation, but it says **Account not found**. Why?
This could mean one of two things:
* You’re signed in to Fullscript with a different account than the account you’re trying to access through the integration. Please go to Fullscript and make sure you are signed in to the correct account.
* You’re trying to log in with an account that’s not registered under this integration. Please make sure you are logging in with the correct account.
### Workflows
#### Can I sync plans created prior to the Elation-Fullscript integration being active?
Plans created before the integration will not automatically be synced to Elation. However, after the integration is enabled, you can go into Fullscript and edit a historic plan, and the products will sync back to Elation as a new plan.
The medications will display as newly documented medication in Elation and Fullscript will send an email to your patient to notify them that their plan has been updated.
#### Can I edit a plan that’s already been sent to the patient?
No, you can’t. A brand new plan will be written.
#### If I delete or cancel a plan in Fullscript, will that update the medications in Elation?
Deleting or canceling a plan in Fullscript will not delete or cancel the medication in Elation and vice versa. You must manually update the information in both systems separately.
#### I’m trying to write a plan for a patient that I know is in Fullscript, but it says **No email found**. Why?
Fullscript treats the patient email as the unique identifier, therefore an email needs to be added to Elation to be able to match it to a patient in Fullscript. Please add an email to the patient’s Elation demographics and then proceed with writing a plan.
#### Can I sync lab orders from Fullscript to Elation?
No. Although labs can be added to plans, at this time, only supplements and personal care items will be synced back to Elation.
## Related Articles
* [Fullscript Resource](https://us.fullscript.com/practitioner-signup/elation-health)
# Elation-Healee Integration Guide
Source: https://help.elationhealth.com/articles/Elation-Healee-Integration-Guide
## Overview
### What is Healee?
Healee offers a secure, HIPAA-compliant communication platform that facilitates smooth interactions between patients and healthcare providers. Through Healee, patients can effortlessly discuss symptoms via messaging, make phone calls, or book virtual video appointments with their providers, all within one integrated platform. This ensures that both patients and providers experience secure, simple, and adaptable care delivery.
By using Healee, healthcare providers can manage patient communications in a centralized and efficient manner, reducing the need for multiple communication tools. Patients benefit from the convenience of having all their interactions with healthcare providers in one place, enhancing their overall experience and engagement with their care. Healee also supports the continuity of care by allowing easy follow-up consultations and maintaining a comprehensive record of all patient-provider communications. With Healee, the entire process of seeking and providing care becomes more streamlined, ensuring that both patients and providers can focus on what matters most: effective and timely healthcare.
### What is the Elation-Healee integration?
The Elation-Healee integration offers the following functionalities:
* Bi-directional automatic link between charts for patients in Healee when you create their chart in Elation.
* Keep patient contact information up to date in both systems effortlessly.
* Ability to transfer conversations from Healee to Elation, ensuring all clinical data is stored in one place within Elation EHR.
### How do I get started?
To begin using this integration,
[click here to tell Elation you are interested](https://help.elationemr.com/s/contactsupport)
. A member of Elation's Implementation Team will contact you about next steps.
### What information is shared between Elation & Healee?
The following information is shared between Elation and Healee:
| Elation | | Healee | Notes |
| ------------------ | - | ------------------------------- | ------------------------------------------------------------------------------------------------------------------------- |
| Chart Creation | ↔ | Contact Profile Creation | When a new patient is created either in Healee or Elation, they are linked to their respective chart in the other system. |
| Demographics Edits | ↔ | Demographics Edits | Demographic edits can be made in either platform and will be reflected across both. |
| Non-visit note | ← | Message history (conversations) | Conversations can be manually synced from Healee to Elation as a non-visit note. |
## Workflow Instructions
### Linking Patients
#### Automatically linking charts created in Elation
Patients need a Contact in Healee in order for them to communicate with your practice via SMS, Secure Message, or Video. When a new chart is created in Elation, Elation will automatically link the chart to the patient's respective Healee contact profile based on the patient's First Name, Last Name and Date of Birth.
If Elation is unable to automatically find a contact with the same parameters, you can link the Elation chart to the Healee contact manually. [See below for instructions](#link_patients_manually) .
#### Automatically linking charts (contacts) created in Healee
When patients create a new Contact profile for themselves in Healee, the integration will automatically link the Contact to the patient's Elation chart if it exists. The link will be based on the following parameters in the following order:
* Match by the Email in the patient's chart in Elation
* If Email is not found then we will match by any primary phone number.
* If primary phone number is not found then we will match by First Name, Last Name and Date of Birth.
If the integration is unable to automatically find a chart with the same parameters, you can link the Elation chart to the Healee contact manually. [See below for instructions](#link_patients_manually) .
#### Manually linking charts between Elation and Healee
To link a patient chart in Elation to a Contact in Healee, follow these steps:
1. Open the patient's Contact details in Healee.
2. Click on the 3 dots at the top right corner
3. Click **Link to Elation**
4. Open the patient’s chart in Elation
5. Copy the patient’s ID from the URL (the set of numbers after the / )
6. Paste the patient’s ID in Healee
7. Click **Save Changes**
To remove a link, follow the same instructions above and click
**Remove link**
.
### Synchronizing demographics
Once the patient is linked between Elation and Healee, updates to the following demographic fields in either Elation or Healee will be synchronized immediately:
* First Name
* Last Name
* Primary Phone number
* Email address
* Date of birth
* Sex at birth
If there is any discrepancy in data upon initial linking, Healee’s data will prevail, assuming that the patient has entered their correct data in Healee when they created their Contact profile.
### Synchronizing messages
Messages from Healee can be manually synced into Elation as Non-Visit Notes by following these instructions:
1. Open the message conversation in Healee.
2. Hover over any message until three horizontal dots appear, then click on the dots.
3. Click **Select**.
4. Click on the radio buttons beside the messages you want to sync to select them individually or click **Select All** to select all messages.
5. Click **Send to EHR Elation** at the bottom of the conversation to send all selected messages to the patient's chart in Elation.
6. Open or refresh the patient’s chart in Elation to view the synchronized messages in a Non-visit note in Requiring Action.
7. Sign off on the Non-visit note once you are ready to store the conversation in the patient's Chronological Record.
# Elation Health - A Certified Electronic Health Records Technology (CEHRT)
Source: https://help.elationhealth.com/articles/Elation-Health-CEHRT
This article describes Elation as a Certified Electronic Health Records Technology.
## What is Certified Electronic Health Records Technology (CEHRT)?
Certified Electronic Health Records Technology (CEHRT) is a certification program administered by the Assistant Secretary for Technology Policy (ASTP)/Office of the National Coordinator for Health Information Technology (ONC) which is a US department under Health and Human Services (HHS). The ONC coordinates with other federal and state agencies to align rule making (example- coordinating with CMS to require providers to use immunization registries bidirectionally and updating criteria to bidirectional functionality). The certification program is regulated by federal rulemaking, which means the ONC has to publish a proposed rule, accept comments from the public, and refine to a final rulemaking which then becomes regulation for the program.
EHRs are not required to be certified, but EHRs that choose to become certified have to meet rigorous certification standards that are regularly updated. Providers and health systems are required to use CEHRT for various government programs and should understand what certification requirements they need to meet their own program requirements.
## Elation as a Certified Electronic Health Records Technology (CEHRT)
Elation currently maintains the most up to date certification status for CEHRT.
* To learn more about the CEHRT program on the ASTP ONC website [click here](https://www.healthit.gov/topic/certification-ehrs/program-resources).
* To learn more and review Elation’s current certification activities and requirements, [click here](https://chpl.healthit.gov/#/listing/9876).
* Elation Health’s current CMS ID is: **0015C1H7GK8MY31**
To find the Elation's CMS ID for your CMS program requirements, follow these steps:
1. Go to this url: [https://chpl.healthit.gov/#/search](https://chpl.healthit.gov/#/search)
2. Enter “Elation” in the search bar
3. Select **CERT ID**
4. Select **CREATE CERTIFICATION ID**
![CMS ID Creator dropdown on CHPL showing Elation EMR selected, CMS EHR Certification ID 0015C1H7GK8MY31, 100% Base Criteria Met, with Download PDF button.]()
### Additional Elation Health CEHRT details
* **Developer Name**: Elation Health, Inc.
* **Product Name(s)**: Elation EMR
* **Version Number(s)**: Version 3
* **Certified Health IT Product List (CHPL) Product Number(s)**: 15.04.04.2717.Elat.03.00.1.181231
* **Developer Real World Testing Plan Page URL**: [https://www.elationhealth.com/real-world-test-plan](https://www.elationhealth.com/real-world-test-plan)
## Product features
Most notable certification criteria and associated Elation Health product features can be found in the table below.
*
Not all certification criteria have product features and many may not have regular use for our primary customer types.
| Regulation Text Citation | Certification Criterion | Product Feature and Help Center Article |
| ------------------------ | ----------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------- |
| §170.315(b)(1) | Transitions of care | [CCDA Exports](/articles/Supported-Elation-CCDA-types) |
| §170.315(b)(10) | Electronic Health Information export | [Patient Exports](/articles/EHI-Export-Criteria) |
| §170.315(b)(2) | Clinical information reconciliation and incorporation | [Receiving Direct Message](/articles/how-to-use-direct-messaging#files_receiving) |
| §170.315(b)(3) | Electronic prescribing | [e-Prescribing Orders](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) |
| §170.315(c)(1)-(c)(3) | Clinical quality measures (CQMs) — record and export | [QRDA Exports and eCQMs](/articles/QRDA-Export-Guide) |
| §170.315(d)(1) | Authentication, access control, authorization | [Provider Authentication Access Control](/articles/EHR-account-setup-and-Provider-account-authentication) |
| §170.315(d)(3) | Audit report(s) | [Audit Logs](/articles/Patient-Chart-Guide-Audit-Logs) |
| §170.315(d)(4) | Amendments | [Visit Note Amendments](/articles/Visit-Note-Documentation-Guide-Amending-signed-Visit-Notes) |
| §170.315(d)(5) | Automatic access time-out | [Time Out for Security](/articles/Best-practices-for-keeping-your-Elation-account-secure#device) |
| §170.315(e)(1) | View, download, and transmit to 3rd party | [Patient Passport](/articles/elation-patient-passport-an-introduction) |
| §170.315(e)(3) | Patient health information capture | [Patient to Provider Communications](/articles/what-patient-passport-messaging-looks-like-to-a-patient#newmessagefeature) |
| §170.315(f)(1) | Transmission to immunization registries | [Immunization Registry](/articles/Immunization-Registry-Interface-Introduction) |
| §170.315(g)(10) | Standardized API for patient and population services | [FHIR API Implementation](/articles/fhir/getting-started-with-standardized-api) |
| §170.315(g)(2) | Automated measure calculation | [Promoting Interoperability Dashboard](/articles/Promoting-Interoperability-MIPS-2024) |
| §170.315(h)(1) | Direct Project | [Direct Address](/articles/how-to-use-direct-messaging) |
Elation Health meets CEHRT certification compliance as an EHR vendor. Compliance for a health care practice may leverage CEHRT criteria and may extend beyond this limited criteria.
# Elation-HintOS Patient-Sync Integration Guide
Source: https://help.elationhealth.com/articles/Elation-HintOS-Patient-Sync-Integration-Guide
This article describes the patient-sync integration between Elation and HintOS.
## What is the Elation-HintOS Patient-Sync Integration?
If you are an Elation EHR customer who also uses [HintOS©](https://support.hint.com/en/articles/5708819-elation-patient-sync) then this integration is ideal for you. The Elation-HintOS Patient-Sync Integration allows you to synchronize patient demographic information, and keep changes up to date, in either system. Any chart that is created in HintOS will automatically be created in Elation EHR and vice versa. If a chart already exists in the other system, the system will try to match the charts using the patient's first name, last name, date of birth, sex and other demographics information before creating a new chart.
## Why is this integration valuable?
The interface between Elation and HintOS allows you to use Elation for clinical documentation while still being able to efficiently manage your patients' memberships using HintOS. The bi-directional synchronization capabilities amongst the demographics fields allows for streamlined workflows in both systems. You can continue to view which memberships your patients are subscribed to in HintOS directly in their Elation chart.
## How can I start using this integration?
To begin using this integration,
[click here to tell the Elation you are interested](https://help.elationemr.com/s/contactsupport)
. Elation's Implementation Team will work with you to get you connected and link the providers between Elation and HintOS.
## What information is shared between Elation & HintOS?
### New Charts
There are two ways to create patient charts. If you create a chart in HintOS, make sure you assign the patient to an Elation [linked provider in HintOS](https://support.hint.com/en/articles/5718673-how-to-create-a-provider) to push the new chart to Elation.
1. Patients can be registered in HintOS and the new patient will be matched to an existing patient or created as a new patient in Elation.
2. Patients can be registered in Elation and the new patient will be matched to an existing patient or created as a new patient in HintOS
You can review a patient's sync status in the **Integrations** section at the bottom of the patient's details in HintOS.
![Integrations section in HintOS patient details showing ELATION labeled with a green "synced" status badge, indicating successful patient sync.]()
If you do not want a patient in HintOS to sync to Elation, do not assign them to an Elation linked provider.
The integration uses first name, last name, date of birth, sex, and other demographic information to determine matches between the systems.
If there are duplicates created by this process refer to the section on [merging charts](#MergeCharts) for more information.
If you only want new charts created in HintOS to be pushed to Elation but not Elation > HintOS, turn off "Create Patients From Elation" in the [HintOS Integrations page](https://app.hint.com/admin/elationv2).
### Demographics
The chart below describes how demographics fields map to each other between Elation and Hint.
*
Take caution when changing the patient’s phone number in HintOS and make sure the change maps to the correct phone type in Elation; especially the **Mobile** number. The "Mobile" phone type in Elation can be tied to features like the Patient Passport Invitation Code, Appointment Reminders and Virtual Visit instructions.
![Bidirectional sync mapping between Elation and HintOS for: First Name, Middle Name, Last Name, DOB, Sex at Birth, Address (Line 1, Line 2, City, State, Zipcode), First 2 Phone Numbers (Number and Type), and Email.]()
### Insurance
Insurance synchronization will only occur when HintOS creates a chart in Elation for a new patient. Once a patient has a chart in Elation,
**updates to insurance information must be made in both systems**
. We recommend keeping insurance information up-to-date in Elation because insurance information is used for other features.
Only the following fields sync from HintOS to Elation when charts are created in HintOS:
![Diagram showing Insurance Payer/Carrier Name, Member ID, and Group ID syncing from HintOS to Elation during chart creation only, indicated by left-pointing arrows.]()
### Memberships
Maintain the patient membership information in HintOS. Membership details will appear as Patient Tags in the Elation patient chart. Any edits made to the below patient membership information in HintOS will update Patient Tags in Elation. The Patient Tags in Elation should be considered as **read-only** and any modifications made in Elation will not appear in or sync to HintOS.
![Mapping table showing HintOS Membership Data fields syncing to Elation Patient Tags: Membership Status → Active Membership, Employer Sponsor Name → Employer: Name, Membership Plan Name → Plan: Name, Patient's Balance → Past Due Balance, Archived Patient → Archived in HintOS.]()
The **Membership**, **Employer**, **Plan** and **Patient’s Balance** tags will not appear if a patient is archived.
\< > indicates information will populate based on what is indicated in HintOS. (Ex. If membership status says inactive in HintOS, the Patient Tag in Elation will say “Inactive Membership”)
## How to use the Integration
### Patient Self-Registers in HintOS
This workflow is optimal if you would like memberships and insurance information for new patients synchronized in both Elation and HintOS.
1. Patients self-registers in HintOS and patient information is collected during this enrollment. If HintOS creates a new chart for patient in Elation, the Elation chart will include insurance information if it is available. If a chart already exists in Elation, insurance information will not be synced.
* Edit patient demographics in either Elation or HintOS.
* Maintain and edit insurance information in Elation
2. Maintain the patient’s membership information in HintOS. The Patient Tags in the Elation patient chart will update based on the patient’s membership information in HintOS.
### Practice Enrolls Patients
This workflow is ideal if patients only have memberships in HintOS and you do not need insurance information saved in HintOS.
1. Create new patient chart in Elation or HintOS. Any new patient charts created in one system will trigger a chart to be created in the other system.
* Edit patient demographics in Elation or HintOS.
* Maintain and edit insurance information in Elation.
2. Maintain the patient’s membership information in HintOS. The Patient Tags in the Elation patient chart will update based on the patient’s membership information in HintOS.
## How to merge duplicate charts
Deleting or merging patients in either system will not synchronize. The deletion or merge needs to be completed in both systems.
First, in Elation:
1. Go to the **losing** duplicate patient chart you would like to remove.
2. Click on the patient's name to edit patient details and click the **Merge Chart** button at the bottom right-hand corner.
3. Enter the name of the **winning** chart you would like to keep and click **Merge Chart**. Everything except for the demographics and **losing** HintOS ID will be merged into the **winning** chart.
Second, in HintOS:
1. Go to the **losing** or inactive patient chart you would like to remove.
2. Click **Edit Patient** and click **Merge**.
3. Select which fields you would like to keep on the **winning** chart. You will have the option to choose the winning Elation ID as part of this flow. To successfully complete the chart merge, the Elation ID chosen here needs to belong to the **winning** chart in Elation.
4. Click **Merge**
*© Copyright 2023 Hint Health Inc.*
## Additional Resources
* [HintOS Guide for Patient Sync Integration](https://support.hint.com/en/articles/5708819-elation-patient-sync)
* [HintOS Guide for Integration Set Up](https://support.hint.com/en/articles/5708873-migrating-to-elation-health-patient-sync-v2)
# Elation-IntakeQ Integration Guide
Source: https://help.elationhealth.com/articles/Elation-IntakeQ-Integration-Guide
This article describes the Elation-IntakeQ integration for electronic intake forms.
This article describes the Elation-IntakeQ integration for electronic intake forms.
## Overview
### What is IntakeQ?
IntakeQ is a HIPAA-compliant online intake forms software. Practices can create electronic intake forms for patients to complete anywhere and at any time. Analytical data is also available to help practices monitor operations and performance.
### What is the Elation-IntakeQ Integration?
The Elation-IntakeQ integration syncs completed IntakeQ forms with Elation and uses the collected demographic information to create or update patient charts. IntakeQ can also retrieve a patient's contact details from Elation to send intake forms.
### How do I get started?
[Contact Elation](https://app.elationemr.com/support/)
to request this integration and a member of our Implementation Team will reach out with next steps.
* IntakeQ is a paid software and you must [subscribe](https://intakeq.com/pricing?r=aw_bbc_sitelink\&utm_term=intakeq\&utm_campaign=IntakeQ_BrandSearch\&utm_source=ppc\&utm_medium=google_ads\&hsa_acc=6542293186\&hsa_cam=18538221264\&hsa_grp=140614257965\&hsa_ad=633227122212\&hsa_src=g\&hsa_tgt=kwd-372151297908\&hsa_kw=intakeq\&hsa_mt=e\&hsa_net=adwords\&hsa_ver=3\&gad_source=1\&gclid=CjwKCAjwl6-3BhBWEiwApN6_klDTIkUw80HC3CZxzcXYfR-QkmxU94GMhse4WnUospv4O-7ABwWWohoCDC4QAvD_BwE) to their services in order to use them.
### What information is shared between Elation and IntakeQ?
The following information is shared between Elation and IntakeQ:
| Elation | | IntakeQ | Notes |
| -------------------- | - | --------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Chart Creation | ↔ | Client (Patient) Creation | For charts to be created in Elation, at least one form completed by the patient in IntakeQ must include the patient's First Name, Last Name, Date of Birth and Sex at birth. |
| Demographics Updates | ↔ | Contact Information Updates | Elation is the source of truth for patient demographics. \* Demographic information from IntakeQ will only be sent to Elation based on answers submitted through IntakeQ forms. Demographics information stored in the IntakeQ profile **IS NOT** shared with Elation. |
| Report | ← | Completed Form | When a patient submits an intake package via IntakeQ, the forms are automatically uploaded as PDFs to the patient's chart in Elation. |
#### Patient demographics
The synchronization of Patient Demographics is bi-directional. Any changes made in Elation will be pushed to IntakeQ. Demographic information from IntakeQ will only be sent to Elation based on answers submitted through IntakeQ forms.
**Demographics information stored in the IntakeQ profile IS NOT synced to Elation.**
The following table shows a mapping of the Patient Demographics fields that are shared between Elation and IntakeQ Forms and their matching field names. The fields with an asterisk ( \* ) are required by Elation.
*
As best practice, we recommend managing demographics in Elation as various other features and integrations depend on accurate demographics in Elation.
| Elation Field Name | IntakeQ Form Field Name |
| ------------------------------------------------------------------- | ------------------------------ |
| Legal first name\* | First Name |
| Legal last name\* | Last Name |
| Middle Name | Middle Initial |
| Date of birth\* | Date of Birth |
| Sex at birth\* | Gender |
| Address | Address |
| Mobile Phone | Mobile Phone |
| Home Phone | Home Phone |
| Work Phone | Work Phone |
| Email | Email Address |
| Preferred contact method | Preferred contact method |
| Primary Insurance carrier name\* | Primary Insurance Company |
| Primary Insurance Plan name\* | Primary Insurance Plan |
| Primary Insurance Group ID | Group Number |
| Primary Insurance Member ID | Member ID / Policy # |
| Primary Insurance Policyholder - Patient's relation to policyholder | Client Relationship to Insured |
| Primary Insurance Policyholder - First name | Insured First Name |
| Primary Insurance Policyholder - Last name | Insured Last Name |
| Primary Insurance Policyholder - Date of birth | Insured Date of Birth |
| Primary Insurance Policyholder - Sex at birth | Insured Gender |
| Primary Insurance Policyholder - Address | Insured Street Address |
| Primary Insurance Policyholder - City | Insured City |
| Primary Insurance Policyholder - State | Insured State |
| Primary Insurance Policyholder - Zip | Zip Code |
For patient's insurance details to sync from IntakeQ to Elation, you must have an IntakeQ Form with the primary insurance fields listed above. For required fields (marked with an asterisk), mark off the 'Is Required' checkbox for those fields in your form. IntakeQ will sync your list of Insurance Carriers from Elation and the intake form will show a dropdown list of all insurance carriers you have in Elation for the patient to select from.
## Workflow Instructions
### Mapping Providers
To map Provider Level Users in Elation with Practitioner accounts in IntakeQ:
1. Click on the **MORE** button at the top right corner of your IntakeQ account
2. Click **Settings**
3. Click **Integrations**
4. Click **Elation Health Integration**
5. Select the corresponding Elation Provider for each IntakeQ Practitioner under **Practitioner Mapping**.
### Specifying integration settings in IntakeQ
IntakeQ offers a few Settings you can configure for the Elation-IntakeQ integration. To configure these Settings in IntakeQ:
1. Click on the **MORE** button at the top right corner of your IntakeQ account
2. Click **Settings**
3. Click **Integrations**
4. Click **Elation Health Integration**
5. Configure any of the following settings as needed (checking the box enables the corresponding Setting):
| Setting | Enabled Behavior | Disabled Behavior |
| -------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------- |
| Split intake packages into multiple files | Each intake form will be its own Report PDF in Elation. | Each intake package (which can consist of multiple forms) will be a single Report PDF in Elation. |
| Allow IntakeQ to update patient demographics | Allow demographic information from completed IntakeQ forms to populate or update demographic details in Elation. | The Elation-IntakeQ integration will never populate or update demographics details in Elation. |
| Prevent IntakeQ from creating new patients in the EHR | Prevent the Elation-IntakeQ integration from creating new charts in Elation. | Allow the Elation-IntakeQ integration to create new charts in Elation. |
| Upload forms after practitioner signs it | Only push completed forms to Elation after a Practitioner signs the form in IntakeQ. | Push completed forms to Elation after the patient submits the form. |
| Allow IntakeQ to sync patient insurance information in the EHR | Allow insurance information from completed IntakeQ forms to populate or update insurance details in Elation. | The Elation-IntakeQ integration will never populate or update insurance details in Elation. |
### Linking patient charts
#### Automatically creating charts in Elation from completed IntakeQ forms
When a patient submits an intake package via IntakeQ, the forms are automatically uploaded as PDFs to the patient chart in Elation. If the patient does not have a chart in Elation yet, IntakeQ will create a patient chart in Elation using demographics information from the completed form(s). By default, for a chart to be created in Elation, at least one form completed by the patient in IntakeQ must include the patient's First Name, Last Name, Date of Birth, and Sex at Birth.
The functionality that allows IntakeQ to create charts in Elation is a [Setting in IntakeQ](#IntakeQ_sync_settings) . If this Setting is disabled then the Elation-IntakeQ integration will never create charts in Elation.
#### Syncing Elation patients to IntakeQ
Any patient chart in Elation will be automatically visible in IntakeQ when searching for a Client (Patient) to send them forms. Simply type the patient's name in the
**Name**
field and select them from the search results.
!["Send Form to Client" dialog in IntakeQ with the Name field highlighted, where users type a patient's name to search for and select an existing Elation patient chart.]()
### Updating demographics
When a patient submits an intake package via IntakeQ, the forms are automatically uploaded as PDFs to the patient chart in Elation. If the completed forms contain demographic information for
[synchronized fields](#demographics_sync)
, that data will be used to populate or update the demographic details in Elation.
IntakeQ will also pull contact information such as Email or Phone from Elation to send intake forms to patients.
#### Updating demographics after forms were completed
By default, demographic information from IntakeQ will only be sent to Elation based on answers submitted through IntakeQ forms. If a patient submitted wrong or incomplete demographics information, you can use one of the following workflows to update that patient's demographics information:
1. Resend the IntakeQ Form to the patient to fix or update the information. After the form is resubmitted, IntakeQ will sync the new information to Elation.
2. Manually update the information in the patient's demographics in Elation.
### Managing IntakeQ Forms
#### Managing IntakeQ Form Options
There are two form options that can be configured for each IntakeQ:
* Elation Report Category
* By default, all completed IntakeQ Forms are pushed to Elation as an **Intake** Report category.
* To select a different [Report Category](/articles/report-types) for a specific IntakeQ Form:
1. Click **Open Form Options**.
2. Select a category for the Form Name.
3. Click **Save** to save your changes.
* Disable Sync
* By default, all completed IntakeQ Forms are pushed to Elation.
* To disabled the sync for a specific IntakeQ Form:
1. Click **Open Form Options**.
2. Check the **Disable Sync** box next to the name of the form you do not want to sync to Elation.
3. Click **Save** to save your changes.
#### Automatically sending completed IntakeQ forms to Elation
When a patient submits an intake package via IntakeQ, the forms are automatically uploaded as PDFs to the patient chart in Elation. The Provider assigned to the completed IntakeQ Forms will see the forms in the Requiring Action section of the patient's chart for sign off.
#### Preventing specific IntakeQ Forms from syncing to Elation
By default, all completed IntakeQ Forms are pushed to Elation. To disabled the sync for a specific IntakeQ Form:
1. Click **Open Form Options**.
2. Check the **Disable Sync** box next to the name of the form you do not want to sync to Elation.
3. Click **Save** to save your changes.
## Related Articles
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Report Category Guide- Categorizing patient documents](/articles/report-types)
* [IntakeQ's Guide to the EIation-IntakeQ Integration](https://support.intakeq.com/article/432-elation-ehr)
* [IntakeQ's Insurance Information Sync Guide](https://support.intakeq.com/article/475-elation-ehr-insurance-information-sync)
# Elation Integrated Video- Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Elation-Integrated-Video-FAQ
Answers to common questions we've received from practices about Elation Integrated Video
## Content
* [Account Set-up](#account_setup)
* [Using Elation Integrated Video](#using_Zoom)
* [Practice Troubleshooting Tips](#practice_troubleshooting)
* [Patient Troubleshooting Tips](#patient_troubleshooting)
## Account Set-up
**I am unable to find the Virtual Visit Settings to activate my Zoom account.**
This feature may come with additional fees.
If you do not see the **Virtual Visit** section in your Settings, it means the Integrated Video functionality has not been turned on for your account. If you wish to turn this feature on for your practice, please have an Admin level user contact Elation using the **I need help** -> **Contact Elation Support** button at the top of their Elation account and a member of the Elation Team will assist you.
**Can I set up multiple Zoom accounts within my practice?**
Yes! Each provider within your account will be able to activate their own integrated video account. Your staff will not have access to their own integrated video account. However, any user in the practice can log into a video visit as the **host** to assist the provider in their upcoming visit by clicking the **Start Video** button in the Elation calendar.
**Do my Virtual Visit Instructions apply to my whole practice, or just me?**
Just you. Each Provider Level User sets and saves their own **Virtual Visit Instructions**, and these instructions don't carry over between providers. This is separate from the per-provider Zoom account itself — see "Can I set up multiple Zoom accounts within my practice?" above.
**Can I connect my existing Zoom account to Elation?**
No. You cannot connect an existing Zoom© account of yours to Elation. You must register for a new Zoom© account with Elation. This account is free of charge as it is part of your Elation subscription.
**Is Elation integrated video HIPAA-compliant?**
Yes! Elation Integrated Video is HIPAA-compliant.
**Are Zoom recordings of my visits available or stored in Elation?**
No. If you record a session using Zoom's recording controls, that recording is managed entirely by Zoom and is not stored or viewable inside Elation. Depending on your Zoom account's settings, local recordings are typically saved to your computer (often in a Documents > Zoom folder) and cloud recordings can be found by logging into Zoom on the web. For help locating a specific recording, contact Zoom support directly, since they manage the recording functionality.
## Using Elation Integrated Video
### Can my staff start my video visits on my behalf?
Yes! Any Elation user at your practice can start your video visit on your behalf using the **Start Video** button. The first user to click the **Start Video** button will be the **host** of the video visit and will have the ability to control the waiting room and other settings in the Zoom© window. Other users within the practice can subsequently click **Start Video** to join the video visit automatically, bypassing the waiting room. Host privileges can then be easily reassigned as needed by clicking **More** >> **Make Host** next to the user's name in the Participant window.
### Can my staff help prep a patient prior to their video visit, while I finish another patient's video visit?
No. Currently, each provider who registers for a Zoom© account with Elation will have one 'meeting room' and the 'meeting room' is tied to the provider's Elation Calendar. This means that staff cannot see one patient while the provider separately sees a different patient on the Calendar at the same time, using the same **Start Video** button. Many practices have started using Elation's [medical history forms](/articles/Getting-Started-with-Patient-Forms) to help with collecting intake information remotely.
### Can I use Elation integrated video for group visits?
Yes! Your practice will be able to control which and how many patients are admitted into the video visit from the waiting room at a given time. This works great if you are hosting a group visit, or if you have patients who want caregivers to join the video visit with them. Please note that these patients will be able to hear and see each other if they are admitted into the video visit at the same time. You can remove patients at any time from the video visit by either placing them back in the waiting room (if you plan to interact with them later that day) or removing them from the visit altogether. To do so, click **More** >> **Put in Waiting Room** or **More** >> **Remove** next to that individual's name in the Participants list.
**What's the maximum number of participants for a group visit?** Elation doesn't set its own cap on the number of participants — the limit depends on your practice's Zoom© plan, and Zoom's plan limits can change over time. If you're planning a larger group session, check your current Zoom plan's participant limit directly with Zoom, or contact Elation Support to confirm what applies to your account.
### I want to join video visits from my phone. Is this possible?
Yes! You can join your video visit on your phone through our iOS phone app, [Elation Go](/articles/elation-go-the-mobile-app-for-practices) . Download the app in the App Store on your device, and use your Elation username and password to login. From here, you can click the **Start Video** button at the bottom of the app to join the video visit.
### Do patients have to download the Zoom app?
**Computer** = Patients who are joining their video visit from a computer do not need to download the Zoom© app. To bypass the app download, these patients can simply click **Join from browser** after clicking on their video visit link. **Mobile Device** = Patients using their mobile device (iOS or Android) to join the video visit will need to download the Zoom© mobile app. Patients do not need to create a Zoom© account or username/password. They will simply be prompted to enter their name, so that you can recognize who they are in the waiting room. **If your patients need additional assistance** , feel free to send them our [quick how-to guide](https://docsend.com/view/8nxj8m4z9yr999xg) on how join Zoom© video calls.
## Practice Troubleshooting Tips
**I am unable to see the \*\* Start Video** button for the virtual visits on my Calendar. How do I fix this?\*\*
When pasting your waiting room link into the **Virtual visit instructions** , do not alter the link in any way. This will prevent your patients from connecting to your meeting.
If you activated your Zoom integration, removing your **Virtual visit instructions** from the **Virtual Visits** Settings will remove your ability to start your video visits with your patients and you will no longer see the **Start Video** button in your virtual appointments. To correct this:
1. Go to your \*\*Virtual Visits \*\* Settings
2. Click the **Copy** button next to your **Waiting room link**
3. Click the **+ Add custom virtual visit instructions** button under **Virtual Visits Preferences** section
4. If there are multiple Provider Level Users in your practice using the Zoom integration then you will have to select your own name from the dropdown.
5. Paste your waiting room link in the instructions along with any additional details you want to include in your instructions.
*
When pasting your waiting room link into the **Virtual visit instructions** , do not alter the link in any way. This will prevent your patients from connecting to your meeting.
**I accidentally deleted my customized Zoom link from the virtual visit instructions. How do I fix this?**
When pasting your waiting room link into the **Virtual visit instructions**, do not alter the link in any way. This will prevent your patients from connecting to your meeting.
If you activated your Zoom integration, removing your customized Zoom link from the **Virtual visit instructions** will prevent patients from connecting to you via integrated video. To correct this:
1. Go to your **Virtual Visits** Settings
2. Click the **Copy** button next to your **Waiting room link**
3. Go to your **Virtual visit instructions** box
4. Paste your waiting room link in the instructions
When pasting your waiting room link into the **Virtual visit instructions**, do not alter the link in any way. This will prevent your patients from connecting to your meeting.
**Patients say my customized Zoom link does not work for them. How do I fix this?**
If you activated your Zoom integration, do not alter your customized Zoom link in your **Virtual visit instructions** in any way- this will prevent patients from connecting to you via integrated video. To correct this:
1. Go to your **Virtual Visits** Settings
2. Click the **Copy** button next to your **Waiting room link**
3. Go to your **Virtual visit instructions** box
4. Delete your old waiting room link from the instructions (do not delete any other parts of the instructions unless you wish to change it)
5. Paste your waiting room link in the instructions
**Why can't I see the waiting room?**
If you clicked on the **Start Video** button from the Elation calendar and still cannot see the visit waiting room, it may be because another user at your practice joined the same video visit before you. The first user to click the **Start Video** button will be the **host** of the video visit and will have the ability to control the waiting room and other settings in the Zoom© window. Other users within the practice can subsequently click **Start Video** to join the video visit automatically, bypassing the waiting room. Host privileges can then be easily reassigned as needed by clicking **More** >> **Make Host** next to the user's name in the Participant window.
**Why am I being asked to sign in? Why was I placed into the waiting room?**
You may have clicked on the video link intended for patients, which places them in a waiting room. Please make sure that you click on the **Start Video** button in the Elation calendar, and not the link in the virtual visit instructions which is meant for the patient. The **Start Video** button enables you to automatically login as the host of the visit, rather than as a patient.
**I removed the patient from the meeting and now they can not rejoin the visit.**
Choosing to ‘Remove’ a patient from a meeting will prevent a patient from being able to enter the Waiting Room again until you end your current video session and start a new one. We recommend using **Put in Waiting Room** over "Remove", unless you are sure that the patient does not need to come back into the video visit again. If you have accidentally clicked "Remove", you will need to end your current video visit session and start a new one to let the patient connect again. You can then end the session by clicking **End Session** in the bottom right hand corner. Once the session has ended, the patient and anyone in the waiting room will need to re-click the video visit link and you can click **Start Video** button again to join.
* We recommend using the Chat function to send **Everyone in the Waiting Room** a message that the current session will be ended in two minutes and notify everyone to rejoin as needed.
## Patient Troubleshooting Tips
Patient is unable to connect to audio
You can include instructions on how to connect to the virtual visit in your [Virtual Visit Instructions](/articles/Elation-Telehealth-powered-by-Zoom#VirtualVisitInstructions) as needed to ensure patients can connect to their appointment Ex. "When prompted to join audio, select the **Wifi or Cellular Data** option if you are on a mobile device or select the **Join Audio by Computer** option if you are on a computer."
When patients first connect to the meeting, they will be prompted to join audio in one of two ways depending on if they are joining the meeting from a mobile device or computer: If a patient accidentally selected **No Audio** they can click on the microphone icon at the bottom of their Zoom account to select audio connection.
1. Mobile device
* Wifi or Cellular Data **(recommended)**
* Dial in
* No audio
2. Computer
* Join Audio by Computer **(recommended)**
* Dial in
* No audio
\*Copyright ©2023 Zoom Video Communications, Inc. \*
## Related Articles
* [Elation Integrated Video- Connecting with patients using video](/articles/Elation-Telehealth-powered-by-Zoom)
* [Telehealth: Billing & Workflow Recommendations](/articles/Telehealth-Coding-and-Workflows-Recommendations)
* [Patient Guide- How to join a virtual visit](https://docsend.com/view/8nxj8m4z9yr999xg)
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Elation Go: The Mobile App for Practices](/articles/elation-go-the-mobile-app-for-practices)
# Elation Note Introduction
Source: https://help.elationhealth.com/articles/Elation-Note
## Overview
### What is the Elation Note?
The Elation Note offers a documentation experience designed with a clinical-first focus that physicians value. It introduces three key enhancements to support your unique documentation needs:
* A new flexible, block-based design that supports structured data entry and downstream reporting.
* Keyboard shortcuts for rich-text formatting and efficient editing.
* Shortcut for inserting chart data into a standard block or text field.
### What are the benefits of using the Elation Note?
The Elation Note:
* Promotes adherence to care protocols.
* Makes documentation more flexible and adaptable to varying workflows.
* Enhances speed and efficiency while charting.
#### What is different from the legacy visit note formats?
The Elation Note is modeled off of Elation’s Complete H\&P Note (2 col-A/P). However, unlike the legacy note which presents the draft as a static form, the Elation Note is a dynamic editor that transforms each section of the note into a distinct block. Each block can be added, deleted and rearranged to meet the needs of the provider, visit or practice.
Other capabilities now available in the Elation Note include:
* Creating custom blocks to better organize and structure your documentation.
* Showing or hiding custom blocks based on applied logic to only see what’s relevant in the moment.
* Using rich text formatting to make notes clearer and easier to read.
* Undo-ing changes if you make a mistake while editing.
![Side-by-side comparison of Legacy Note (left) and Elation Note (right), showing the Elation Note's two-column layout with dynamic blocks for HPI, Covid Screening, Assessment & Plan, and Vitals & Observations.]()
### How frequently is the Elation Note updated with new features or improvements?
In 2025, Elation will continue building on the Elation Note in the open. You will see frequent updates and your feedback will directly shape what comes next. [Click here for a summary of the updates as they come out](/articles/Elation-Note-Release-Summary).
### Anatomy of the Elation Note
![Elation Note draft showing labeled anatomy: (A) note header with date/time and action buttons, (B) Clinical Reminders with "BMI needs to be recorded" alert, (C) note body with HPI, Allergies, Past Medical/Surgical/Family/Social History blocks and Vitals & Observations panel, (D) Billing Information section, and (E) Sign, Save as Draft, and Delete action buttons.]()
#### Note Header (A)
The header contains fields that can be updated as needed and buttons associated with our new block functionality.
* **Visit note category**- Defines how the visit note gets labeled. The dropdown options can be edited by Admin users under this settings page.
* **Provider**- The provider to whom the note is attributed to.
* **Date & Time**- Defaults to the patient’s appointment or current date/time if there isn’t an appointment.
* Buttons to quickly take certain actions in the note.
* **Document Tags** - View/edit [document tags](/articles/tag-reports-and-notes-with-document-tags).
* **Templates** - Add [Elation Note Template(s)](/articles/Elation-Note-Guide-Managing-Templates).
* **Add Block** - Add a [block](/articles/Elation-Note-Guide-Using-visit-note-blocks) to the note.
* **Undo** - Undo the last action.
* **Redo** - Redo the last action that was undone.
#### Clinical Reminders (B)
This section displays reminders for any electronic clinical quality measures (eCQMs) that are relevant to the patient. [Refer to our Clinical Reminders guide for more details on how Clinical Reminders operate](/articles/clinical-reminders-for-clinical-quality-measures).
Clinical Reminders are only available for Health Maintenance measures and customers using custom Care Gaps at this time.
#### Note Body (C)
The body is where users can input content for the visit note - from the exam reason (i.e. chief complaint) through follow-up instructions.
At a glance, the body is nearly identical to the body of the original 2 column note. In fact, the Elation Note by default shows every section from the Complete H\&P Note (2 col-A/P) with the **exception** of the **Data** section. However, each of these sections in the Elation Note is now a dynamic block, also known as a [standard block](/articles/Elation-Note-Guide-Using-visit-note-blocks).
The **Vitals & Observations** block includes inline unit parsing and auto-conversion for height, weight, and head circumference. You can type values in any common unit format — including compound inputs (e.g. `5'10"`), fractions (e.g. `5 1/2'`), and European-style decimal commas (e.g. `12,5 kg`) — and Elation will automatically convert and store the value in the standard unit for each field.
#### Billing Information & Confidential Indicator (D)
This section will show a summary of diagnosis and CPT codes that have been added to the note. By clicking **Edit Bill**, users can update more specific billing details and complete charge entry.
Check the **Keep this confidential** checkbox to mark the note as [confidential](/articles/confidential-items-in-your-patient-chart).
If you create any orders during a confidential visit, be sure to mark both the orders and the visit note as confidential.
#### Action Buttons (E)
Users can sign, save, or delete the draft note with the buttons at the bottom of the screen. Only Provider Level Users will see the option to sign.
### Glossary of Features
| **Feature** | **Details** |
| -------------------------------------------------------------------------------------- | -------------------------------------------------------------------- |
| [CPT Code Command](/articles/Elation-Note#slash_command) | Search for and add a CPT code to the note. |
| [Custom Blocks](/articles/Elation-Note-Guide-custom-blocks) | Insert data blocks built and maintained by members of your practice. |
| [Dx Code Command](/articles/Elation-Note#slash_command) | Search for and add a diagnosis code to the note. |
| [Dynamic Macros](/articles/Elation-Note-Guide-Documenting-an-encounter#dynamic_macro) | Insert real-time patient data into the note. |
| [Rich Text Formatting](/articles/Elation-Note-Guide-Documenting-an-encounter#richtext) | Style and structure text beyond plain characters |
| [Standard Blocks](/articles/Elation-Note-Guide-Using-visit-note-blocks) | Insert data blocks built and maintained by Elation. |
| [Templates](/articles/Elation-Note-Guide-Managing-Templates) | Insert a visit note template into the note. |
## Setup
To get the most out of the Elation Note, we recommend setting up custom blocks and templates. They help you focus your documentation on the information that matters most—and make it easy to quickly add content you use often.
For example, the \***E Medicare Annual Wellness Visit – AWV** template from Elation’s Template Library is designed to document the key information typically collected during a Medicare Annual Wellness Visit. By applying this template each time you document this type of visit, you’ll have all the relevant fields ready to fill out—helping ensure consistency and completeness in your documentation.
The ability to edit the \***E Medicare Annual Wellness Visit – AWV** template from Elation’s Template Library will be available soon.
The \***E Medicare Annual Wellness Visit – AWV** template won't populate values for hosted database customers. Support for this data through the hosted database will be available soon.
### Creating custom blocks
Custom blocks allow practices to create organized groups of input fields—like checkboxes, dropdowns, and text fields—for capturing structured data that [standard blocks](/articles/Elation-Note-Guide-Using-visit-note-blocks) currently don’t capture.
Once created, custom blocks can be added directly to an Elation Note draft or built into Elation Note Templates for repeated use.
[Click here for instructions on how to create custom blocks](/articles/Elation-Note-Guide-custom-blocks).
### Creating Elation Note Templates
Templates are prebuilt, reusable formats designed for specific visit types—like annual wellness exams—or procedures where documentation can follow a consistent structure. They help reduce manual typing, prevent omissions, and support a smooth, organized workflow during the visit.
The Elation Note has its own template builder that lets you take advantage of both standard and custom blocks to create more flexible, structured templates.
[Click here for instructions on how to create templates for the Elation Note](/articles/Elation-Note-Guide-Managing-Templates).
Legacy visit note templates are still supported in the Elation Note and can be applied using the **/template** command. If you need to edit a legacy visit note template, refer to the instructions on [this Help Center page](/articles/elation-visit-note-templates#CreateTemplate) .
## Workflow Instructions
### Using the / command
Use the forward slash (**/**) key on your keyboard to search for and add predefined content to your visit note draft.
| **Command** | **Object** | **Apply to visit note draft** | **Apply to Template** |
| --------------------------- | ---------------------------------------------------- | ----------------------------- | --------------------- |
| /cardiac order | Cardiac Order placeholder | Yes | Yes |
| /cpt code | Popular CPT Code search | Yes | Yes |
| /dx code | ICD-10 code search | Yes | Yes |
| /template | Legacy Visit Note Templates & Elation Note Templates | Yes | No |
| /*\[standard block name]* | Standard Block | Yes | Yes |
| /*\[custom block shortcut]* | Custom Block | Yes | Yes |
| /lab order | Lab Order placeholder | Yes | Yes |
| /imaging order | Imaging Order placeholder | Yes | Yes |
| /prescription | Prescription placeholder | Yes | No |
| /pulmonary order | Pulmonary Order placeholder | Yes | Yes |
| /sleep order | Sleep Order placeholder | Yes | Yes |
### Using the @ command
Use the at sign (**@**) key on your keyboard to insert dynamic fields (also known as Dynamic Macros) into any standard block or text field to insert any of the following real-time patient data into your visit note.
* **Clinical Profile (Allergies)**
* Bulleted list of active allergies from the **Allergies** section of the Clinical Profile.
* **Clinical Profile (Medications)**
* Bulleted list of active, permanent medications from the **Permanent Rx Meds** section of the patient's Clinical Profile.
* **Clinical Profile (Problems)**
* Bulleted list of active problems from the **Problem List** section of the patient's Clinical Profile.
* **Patient age**
* Patient's age at the time of visit.
* **Patient DOB**
* Patient's **Date of birth** from their Demographics.
* **Patient name**
* Patient's **Legal first name**, **Middle name** & **Legal last name** from their Demographics.
When a template containing a dynamic macro is applied to a visit note, any **@** fields will automatically be replaced with the corresponding patient data.
**Exception:** Dynamic macros cannot be used in custom blocks, Vitals fields, structured PE and ROS fields or anywhere outside of the Elation Note draft or template builder.
### Documenting an encounter
[Click here for instructions on how to use the Elation Note to document an encounter](/articles/Elation-Note-Guide-Documenting-an-encounter).
## Frequently Asked Questions
### What features from the legacy note are not yet available in the Elation Note?
| **Feature** | **Functionality** | **Legacy Notes** | **Elation Note** |
| :---------------------------------------------------- | :------------------------------------------------------------------------------------------------------ | :------------------------- | :------------------------------------------- |
| Editing experience | Write + edit a note | Yes | Yes |
| | Utilize dynamic data blocks | No | Yes |
| | Apply rich-text formatting | No | Yes |
| | View-only draft note | No | Yes |
| | Edit visit note concurrently | Yes | Yes |
| Note formats | One column format | Yes | No |
| | Two column format | Yes | Yes |
| | Non-visit Note format | Yes | Coming Soon |
| Export data from Clinical Profile to note | Availability | Yes | Yes |
| | Export full history | Yes | Yes |
| | Export problem list | Yes | Yes |
| Export data from note to Clinical Profile | Availability | Yes | Coming Soon |
| Order lab tests | Open a new Lab Order Form from visit note | Yes | Yes |
| | View lab order status in visit note | No | Yes |
| | Leverage order sets when adding a Lab Order block to a visit note template | No | Yes |
| Order medications | Open a new Prescription Form from visit note | Yes | Yes |
| | View prescription status in visit note | No | Yes |
| | Add a Prescription Order block to visit note templates | No | Coming Soon |
| Create referrals | Open a new Referral from visit note | Yes | No |
| | View referral status in visit note | No | Coming Soon |
| | Add a Referral block to visit note templates | No | Coming Soon |
| Order imaging tests | Open a new Imaging Order from visit note | Yes | Yes |
| | View Imaging Order status in visit note | No | Yes |
| | Add an Imaging Order block to visit note templates | No | Yes |
| Order cardiac tests | Open a new Cardiac Order from visit note | Yes | Yes |
| | View Cardiac Order status in visit note | No | Yes |
| | Add a Cardiac Order block to visit note templates | No | Yes |
| Order sleep tests | Open a new Sleep Order from visit note | Yes | Yes |
| | View Sleep Order status in visit note | No | Yes |
| | Add a Sleep Order block to visit note templates | No | Yes |
| Order pulmonary tests | Open a new Pulmonary Order from visit note | Yes | Yes |
| | View Pulmonary Order status in visit note | No | Yes |
| | Add a Sleep Order block to visit note templates | No | Yes |
| Document injections | Open a new Document Injected Medication form from visit note | Yes (Beta) | Coming Soon |
| | View status of injected medication in visit note | No | Coming Soon |
| | Add a Document Injected Medication block to visit note templates | No | Coming Soon |
| Document vaccines | Open a new Vaccine Form from visit note | Yes | No |
| | View status of vaccine in visit note | No | Coming Soon |
| | Add a Vaccination block to visit note templates | No | Coming Soon |
| Document giving sample medications | Open a new Samples form from visit note | Yes | No |
| | View status of samples in visit note | No | Coming Soon |
| | Add a Samples block to visit note templates | No | Coming Soon |
| Document Point-of-Care Labs | Document a Point-of-Care Lab from visit note | Yes | Coming Soon |
| | Export Point-of-Care lab result to visit note | Yes | Yes |
| Document Vitals | Document blood pressure (BP) | Yes | Yes |
| | Document heart rate (HR) | Yes | Yes |
| | Document temperature (Temp) | Yes | Yes |
| | Document respiratory rate (RR) | Yes | Yes |
| | Document height (Ht) | Yes | Yes |
| | Document weight (Wt) | Yes | Yes |
| | Document body mass index (BMI) | Yes | Yes |
| | Document oxygen saturation (O2) | Yes | Yes |
| | Document pain score (Pain) | Yes | Yes |
| | Document body fat %, change in dry lean mass, change in body fat mass, waist circumference, and ketones | Yes | No |
| | Document multiple values for a type of vital | Only for BP | Only for BP, HR, RR, Temp, O2, FiO2 and Pain |
| | Open vitals trend table | Yes | Yes |
| | Reference previous vital values | Only BMI | Coming Soon |
| Use Appointment Automation
| Open new visit note draft via appointment automation | Yes | Yes |
| | Apply visit note templates to visit note drafts created via appointment automation | Yes | No |
| Document Physical Exam (PE) / Review of Systems (ROS) | Create PE/ROS templates | Yes | Coming Soon |
| | Apply PE/ROS templates | Yes | Yes |
| | Apply previous PE/ROS template values | Yes | Coming Soon |
| Document Assessment & Plan | Search for diagnosis codes in Assessment field | Yes | Coming Soon |
| | Use Dx Code Navigator | Yes | Yes |
| | Search for procedure codes in the Procedure field | Yes | Coming Soon |
| | Open patient handouts | Yes | Coming Soon |
| Print visit notes | Print Care Plan from visit note draft | Yes | Yes |
| | Print signed visit note | Yes | Yes |
| | Print Encounter Summary (MIPS) | Yes | Coming Soon |
| | Print Patient Summary | Yes | Yes |
| | Print Patient Instructions | Yes | Yes |
| | Print simple Invoice (without DX codes) | Yes | Yes |
| | Print claims Invoice (with ICD-10) | Yes | Yes |
| | Print claims Invoice (with ICD-9) | Yes | No |
| Amend signed visit notes | Amend signed visit note | Yes | Yes |
| | Record patient requested amendment | Yes | Coming Soon |
| | Delete amended visit note | Yes | Yes |
| | View history of amendment changes | Yes | Yes |
| | Save note amendment as draft | Yes | Yes |
| | Preview note amendment | Yes | No |
| Manage Clinical Reminders - MIPS | View and dismiss clinical reminders in draft visit note | Yes | Yes |
| | Action on clinical reminders in draft visit note | Yes | Coming Soon |
| Manage Care Gaps
| View and dismiss Care Gaps | Yes | Yes |
| | Action on Care Gaps | Yes | Yes |
| Apply Document Tags
| Add Document Tags to a draft visit note | Yes | Yes |
| | Add Document Tags to a signed visit note | Yes | Yes |
| | Add Document Tags to a visit note template | Yes | No |
| | Use Document Tags to automatically apply CPT Codes to the bill | Yes | No |
| Copy forward a signed visit note | Export the entire signed visit note to a new note | Legacy Note to Legacy Note | Note 2.0 to Note 2.0 |
| | Export just the HPI section of a signed visit note to a new note | Legacy Note to Legacy Note | No |
| Send Visit Note | Via Office Message | Yes | Appears as a 2-col A/P Note format |
| | Via Provider Letter | Yes | Appears as a 2-col A/P Note format |
| | Via Provider Referral | Yes | Appears as a 2-col A/P Note format |
| | Via Patient Letter | Yes | Appears as a 2-col A/P Note format |
| Use Note Assist | Use the Scribe feature to populate free text | Yes | Yes |
| | Use the Scribe feature to populate structure data | No | Yes |
| | Use the Scribe feature to trigger actions | Yes | Yes |
| Miscellaneous | Search for visit note in chronological record. | Yes | Coming Soon |
| | Assign visit note categories | Yes | Yes |
| | View Growth Charts | Yes | Yes |
| | Edit the bill of a signed note | Yes | Yes |
| | Using Billing Guidance | Yes | Yes |
| | Use a built-in timer | Yes | No |
| | Specify user default setting for visit note format by encounter type | Yes | Yes |
| | Mark a visit note as confidential | Yes | Yes |
| | Apply coding automation | Yes | Coming Soon |
| | Apply lab coding templates | Yes (Beta) | Coming Soon |
| | Co-sign notes | Yes (Beta) | Coming Soon |
| | Share visit note summary with Patient via Patient Passport. | Yes | Coming Soon |
| | Share signed visit note through the Patient Longitudinal Record | Yes | Coming Soon |
| | Share signed visit note through the Collaborative Health Record. | Yes | Coming Soon |
| | View signed visit notes in Billing Home | Yes | Yes |
| | View signed visit notes in Productivity Reports | Yes | Coming Soon |
### Can I apply a legacy visit note template to the Elation Note?
Yes, you can apply a legacy visit note template to the Elation Note. The data will populate in their corresponding blocks, wherever they are in the note. If the blocks don't exist, then we will append the block to the bottom of the note (respecting their right or left location in the template).
1. [Follow any of these 3 workflows](/articles/Elation-Note-Guide-Using-visit-note-blocks#add) to insert the **Template** block into your visit note.
2. You cannot export legacy visit note templates from the Visit Note Templates shortcut at the top of the chart.
3. Search for and select the template you want to add.
### Can I apply legacy PE and ROS templates to the Elation Note?
Yes, you can apply legacy PE and ROS templates to the Elation Note yet. Simply click on the templates ![]()
icon at the top of the PE or ROS blocks to search for and select the template you want to use.
### Is the Elation Note available in the API?
The Elation Note introduces new API endpoints. If you want to leverage the Elation Note, you must either create new workflows and/or migrate existing workflows to these endpoints. We will be developing these endpoints further to take advantage of new Elation Note features like custom blocks and templates.
[Click here for our API documentation](https://help.elationhealth.com/articles/rest/visit-notes-api/notes).
### Is content from the Elation Note available in the Hosted Database?
Yes, and Elation Note's custom block feature is intended to make querying structured data easier than before.
Please review our data validation guide. If you decide you would like to enable tables to reflect custom block data from Elation Note, contact your account representative and request to turn these tables on.
### Are the features in Elation Note designed with regulatory compliance in mind?
When an Elation Note is created, a version of it is created in the legacy note format. This backported legacy note format complies with our regulatory and certification standards using the same methods and at the same quality as the legacy note. For example, CCDA, FHIR, PLR/CHR and Patient Passport data are all being populated in the same methods and quality as legacy note.
We are committed to promoting strong data quality and interoperability. As Elation Note is still in development, each time we improve the data structure of the note, we plan on making the changes available to existing signed notes when appropriate. For example. if our team discovers that data was previously missing in our backported note, we will run a migration to ensure all existing signed notes will include the missing data point to ensure a more fulsome note. We believe this is the correct thing to do, as it places the practice in a better posture for the future.
A note on CMS reporting for AWVs
Elation Note introduces a powerful new feature of custom blocks. Depending on how your practice is using custom blocks, it’s important to review the data you are reporting on with your reporting partners (e.g. ACOs or other third party organizations).
### Can I add dynamic macros to a custom block?
No, dynamic macros cannot be added to a custom block.
### Can I add more dynamic macros?
No, additional dynamic macros cannot be added. Elation will notify you if we add additional options.
### How frequently is the Elation Note updated with new features or improvements?
In 2025, Elation will continue building on the Elation Note in the open. You will see frequent updates and your feedback will directly shape what comes next.
## Related Articles
* [Elation Note Guide - Managing custom blocks](/articles/Elation-Note-Guide-custom-blocks)
* [Elation Note Guide - Manage Elation Note Templates](/articles/Elation-Note-Guide-Managing-Templates)
* [Elation Note Guide - Using visit note blocks](/articles/Elation-Note-Guide-Using-visit-note-blocks)
* [Elation Note Guide - Documenting an encounter](/articles/Elation-Note-Guide-Documenting-an-encounter)
* [Elation Note Guide - Release Summary](/articles/Elation-Note-Release-Summary)
# Elation Note Guide - Documenting an encounter
Source: https://help.elationhealth.com/articles/Elation-Note-Guide-Documenting-an-encounter
## Overview
This article will guide you through documenting a patient encounter using the Elation Note. Along the way, you’ll learn how to use features like templates, dynamic macros and rich text formatting to make your documentation more efficient, clear, and consistent.
You’re free to explore these workflows and choose the ones that feels most comfortable and efficient for your style. There’s no need to use them all—just what works best for you.
## Workflow Instructions
### Starting a new Elation Note draft
The Calendar is designed to provide an intuitive experience for managing appointments and providing visibility into each Provider Level User’s schedule.
Open the patient’s chart.
At the top of the chart, click **Visit Note** -> **Elation Note**. Click on the patient’s name from their appointment today to open an Elation Note draft if you are using Elation Note with the [visit note automation feature](/articles/visit-note-automation).
A new draft note will open on the right-hand side of the chart.
### Addressing Clinical Reminders
Review the Clinical Reminders at the top of the visit note draft to address/dismiss any relevant reminders.
Clinical Reminders are only available for [Health Maintenance measures](/articles/health-maintenance) and customers using custom Care Gaps at this time.
### Writing a visit note
#### Using a template
In the Elation Note, you can export templates created with Elation’s legacy Visit Note Template feature or the Elation Note Templates feature. [Click here to learn more about how to create the new Elation Note Templates](/articles/Elation-Note-Guide-Managing-Templates).
Multiple templates (both legacy and new) can be applied to the same visit note draft. The contents of the template will simply add to what’s already been documented in the draft.
![Elation Note draft open on the right side of the chart, with an on-screen keyboard visible, and the cursor active in the HPI text field ready for typing.]()
##### Option 1: Exporting a legacy template
As a recommendation, keep all of the default blocks that appear when you start your draft note. Doing so helps ensure the contents of your legacy template appear in the expected order. The data will populate in their corresponding blocks, wherever they are in the note. If the blocks don't exist, then we will append the block to the bottom of the note (respecting their right or left location in the template).
[Follow any of these 3 workflows](/articles/Elation-Note-Guide-Using-visit-note-blocks#add) to insert the Template block into your visit note.
Search for and select the template you want to add.
When exporting a legacy template to the Elation Note, you must use one of the workflows in the above link. You cannot export them from the Visit Note Templates shortcut at the top of the chart.
##### Option 2: Exporting an Elation Note Template
If you haven’t written anything in the draft yet:
Delete all of the default blocks from your draft first.
Using your keyboard: Select all contents of the note by pressing **ctrl**/**command** + **a**.
Press **Delete**/**Backspace** until all blocks are removed.
Once the note has no more blocks, click the **Templates** icon at the top of the Visit Note.
Search for & select the template you want to add.
If you’re adding an Elation Note Template to a draft that already has content:
Click the **Templates** icon at the top of the Visit Note.
Search for & select the template you want to add. The blocks from the recently added template might not appear in the expected order (i.e. blocks may get appended to the bottom of the note). If needed, use the Grid icon to drag-and-drop the blocks to the right position.
**EXCEPTION** Elation Note Templates aren’t supported when setting up [visit note automation](/articles/visit-note-automation) . Click on the white space to open the appointment popover and then click **Chart** to open the chart and avoid visit note automation if you plan to use an Elation Note.
#### Typing directly into the note
You can place your cursor into any text field within a block or outside of a block to type new content.
![Elation Note draft showing the Billing Information section at the bottom, with "Sign Visit Note," "Save as Draft & Close," "Delete," and "Print" action buttons visible.]()
##### Creating a text field outside of a block
Option 1: Add a text field above or below a block
At the top of any existing block, click the **Grid** icon ![Grid icon used to access block-level actions like moving, adding above/below, or deleting a block]()
on the left or the **More Actions** icon ![More Actions icon]()
on the right.
Select **Add block above** or **Add block below** depending on where you want the new text field to appear.
When the dropdown menu appears, delete the forward-slash ( **/** ) so that you’re left with a regular text field that you can type in.
Option 2: Add a text field below a text field
In an existing block, place your cursor at the end of the last line of text.
Press **Return** / **Enter** on your keyboard twice. With the first keystroke, you’ll create a new line, and with the second, you’ll create a text field outside the block.
#### Importing content from outside the note
For the blocks that are associated with the subjective data, there are a few workflows to transfer data from the Clinical Profile or Patient Demographics to the draft note.
##### Option 1: Using the import button found at the top of the block
**Exception:** Only certain blocks will feature an **Import** icon.
Click the **Import** icon to import the content from the corresponding section of the Clinical Profile.
##### Option 2: Inserting a block whose name ends with (from Clinical Pr) into the note
**Exception:** Blocks ending with **(from Clinical Pr)** are only available for certain sections of the Clinical Profile.
[Follow any of these 3 workflows](/articles/Elation-Note-Guide-Using-visit-note-blocks#add) to search for and enter a block that ends with **(from Clinical Pr)**.
The block will appear pre-populated with content from the corresponding section of the Clinical Profile.
If you administer an updated Clinical Questionnaire, any previously imported results will remain visible in read-only mode for reference.
##### Option 3: Initiating an export from the Clinical Profile
Scroll to the section of the Clinical Profile that you’d like to export.
Hover over the heading name or a specific line-item under the heading until you see an **Actions** button appear.
Click **Actions** and in the dropdown menu, select the type of import that you’d like to perform.
**EXCEPTION** Currently, exporting the synopsis of a diagnosis from the **Problem List** isn’t supported, but this functionality is planned for a future update.
##### Option 4: Applying a Dynamic Macro
Use the **@** shortcut to insert any of the following chart data into a standard block or text field: **Clinical Profile (Allergies)** • **Clinical Profile (Medications)** • **Clinical Profile (Problems)** • **Patient age** • **Patient DOB** • **Patient name**
**Exception:** Dynamic macros cannot be used in custom blocks, Vitals blocks, structured PE and ROS fields or anywhere outside of the Elation Note draft or template builder.
#### Using the + button in certain blocks
The **Allergies**, **Reconciled Medications**, and **Assessment & Plan** blocks have a **+** button that allows you to simultaneously add structured information to the draft note and Clinical Profile.
At the top of one of the 3 blocks mentioned above, click the **+** button.
A pop-up window that corresponds with the block will appear.
Complete the fields within the pop-up window.
Click **Save**.
**Exception:** The Family History block also has a + button, but it can only be used to add information to the note daft.
The Procedures Administered block also includes a + button, but it can only be used to add a procedure to the visit note along with any related CPT codes to the billing section.
### Deleting content from your note
Aside from pressing the **Delete**/**Backspace** key on your keyboard to delete individual text, you can also use the methods below when appropriate.
#### Option 1: Using buttons to remove an entire block
At the top of any existing block, click the **Grid** icon ![Grid icon used to access block options such as Add block above, Add block below, and Delete]()
on the left or the **More Actions** icon ![More Actions icon]()
on the right.
Select **Delete** from the dropdown menu.
#### Option 2: Highlighting content to delete
Highlight text from the visit note with your cursor. The highlighted portion can span across blocks.
Press the **Delete** / **Backspace** key on your keyboard to delete the highlighted text.
### Copying forward a signed Elation Note
In the Chronological Record, locate the signed visit note.
Click **Actions** -> **Export to New Note (All Sections)**.
A new draft will appear with the contents of the prior visit note.
**Exception:** You can only copy forward a signed Elation Note to an Elation Note draft (i.e. you cannot copy forward a legacy visit note into an Elation Note draft).
### Undo-ing or redo-ing actions
The **Undo** button ![Undo button icon used to reverse the last action in the Elation Note draft]()
at the top of the note lets you undo the last action as long as you never saved the note or exited the chart since taking the last action. This includes undo-ing a delete action.
* You can also press Ctrl/command + z on your keyboard.
The **Redo** button ![Redo button icon used to restore the last undone action in an Elation Note]()
lets you redo the last action that was undone.
* You can also press Ctrl/command + y on your keyboard.
### Applying rich-text formatting with keyboard shortcuts
Within any text field (inside or outside a block), you can use the following keyboard shortcuts to achieve more detailed formatting.
| **Action** | **Steps** |
| --------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Create a heading | **#**+**space**+ type your **heading text** |
| Bold | **Ctrl**/**command**+**b** |
| Italicize | **Ctrl**/**command**+**i** |
| Bold and Italicize | **Ctrl**/**command**+**b**+**i** |
| Undo | **Ctrl**/**command**+**z** You can also click the **Undo** button ![Undo button icon used to reverse the last action in the Elation Note]()
at the top of the note. |
| Redo | **Ctrl**/**command**+**y** You can also click the **Redo** button ![Redo button icon used to restore the last undone action in an Elation Note]()
at the top of the note. |
| Copy | **Ctrl**/**command**+**c** |
| Cut | **Ctrl**/**command**+**x** |
| Paste | **Ctrl**/**command**+**v** |
| Create a bulleted list | Press the **dash-** key followed by\*\* space\*\*. Use the Tab key to indent. • Press Shift + Tab to un-indent. |
| Convert an empty bullet to a paragraph | Press the **Enter**/**Return** key. |
| Create a numbered list | Press a **number**+ the **period**.key +**space** key Use the Tab key to indent. • Press Shift + Tab to un-indent. |
| Convert an empty numbered list to a paragraph | Press the **Enter** key |
| Move cursor to the start of a line | **Ctrl**+**a** |
| Moving between blocks | Press the up **↑** or down **↓** arrow. |
| Select all contents in the note | **Command**/**Windows** key +**a** |
### Amending an Elation Note
Provider Level Users can amend visit notes they sign. All changes will be tracked and logged for auditing and legal purposes.
In the Chronological Record, locate the signed visit note.
Click **Actions** -> **Amend Visit Note** -> **Continue**.
The visit note will appear in draft form for you to edit.
Click **Sign Amended Visit Note** to save your amendments.
You may need to refresh the chart to see your amendments.
### Printing a note, Patient Summary, or Care Plan
To print
* an Elation Note draft, click **Print** and then select one of the print options.
* a signed Elation Note, click **Actions** -> **Print Note** and then select one of the print options.
To print a patient's **Care Plan**, use the **Patient Summary** option below—the Care Plan section is included in that printout by default.
#### Print Options
* **Bill**
* By default, diagnosis codes are included in the printout. Unselect the **Include dx codes box** from the **Print Selection** to exclude diagnosis codes from the printout.
* **Patient Summary**
* By default, the **Exam reason**, **Vitals**, **Procedures administered**, **Care plan** and **Follow up** sections will be printed, if available. You can uncheck the corresponding boxes to exclude that data from the printout.
* Select **Bill**, **Active medications** or **Active problems** to include the corresponding data in the printout.
* **Note**
* By default, all sections of note, excluding the billing information is included in the printout.
* Select **Bill** to included billing data in the printout.
**How the patient is identified on the printout**
When you print directly from the note (**Print**, or **Actions** -> **Print Note**), the patient's preferred name (or legal name if no preferred name is set) appears once at the top of the document. If the patient has a preferred name, their legal name is also shown in smaller text below it. The name is not repeated on each page of a multi-page printout, and there is no setting or dynamic macro that adds it to every page of that printout.
If you need the patient's legal name, date of birth, and page number to appear on **every** page—for example, so no page of a multi-page note can be mistaken for another patient's—generate the note as a PDF instead by **faxing**, **sharing**, or **exporting** it. Elation automatically adds a footer with the patient's legal name, date of birth, and "Page X of Y" to every page of those PDFs.
## Frequently Asked Questions
### Can I add dynamic macros to a custom block?
No, dynamic macros cannot be added to a custom block.
### Can I add more dynamic macros?
No, additional dynamic macros cannot be added. Elation will notify you if we add additional options.
### Can I create a new PE or ROS template from the Elation Note?
No, you cannot create a new PE or ROS template from the Elation Note. Open a legacy note, create the new PE or ROS template there, and you’ll be able to apply it to any Elation Note moving forward.
### Will the patient's name print on every page of a multi-page note?
When you print directly from the note (**Print**, or **Actions** -> **Print Note**), the patient's preferred name (or legal name if no preferred name is set) appears once at the top of the printout—it is not repeated on each page. If the patient has a preferred name, their legal name is also shown in smaller text below it.
To have the patient's legal name, date of birth, and page number appear on every page, generate the note as a PDF by **faxing**, **sharing**, or **exporting** it. Those PDFs automatically include a footer with the patient's legal name, date of birth, and "Page X of Y" on each page.
### Does a saved amendment draft appear in my Draft Notes inbox on Practice Home?
No. An amendment saved as a draft appears only in the Requiring Action queue at the top of the patient's chart — it does not appear in the Practice Home **Draft Notes** inbox. It's removed from the Requiring Action queue once the amendment is signed or discarded. The **Draft Notes** inbox only lists notes that have never been signed.
## Related Articles
* [Elation Note Introduction](/articles/Elation-Note)
* [Elation Note Guide - Managing custom blocks](/articles/Elation-Note-Guide-custom-blocks)
* [Elation Note Guide - Managing Elation Note Templates](/articles/Elation-Note-Guide-Managing-Templates)
* [Elation Note Guide - Using visit note blocks](/articles/Elation-Note-Guide-Using-visit-note-blocks)
* [Elation Note Guide - Release Summary](/articles/Elation-Note-Release-Summary)
# Elation Note Guide - Managing Elation Note Templates
Source: https://help.elationhealth.com/articles/Elation-Note-Guide-Managing-Templates
## Overview
### What are Elation Note Templates?
Templates are prebuilt, reusable formats designed for specific visit types—like annual wellness exams—or procedures where documentation can follow a consistent structure. They help reduce manual typing, prevent omissions, and support a smooth, organized workflow during the visit.
The Elation Note has its own template builder that lets you take advantage of both standard and custom blocks to create more flexible, structured templates.
Legacy visit note templates are still supported in the Elation Note and can be applied by typing the **/template** command into the note. If you need to edit a legacy visit note template, refer to the instructions on [this Help Center page](/articles/elation-visit-note-templates#CreateTemplate) .
### What templates are made available through Elation’s template library?
When your Elation account is first set up, it will come preloaded with the following Elation Note templates:
* \*E Medicare Annual Wellness Visit - AWV
The ability to edit the \***E Medicare Annual Wellness Visit – AWV** template from Elation’s Template Library will be available soon.
The \***E Medicare Annual Wellness Visit – AWV** template won't populate values for hosted database customers. Support for this data through the hosted database will be available soon.
## Workflow Instructions
### Creating an Elation Note Template
| **1** | In the blue navigation bar at the top of your Elation account, click your **email address** followed by **Settings** . |
| ------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | In the left-hand navigation menu, click the **Elation Note Templates** page. |
| **3** | Click **+ Create Template** . A pop-up window will appear with what resembles a blank Elation Note. |
| **4** | Fill in the mandatory **Template name** field with a description that will help you search for and identify this template in the future. |
| **5** | Add any of the following types of content to the template: Blocks (both standard and custom) • Free-text • Dynamic Macros |
| **5a** | To add a custom block: Click into the section of the template where you want it to appear. • Click **Insert Block** in the text editor toolbar. • Search for the block by name and select it. |
| **6** | Click **Save & Close** to complete. |
**Exception:** Dynamic macros cannot be used in custom blocks, Vitals fields, structured PE and ROS fields or anywhere outside of the Elation Note draft or template builder.
### Editing an Elation Note Template
| **1** | Locate the Template on the Settings page. |
| ----- | ----------------------------------------- |
| **2** | Click the **pencil** icon. |
| **3** | Make edits in the pop-up window. |
| **4** | Click **Save & Close** . |
**Deleting an Elation Note Template**
| **1** | Locate the Template on the Settings page. |
| ----- | ----------------------------------------- |
| **2** | Click the **trash can** icon. |
Delete with caution as deleted templates cannot be restored.
### Adding an Elation Note Template to a draft note
[Click here to learn how to add a Template to an Elation Note.](/articles/Elation-Note-Guide-Documenting-an-encounter#Template)
## Frequently Asked Questions
### Is it possible to duplicate an Elation Note Template to make a new one?
You cannot duplicate an Elation Note Template to make a new one. This feature is coming soon!
**Is there an easy way to convert a legacy visit note template to an Elation Note Template?**
At this time, a legacy visit note template must be manually converted to an Elation Note Template. You can still apply a legacy visit note template to the Elation Note.
**Can I add dynamic macros to a custom block?**
No, dynamic macros cannot be added to a custom block.
**Can I add more dynamic macros?**
No, additional dynamic macros cannot be added. Let us know what macros you’d like to see in Elation by sending us feedback via the **I need help** button.
**Can I create a new PE or ROS template from the Elation Note?**
No, you cannot create a new PE or ROS template from the Elation Note. Open a legacy note, create the new PE or ROS template there, and you’ll be able to apply it to any Elation Note moving forward.
**Is there a library of Templates I can access?**
Elation has a few sample templates that will be made available to all customers soon.
**Can Elation create a template for me?**
Elation cannot create templates for you.
### If I delete a custom block that was added to a Template, what happens to the Template?
If you need to delete a custom block, we recommend reviewing your templates and removing the custom block first. If you don’t remove a custom block from a template before deleting the custom block, the template, draft and signed note will show an empty block where the custom block used to be. Our team will be working on a fix for this soon.
## Related Articles
* [Elation Note Introduction](/articles/Elation-Note)
* [Elation Note Guide - Managing custom blocks](/articles/Elation-Note-Guide-custom-blocks)
* [Elation Note Guide - Using visit note blocks](/articles/Elation-Note-Guide-Using-visit-note-blocks)
* [Elation Note Guide - Documenting an encounter](/articles/Elation-Note-Guide-Documenting-an-encounter)
* [Elation Note Guide - Release Summary](/articles/Elation-Note-Release-Summary)
# Elation Note Guide - Using visit note blocks
Source: https://help.elationhealth.com/articles/Elation-Note-Guide-Using-visit-note-blocks
## Overview
### What are blocks?
The Elation Note is built from modular parts called blocks, which you can customize to fit the visit. Add, remove, or rearrange blocks based on what you need to document. This flexibility helps you organize your notes in a way that works best for your workflow.
### What types of blocks are there?
There are two types of blocks:
* Standard blocks
* These are created and managed by Elation.
* They represent the common parts of a SOAP note.
* A default set of standard blocks will be available.
* Use a standard block when you want to include commonly used, structured sections in your note—such as History of Present Illness (HPI), Vitals, Physical Exam, or Assessment and Plan. Standard blocks help ensure consistency across documentation
* Each standard block can only be added once to an Elation Note with the exception of:
* lab order
* imaging order
* prescription
* Populates[USCDI](/articles/Cures-Act-Patient-Data-and-USCDI)data classes.
* Included in [CCDA exports](/articles/Supported-Elation-CCDA-types) if corresponding standard blocks are used.
* Custom blocks
* These are created and managed by you and your practice.[Click here to learn more about Custom blocks](/articles/Elation-Note-Guide-custom-blocks).
* Use a custom block when the standard options don’t quite fit what you need to document across multiple patients.
* Custom blocks can be added multiple times to an Elation Note.
* Populates the[USCDI](/articles/Cures-Act-Patient-Data-and-USCDI)data class for **data**.
* Custom blocks must be nested inside standard blocks to ensure ensure that custom block data is included in the parent block's data class for USCDI/CCDA. For example, a custom block nested in allergies will have its results included in the allergies data class for the [CCDA export](/articles/Supported-Elation-CCDA-types).
Any data your practice needs or relies on for CCDA or FHIR will not include data from custom blocks unless the custom block is nested in a standard block.
![Visit note showing a "Custom Block" labeled "Blood Sugar Levels" with mandatory fields for blood sugar level (mg/dL) and time of last meal, alongside a "Standard Block" labeled "Vitals & Observations" with BP, HR, and RR fields.]()
### What does a standard block look like?
Standard blocks display the block name and several quick action icons, allowing you to perform common tasks directly from the block.
![Visit note with the ROS block's More Actions menu open, showing "Add block above," "Add block below," and "Delete" options. The Grid and More Actions icons on multiple blocks are circled for reference.]()
| **Icon** | **Name** | **Description** | **Availability** |
| ---------------------------------------------------------------------------------------------------------------------------------------- | ------------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------- |
| | Name | Name of the block. | All blocks |
| ![More Actions menu icon]()
| More Actions | Reveal the actions menu. | All blocks |
| ![Grid icon used to drag and reposition a block or access the actions menu]()
| Grid | Appears when you hover near the top of the block. Allows you to click-and-drag the block to a different position and access the same actions menu as the … button. | All blocks |
| ![Plus (+) button used to add a new block to the visit note]()
| Add | Opens a form to add new information to both the block and the Clinical Profile simultaneously. • For Procedures Administered - Opens a form to add a procedure code to both the block and the billing information simultaneously. | **Allergies**, **Family History**, **Reconciled Medications**, **Assessment & Plan**, and **Procedures Administered** blocks only. |
| ![Import icon for pulling Clinical Profile section data into a visit note block]()
| Import | Imports data from the corresponding Clinical Profile section to the block. | Clinical Profile related blocks only. |
| ![Reveal icon button for expanding all systems within the ROS and PE blocks]()
| Reveal | Reveals the systems within the **ROS** and **PE** blocks. | **ROS** and **PE** blocks only. |
| ![Hide icon button for collapsing all systems within the ROS and PE blocks]()
| Hide | Hides the systems within the **ROS** and **PE** blocks. | **ROS** and **PE** blocks only. |
| ![Circular arrow icon for the Clear action that deletes all content from the block]()
| Clear | Deletes all content from the block. | **ROS** and **PE** blocks only. |
| ![Templates icon button for opening the template selector for ROS and PE blocks]()
| Templates | Opens the template selector for the block. | **ROS** and **PE** blocks only. |
| ![Growth Chart icon button for opening the growth chart from the Vitals block]()
| Growth Chart | Opens the growth chart. | **Vitals** block only. |
| ![Vitals Trend icon — a small line graph symbol used to open the vitals trend table from the Vitals block.]()
| Vitals Trend | Opens the vitals trend table. | **Vitals** block only. |
| ![Delete icon — a trash can symbol used to delete an order placeholder in Prescription, Lab Order, and Imaging Order blocks.]()
| Delete | Deletes the order placeholder. | **Prescription**, **Lab Order** and **Imaging Order** blocks only. |
Click here for a list of all the standard blocks.
* allergies
* assessment & plan
* care plan
* cognitive status
* data
* diet
* exercise history
* family history
* follow up
* functional status
* habits
* hpi
* past medical history
* past surgical history
* physical exam
* procedures administered
* psychological status
* reconciled medications
* review of systems
* social history
* vitals
The **Vitals & Observations** block supports inline unit parsing and auto-conversion for height, weight, and head circumference. You can type values in any common unit format — including compound inputs (e.g. `5'10"`), fractions (e.g. `13 3/4 in`), European-style decimal commas (e.g. `12,5 kg`), and case-insensitive units (`CM`, `Kg`, `LBS`) — and Elation will automatically convert and store the value in the standard unit for each field. If the input cannot be recognized, the field reverts to the last valid value.
### What does a custom block look like?
Custom blocks display only the block Name, the **Grid** icon ![Grid icon used to drag and reposition a block or access the actions menu]()
, the **More Actions** icon ![More Actions menu icon]()
, and the contents within the block. If a custom block contains any mandatory fields, you’ll see an indicator at the top of the block to let you know.
[Click here to learn more about Custom blocks](/articles/Elation-Note-Guide-custom-blocks).
## Workflow Instructions
### Adding a block
The Calendar is designed to provide an intuitive experience for managing appointments and providing visibility into each Provider Level User’s schedule.
#### Option 1 (Recommended for inserting a block between existing blocks)
| **1** | At the top of any existing block, click the **Grid** icon ![Grid icon used to drag and reposition a block or access the actions menu]()
on the left or the **More Actions** icon ![More Actions menu icon]()
on the right. |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Select **Add block above** or **Add block below** depending on where you want the new block to appear. |
| **3** | From the dropdown menu, select the block that you want to add. |
#### Option 2 (Recommended for placing a block in a specific text field or location within the note)
| **1** | Place your cursor where you want the new block to appear. |
| ----- | ------------------------------------------------------------------------------------- |
| **2** | At the top of the visit note draft, click the **+** button. |
| **3** | From the dropdown menu, select the block that you want to add from the dropdown menu. |
#### Option 3 (Recommended if you prefer using your keyboard over your mouse)
| **1** | Place your cursor where you want the new block to appear. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Press the forward slash ( **/** ) key on your keyboard to initiate a slash command. |
| **3** | From the dropdown menu, start typing the block name to search for the block that you want to add. |
| **4** | Use the **down arrow** or **up arrow** keys to navigate to the block you want to add and then use the **Return**/**Enter** key to select and add the block. |
![Slash command dropdown in the HPI field showing available blocks to add, including options like physical exam, past medical history, reconciled medications, and prescription.]()
### Deleting a block
Delete with caution. You can only recover deleted blocks with the **Undo** button at the top of the visit note while editing in the same session. Once you save the visit note draft or leave the chart you will not be able to undelete deleted blocks, even with the **Undo** button.
#### Option 1 (Recommended for deleting one block at a time)
| **1** | At the top of the block that you wish to delete, click the **Grid** icon ![Grid icon used to drag and reposition a block or access the actions menu]()
on the left or the **More Actions** icon ![More Actions menu icon]()
on the right. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Select **Delete** . |
#### Option 2 (Recommended for deleting more than one block at the same time)
| **1** | Highlight the contents of the block(s) and block name(s) with your cursor. |
| ----- | -------------------------------------------------------------------------- |
| **2** | Press **Delete** / **Backspace** on your keyboard. |
#### Option 3 (Recommended if a block is empty and you prefer using your keyboard over your mouse)
| **1** | R epeatedly press **Delete** / **Backspace** on your keyboard until all contents and the block are removed. |
| ----- | ----------------------------------------------------------------------------------------------------------- |
#### Option 4 (Recommended for deleting all blocks from the note)
| **1** | Select all contents of the note by pressing **ctrl** / **command** + **A** on your keyboard. |
| ----- | -------------------------------------------------------------------------------------------- |
| **2** | Press **Delete** / **Backspace** on your keyboard until all blocks are removed. |
### Moving a block
You can change the position of your blocks within the visit note. They can be stacked or embedded in text fields.
![Office Visit Note showing stacked blocks (HPI, ROS) arranged sequentially, and an embedded "Follow Up" block nested inside a "Care Plan" block, illustrating the two block arrangement types.]()
| **1** | Hover over the name of the block until you see the **Grid** icon ![Grid icon used to drag and reposition a block or access the actions menu]()
on the left. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click and hold the **Grid** icon ![Grid icon used to drag and reposition a block or access the actions menu]()
as you drag the block to a different location. A line will temporarily appear to show where the block’s new location will be. |
| **3** | Let go of your mouse to lock in the new location. |
![Office Visit Note with HPI, ROS, and Care Plan blocks stacked sequentially, illustrating the standard stacked block arrangement.]()
## Frequently Asked Questions
### Can I add the same standard block more than once?
No, the same standard block cannot be added more than once. A yellow banner will appear at the top of the chart if you try to add a standard block that's already included in the visit note.
### Can I add the same custom block more than once?
Yes, the same custom block can be added more than once.
**I want a field to appear conditionally based on more than one rule, is this possible?**
Currently, fields can only appear conditionally based on one rule. We plan on expanding this functionality soon; send us your feedback on how you’d like to configure logic within your custom blocks and templates.
### Can I restore a deleted block?
Delete with caution. You can only recover deleted blocks with the **Undo** button while editing in the same session. Once you save the visit note draft or leave the chart you will not be able to undelete deleted blocks, even with the **Undo** button.
## Related Articles
* [Elation Note Introduction](/articles/Elation-Note)
* [Elation Note Guide - Managing custom blocks](/articles/Elation-Note-Guide-custom-blocks)
* [Elation Note Guide - Managing Elation Note Templates](/articles/Elation-Note-Guide-Managing-Templates)
* [Elation Note Guide - Documenting an encounter](/articles/Elation-Note-Guide-Documenting-an-encounter)
* [Elation Note Guide - Release Summary](/articles/Elation-Note-Release-Summary)
# Elation Note Guide - Managing custom blocks
Source: https://help.elationhealth.com/articles/Elation-Note-Guide-custom-blocks
## Overview
### What are custom blocks?
A custom block is a reusable section that helps you collect specific, structured information during a patient visit. You can add questions and instructions to guide what you want to document, and group related fields together to keep everything organized for you and your team.
The question formats available are:
| **Question Format** | **Use Case** |
| ------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Paragraph Text | Add a question prompt that allows a free-text response. Optionally, enter default text to appear in the visit note when the custom block is added. |
| Dropdown Select | Add a question that displays a dropdown menu with multiple options, allowing only **one** selection to appear in the visit note. Optionally, specify a default option to appear in the visit note when the custom block is added. Only the **selected response** will appear in the visit note printout. |
| Radio Select | Add a question to the visit note draft that displays multiple options but allows only one to be selected. Optionally, set a default option to be selected in the visit note when the custom block is added. Only the **selected response** will appear in the visit note printout. |
| Checkbox | Add a question to the visit note draft that displays multiple checkboxes, allowing more than one option to be selected. Optionally, set one or more default options to be selected in the visit note when the custom block is added. Only **selected responses** will appear in the visit note printout. |
| Date | Add a question with a date picker. Optionally, set a default date that appears in the visit note when the custom block is added. |
Custom blocks can be manually added to any Elation Note draft or included in an Elation Note Template for easy reuse. Data from custom blocks populates the USCDI data class for **data**.
### When should I use a custom block?
Use a custom block when the standard options don’t quite fit what you need. They're great for adding structured input fields, building layouts that work better for your workflow, or adding conditional logic to show or hide fields based on user input.
Common use cases include:
* Assessment tools that are not available through Elation’s Clinical Questionnaires (e.g. STEADI 3 and IADL)
* Questions around care coordination (e.g. Advanced Care Planning and Healthcare Proxy)
* Screenings for chronic conditions (ex. Diabetic Foot Exam and Asthma Control Assessment)
#### When to avoid using custom blocks
Custom blocks should not be used to replace other standard data collection formats (e.g. patient vitals or clinical questionnaires). Elation relies on these standard data collection points to populate important measures, such as the vitals table for trending in the chronological record and quality measures (MIPs).
### What does a custom block look like?
#### Custom block builder view
![Custom block builder showing an "Opioid Screening" block (/ops shortcut) with labeled callouts A–O identifying each UI element: shortcut, label, access, question text, question type, options, default pin, delete, add option, sort arrows, mandatory toggle, add logic, duplicate, quick-action buttons, and add section.]()
| **Label** | **Name** | **Description** |
| --------- | --------------------------------- | ----------------------------------------------------------------------------------------- |
| A | Shortcut | Specify a shortcut to use when inserting this custom block into your Elation Note. |
| B | Custom Block Label | Name the block based on its content and purpose. |
| C | Access - coming soon | Displays the visibility level of the custom block. |
| D | Question Text | Type the question you want to ask. |
| E | Question Type | Specifies the question format for this section. |
| F | Option | Enter one of the possible answers for the question. |
| G | Toggle Default pin | Click the pin next to the answer you want to set as the default for the question. |
| H | Delete icon | Delete a question or answer. |
| I | Add Option | Add another possible answer. |
| J | Sort arrows | Move a question or answer to a different position. |
| K | Mandatory toggle | Mark a question as required. |
| L | Add Logic | Create a rule that displays this section only when a specific answer is selected earlier. |
| M | Duplicate icon - coming soon | Duplicates a section |
| N | Quick actions for adding sections | Pick the question format you want to add. |
| O | Add Section | Click to add a new question. A new **Dropdown** field will be added by default. |
#### Custom block in visit note
![Visit note HPI section showing a "Blood Sugar Levels" custom block with a "1 Mandatory Field" badge highlighted, and the block's three-dot menu open displaying "Add block above," "Add block below," and "Delete" options.]()
## Workflow Instructions
### Creating custom blocks
Custom blocks can only be created from Settings:
| **1** | In the navigation bar at the top of your Elation account, click your **email address** followed by **Settings** . |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------- |
| **2** | In the left-hand navigation menu, click the **Custom Blocks** page. |
| **3** | Click the **+ Create Custom Block** button. The custom block builder will appear in a pop-up window. |
| **4** | Complete the mandatory **Shortcut** and **Description** fields. Choose a shortcut that you can easily remember for convenience. |
| **5** | Click any of the buttons in the yellow menu to add sections to your custom block. (Details about each section are described above.) |
| **6** | When the selected section appears, fill out the associated fields for the selection. |
| **7** | Click **Save & Close** to complete. |
#### Grouping sections
Group similar sections together to keep your layout organized. Fields can be moved in and out of groups. If a group is emptied of fields, it will be deleted automatically.
Click **Add Group** to add a heading to your custom block and then add your sections to the group.
#### Adding instructions
Enter free-text instructions that appear only while the visit note is in draft mode. These can be used to guide documentation or provide context and directions for collaborators.
Click **Add Instructions** to add a section for instructions.
#### Creating conditional logic rules
Apply conditional logic to Dropdown, Radio, and Checkbox sections to configure rules that show or hide other sections based on earlier responses.
| **1** | Click **Add Logic** to open the Conditional Logic builder for the question that you want to display under specific conditions. This question will appear in the **Display** section. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Choose the question and answer that you want the rule to look at in the **if** section. |
Here is an example of a question with conditional logic rules:
* The question *“Does the patient have a pain management plan (medication or other therapy) reviewed in the past year?”* only appears if the answer to **“Is patient on a current opioid prescription?”** is a **Yes**.
![Conditional Logic panel highlighted for the "Does the patient have a pain management plan…" question, showing the rule: display if "Is patient on a current opioid prescription?" answer "1. Yes" is selected.]()
### Editing a custom block
| **1** | Locate the custom block on the Settings page. |
| ----- | --------------------------------------------- |
| **2** | Click the **pencil icon** . |
| **3** | Make edits in the pop-up window. |
| **4** | Click **Save & Close** . |
### Deleting a custom block
| **1** | Locate the custom block on the Settings page. |
| ----- | --------------------------------------------- |
| **2** | Click the **trash can icon** . |
Delete with caution as deleted custom blocks cannot be restored.
### Adding a custom block directly to a draft note
[Click here to learn how to add a custom block to an Elation Note](/articles/Elation-Note-Guide-Using-visit-note-blocks#add).
### Adding a custom block to a template
[Click here to learn how to add a custom block to an Elation Note Template](/articles/Elation-Note-Guide-Managing-Templates).
## Frequently Asked Questions
### Can I add a custom block to a legacy visit note format?
Currently, Elation does not support adding a custom block to a legacy visit note format, such as the Complete H\&P Note (2 col-A/P) or SOAP Note. Custom blocks are only available in the Elation Note. If your practice uses a legacy visit note template, you can apply it inside an Elation Note draft with the **/template** command and add custom blocks there. See [Elation Note Guide - Managing Elation Note Templates](/articles/Elation-Note-Guide-Managing-Templates) for more on applying legacy templates within the Elation Note.
### Is it possible to duplicate a custom block to make a new one?
You cannot duplicate a custom block to make a new one. This feature is coming soon.
### If I delete a custom block that was added to a Template, what happens to the Template?
If you need to delete a custom block, we recommend reviewing your templates and removing the custom block first. If you don’t remove a custom block from a template before deleting the custom block, the template, draft and signed note will show an empty block where the custom block used to be. Our team will be working on a fix for this soon.
### Is data from custom blocks included in CCDA exports?
Custom blocks must be nested inside standard blocks to ensure that custom block data is included in the parent block's data class for USCDI/CCDA. For example, a custom block nested in allergies will have its results included in the allergies data class for the CCDA export.
## Related Articles
* [Elation Note Introduction](/articles/Elation-Note)
* [Elation Note Guide - Managing Elation Note Templates](/articles/Elation-Note-Guide-Managing-Templates)
* [Elation Note Guide - Using visit note blocks](/articles/Elation-Note-Guide-Using-visit-note-blocks)
* [Elation Note Guide - Documenting an encounter](/articles/Elation-Note-Guide-Documenting-an-encounter)
* [Elation Note Guide - Release Summary](/articles/Elation-Note-Release-Summary)
# Elation Note Guide - Release Summary
Source: https://help.elationhealth.com/articles/Elation-Note-Release-Summary
This article outlines the timeline and details of the upgrades to the Elation Note.
## Overview
This article outlines the timeline and details of the upgrades to the Elation Note.
## Updates
### April 2026
Added support for [Billing Guidance](/articles/billing-settings---service-locations--procedure-codes#how-to-enable-billing-guidance) in Elation Note. Practices can configure warnings or errors when an Elation Note is signed without a service location, CPT codes, or diagnosis codes.
### December 22, 2025
Added the ability to [print](/articles/Elation-Note-Guide-Documenting-an-encounter#print_note) signed or drafted Elation Notes. Print options include:
* Billing information only.
* A Patient Summary version - including visit summaries, vitals, procedures, care plan, follow-up, current medications and problems.
* The entire note.
For the **Bill** and **Patient Summary** versions, you can select or deselect preset sections to customize what’s included before printing.
### November 11, 2025
Expanded orders documentation by adding the following [order placeholder blocks:](/articles/Elation-Note#slash_command)
* Cardiac
* Pulmonary
* Sleep
### November 6, 2025
Updated the Reconciled Medications block to clearly distinguish between reconciled medications and prescription orders.
* Documented medications, including **New**, **Refill**, **Change** and **D/C**, will have a **Doc'd**.... tag to distinguish them from prescription orders.
### August 28, 2025
Updated the following in the \***E Medicare Annual Wellness Visit - AWV** template:
* Improved performance with Note Assist.
* Streamlined **The Timed Up and Go** & **Preventative Services** blocks.
* Added a new **Care Team members** reminder block.
### August 6, 2025
* Updated feature name in the EHR to Elation Note.
* Adding 'Coming Soon' labels to functionality that will be available in the near future.
* [Amend](/articles/Elation-Note-Guide-Documenting-an-encounter#amend_note) Elation Notes.
* Use the Elation created \***E Medicare Annual Wellness Visit - AWV** [template](/articles/Elation-Note-Guide-Managing-Templates#library) for annual wellness visits.
* Mark Elation Notes as [confidential](/articles/Elation-Note#billing_information).
## Related Articles
* [Elation Note Introduction](/articles/Elation-Note)
* [Elation Note Guide - Managing custom blocks](/articles/Elation-Note-Guide-custom-blocks)
* [Elation Note Guide - Managing Elation Note Templates](/articles/Elation-Note-Guide-Managing-Templates)
* [Elation Note Guide - Using visit note blocks](/articles/Elation-Note-Guide-Using-visit-note-blocks)
* [Elation Note Guide - Documenting an encounter](/articles/Elation-Note-Guide-Documenting-an-encounter)
# Elation-Puredi Integration Guide- Using Puredi as your Revenue Cycle Management system alongside Elation
Source: https://help.elationhealth.com/articles/Elation-Puredi-Integration-Guide
This article describes the Elation-Puredi integration and guides Elation EHR customers on how to use Puredi as a Revenue Cycle Management system alongside Elation.
## What is Puredi?
Puredi® is a Revenue Cycle Management software that practices can use alongside Elation. Practices most commonly use Puredi to submit claims to Payers for services rendered and track the progress of claim payments.
## What is the Elation-Puredi Integration?
The Elation-Puredi integration allows practices to send claims-related data from Elation to Puredi for practices to submit claims to Payers (through Puredi) for services rendered in Elation. The Elation-Puredi integration reduces the need for double documenting in two softwares and allows practices to store all their clinical data in Elation while using Puredi side-by-side to manage their revenue.
## How do I get started?
You must first have an account with Puredi before you can use this integration. Elation will work with Puredi to set you up on Puredi and turn on the integration if you do not have Puredi account yet. You can send Elation a request to turn on the Puredi integration by
* emailing [implementation@elationhealth.com](mailto:implementation@elationhealth.com) if you are being onboarded to Elation
* emailing [integrations@elationhealth.com](mailto:integrations@elationhealth.com) after you exited the onboarding phase
## Accessing Puredi from Elation EHR
Customers using Elation and Puredi can access the Puredi login page directly from Elation. Click on the **Billing System** button under the **Billing** button at the top of the Elation Practice Home page to access the Puredi login page.
![Billing dropdown menu expanded in Elation, with "Billing System" option highlighted in a red box to indicate where to click to access Puredi.]()
## What information is synchronized?
| **Data** | **Sync Direction** |
| -------------- | ----------------------- |
| Patient Charts | Elation **→** Puredi |
| Demographics | Elation **↔** Puredi |
| Insurance | Elation **→** Puredi |
| Appointments | Elation **→** Puredi \* |
| Bills | Elation **→** Puredi |
### Mapping Data
Follow these instructions to map the following data between Elation & Puredi:
1. Providers- notify Elation and/or Puredi if new providers are added to both systems. Additional actions have to be taken on the backend to connect new providers to each other across systems
2. Practice Locations- notify Elation and/or Puredi if new Practice Locations (Service Locations) are added to both systems. Additional actions have to be taken on the backend to connect new locations to each other across systems
You can freely add Appointment Types and CPT Codes in Elation and those will be automatically pushed to Puredi.
## Patient Charts
### Creating Charts
All patient charts must be created in Elation in order for the patient's chart to be created in Puredi. See the
[Patient Demographics section](#demographics)
for details about managing demographics information after charts are created in Elation.
### Merging Charts
Each chart can only have a one to one connection between Elation and Puredi and this connection is established upon chart creation. If you happen to see a duplicate chart for the same patient in Elation, please make sure you find the chart that is connected between the two systems and keep the connected chart after performing a merge.
* For example, patient John Smith has one chart in Puredi but two charts in Elation. The best way to find out which of the two charts in Elation is connected to Puredi is by looking at the **External Link** field in Puredi to see which Elation Patient ID is tied to the Puredi chart.
Here are the proper merge steps for Elation charts:
1. Open the duplicate chart that is not connected to the integration
2. Click on the patient's name to open their Demographics
3. Click on the **Merge Chart** button
4. Find & select the chart you want to keep (the one that is connected to the integration)
5. Click **Merge Chart**
6. Confirm you understand the transfer of data and then click **Yes, merge charts**
### Deleting Charts
Deleting a chart in Elation will not delete the chart in Puredi and vice versa. Please take caution when deleting charts in Elation while using the Puredi integration as charts have a one to one connection via the integration. If the patient is still active in your practice, the deleted chart must be restored in order for the patient's information to sync properly across the two systems.
You can restore a deleted patient chart yourself using the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice). Go to **Reports** > **User Activity Log**, filter by the patient or by the "Delete" action, and click the **Restore** button next to the deleted chart. [Admin Level Users](/articles/administrative-privileges) can view and restore activity for all users in the practice.
## Patient Demographics
After a patient's chart is created in Elation, the synchronization of Patient Demographics is bi-directional. Any changes made in one system will be pushed to the other system. The following table shows a mapping of the Patient Demographics fields that are shared between Elation and Puredi and their matching field names.
*
As best practice, we recommend managing demographics in Elation when possible because you will already be managing insurance information and appointments in Elation. This will allow your front office staff to stay in one system (Elation) for a majority of their work.
| Elation Field Name | Puredi Field Name |
| ----------------------------- | ----------------- |
| Legal First Name | First |
| Legal Last Name | Last |
| Date of birth | Birth Date |
| Sex at Birth | Gender |
| SSN | SSN |
| Ethnicity | Race/Ethnicity |
| Home Phone | Home Phone |
| Mobile Phone | Mobile Phone |
| Email | Primary Email |
| Address | Address |
| Ste or apt # | Address |
| City | City |
| State | State |
| Zip | Zip |
| Provider Assigned in Practice | Provider |
| Elation Patient ID | External Link |
## Insurance
The synchronization of insurance information is uni-directional from Elation to Puredi. Practices must enter insurance information in Elation in order for the insurance information to push to Puredi.
The following table lists the insurance related fields that are pushed from Elation to Puredi and show how the Elation fields map to the Puredi fields. Fields that are not listed are not shared between Elation and Puredi:
| Elation Field Name | Puredi Field Name |
| ---------------------- | ----------------- |
| Insurance Carrier Name | Payer |
| Group ID | Group Number |
| Member ID | Member Id |
The Insurance Policyholder fields are not connected via the integration. If the patient insurance policyholder is not the patient, please enter the policyholder's information in both Elation and Puredi.
### Carriers
Insurance Carriers and plans details should only be maintained in Elation as Elation is the source of truth for insurance. It is most important for you to create Carriers in Elation to avoid creating duplicate Payers in Puredi.
Elation 'Plans' do not sync to Puredi. If a specific Payer has multiple Plans and there is a different Payer ID or mailing address for different Plans, we recommend creating separate Elation 'Carriers' for each Payer ID or Mailing Address. For example: The Payer called **American Global Insurance** has a PPO option (with Payer ID 1234) and a Medicare Advantage option (with Payer ID 6789). I will create two Carriers in Elation to make sure claims are routed properly in Puredi- one Carrier called **American Global Insurance- PPO** and one called **American Global Insurance- Medicare Advantage**. This way I will also have two separate Payers in Puredi to house the respective Payer ID's.
## Appointments
The synchronization of new appointments is uni-directional from Elation to Puredi. Practices must create new appointments in Elation for the appointment to push to the corresponding Provider calendar in Puredi.
After new appointments are created in Elation, you may update appointment details in either Elation or Puredi. We recommend making updates in Elation when possible to keep workflows in one system and have a single source of truth for Appointment details.
The following table lists the Appointment fields that are pushed from Elation to Puredi and show how the Elation fields map to the Puredi fields. Fields that are not listed are not shared between the Elation and Puredi:
| Elation Field Name | Puredi Field Name |
| ---------------------------------- | ------------------- |
| Patient name | Patient |
| Description - chief complaint (CC) | Reason for Visit |
| Date | Date |
| Start time | Time |
| Duration | End Time |
| Appointment Type | Appointment Type |
| Status | Appointment Status |
| Provider | Resource & Provider |
| Location | Facility |
## Bills
The synchronization of bills is uni-directional from Elation to Puredi. Once a provider signs a visit note in Elation, the billing information in the visit note will be pushed to Puredi as a
*Claim*
. Once a bill is pushed to Puredi, edits must be made in both Elation and Puredi if needed. If you are missing any CPT and ICD-10 codes upon signing your visit note, Elation will notify you and prompt you to update your billing information before sending it to Puredi.
The **Delayed Billing** feature is supported by the Puredi integration. Learn more about the feature [here](/articles/How-to-set-up-Delayed-Billing) .
The following table lists the fields that are pushed from Puredi to Elation and show how the Puredi fields map to the Elation fields. Fields that are not listed are not shared between Elation and Puredi:
| Elation Field Names | Puredi Field Names |
| ---------------------- | ------------------ |
| CPT Code | Service |
| Modifier | Modifiers |
| Dxs | Dx |
| Service Location (POS) | Facility |
### Additional billing fields
You can enable additional billing fields, especially for incident-to billing, and synchronize these fields from Elation EHR to Puredi. The fields include S
**upervising Provider**
,
**Billing Provider**
, and
**Prior Authorization**
and the mapping is shown below. To enable any of these fields:
1. Go to Elation EHR
2. Click on your email at the top of your account and then click **Settings**
3. Click **Billing** to open the Billing settings
4. Scroll down to the Billing Fields section
5. Click on the toggle to configure the fields you want to include on your bills - green is ON (enabled) and gray is OFF (disabled)
6. Once a field is enabled, it will appear at the top of the bill in your EHR visit notes
* Data stored in enabled fields will also push to Puredi when you push the bill over.
| Elation Field Names | Puredi Field Names |
| ---------------------------------------------------------------------------------------- | -------------------- |
| Supervising Provider | Supervising Provider |
| Prior Authorization | Auth Number |
| Billing Provider (appears after you check off the **Mark as incident-to encounter** box) | Billing Provider |
* **Billing Provider**: This field is commonly used for incident-to billing.
## Getting Support
### Puredi
If you need assistance with your Puredi configuration or have questions about the Puredi Application, contact Puredi here:
[support@puredi.com](mailto:support@puredi.com)
### Elation
If you need assistance with Elation or the Elation-Puredi integration, contact Elation using the **I need help** >> **I need help from an Elation Team Member** button at the top of your Elation account.
## Related Articles
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Billing Guide- Setting up CPT Codes and Place of Service](/articles/billing-settings---service-locations--procedure-codes)
# Elation Read-Only Access
Source: https://help.elationhealth.com/articles/Elation-Read-Only-Access
This article explains the two main scenarios in which Elation offers Read‑Only access: a Read‑Only website for active practices when the main Elation EHR site is unavailable, and a Read‑Only practice status for practices that have ended their active subscription but still need secure access to historical patient records.
## Overview
### What is Read‑Only access?
Read‑Only access allows you to:
* Sign in to Elation using approved user accounts, and
* View existing data in your Elation EHR, such as visit notes, documents, labs, and imaging, and
* Print or download specific information as needed,
while preventing any new changes to your clinical data.
Read‑Only access is intended to:
* Help you continue caring for patients when the main Elation EHR site is not available or not accessible, and
* Help you meet medical record retention and record request needs after your active Elation EHR subscription ends.
### What read only options are available?
Elation offers Read‑Only access in two main scenarios
1. A Read‑Only website that active practices can use when the main Elation EHR site is not available or not accessible.
2. A Read‑Only practice status for practices that have ended their active Elation EHR subscription but still need secure access to historical patient records.
## Read‑Only website when Elation EHR is not available (active practices)
### When to use the Read‑Only website
Use the Read‑Only website if:
* You are an active Elation EHR customer, and
* app.elationemr.com is not available, not loading as expected, or you cannot sign in, or
* The [ElationEMR Status Page](https://elation.status.io/) indicates a service disruption that affects the EHR.
In these situations, the Read‑Only website gives you view‑only access to your existing EHR data so you can continue seeing patients while Elation engineers work to restore normal service.
### How to access the Read‑Only website
| 1 | Open a supported web browser (Chrome or Firefox) on your computer. |
| - | ----------------------------------------------------------------------------------- |
| 2 | Go to [https://app-ro.elationemr.com](https://app-ro.elationemr.com) . |
| 3 | Sign in using the same email address and password you normally use for Elation EHR. |
You may also see a link to the Read‑Only website on the status page or in in‑app banners when the main EHR site is not functioning as expected.
### What you can do in the Read-Only website
While using the Read‑Only website, you can:
* **View existing patient charts**
* Open patient charts to review:
* Previously signed visit notes
* Documents and scanned records
* Lab and imaging results
* Other history stored in the chart
* **Print information from the chart**
* Print the information you need so you can document care on paper or in your usual temporary workflows while the main site is not available.
* **View your schedule and start integrated video visits**
* View your Elation Calendar to see upcoming appointments.
* For appointments that were already scheduled as integrated video visits, you can use the Start Video button from the Read‑Only website to join those video visits (assuming the video vendor itself is available).
We recommend using the Read‑Only website to reference clinical information and keep your schedule moving, then updating the EHR once full functionality returns.
### What you cannot do from the Read‑Only website
Because the Read‑Only website is configured to protect your data when the main EHR site is not available, it does not support normal write‑type actions.
Click here for more details about unsupported actions.
While on the Read‑Only website, you cannot:
* Enter or edit information in patient charts (for example, you cannot):
* Create or sign new visit notes
* Change diagnoses, medications, allergies, or other structured data
* Send new prescriptions or refills, including controlled substances
* Place electronic lab or imaging orders
* Send provider letters or referrals via Elation fax
* Send or manage new patient messages or portal conversations
#### Recommendations for documentation while the EHR site is not available
When the main site is not available, we recommend:
* **Documentation**
* Document your encounters outside of Elation (for example, on paper or in a secure text document).
* Once the EHR is fully restored, upload your temporary documentation to the patient's chart (for example, as a **New Visit Note** document) so it is stored for future reference.
* **Orders and referrals**
* For urgent orders or referrals, call the facility or use an external fax solution.
* For non‑urgent items, draft them and wait to sign and send them once the EHR is back to normal service.
* **Prescriptions and EPCS**
* For urgent prescriptions, call the pharmacy to provide a verbal order (if permitted in your jurisdiction).
* For non‑urgent prescriptions, draft them and sign them once e‑prescribing connectivity returns.
* **Lab results**
* For urgent results, call the lab vendor to obtain the results directly.
* For non‑urgent results, you can wait for the integration to resume; results will flow into Elation once service recovers.
### Reliability and limitations
The Read‑Only website is intended to be available when the main EHR site is not accessible, but there are important limitations:
* The Read‑Only site shares some underlying infrastructure and services with the main EHR.
* In certain types of incidents (for example, issues affecting the primary database or shared infrastructure), both the main EHR and the Read‑Only environment may be impacted at the same time.
If you cannot reach the Read‑Only website:
| 1 | Follow your local temporary workflows (for example, paper charting, paper prescriptions, external fax). |
| - | ---------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Monitor the [ElationEMR Status Page](https://elation.status.io/) and any in‑app banners for updates and confirmation when service is restored. |
## Read‑Only practice status after your active subscription ends
### When Read‑Only practice status is used
Read‑Only practice status is used when:
* Your practice has ended its active Elation EHR subscription, and
* You still need secure access to historical EHR data (for example, to respond to patient record requests or audits).
In these cases, Elation may offer Read‑Only access as an ongoing, limited service:
* You pay for a set number of Read‑Only users who can sign in and view historical data from your Elation practice.
* Your practice and users are configured so that no new clinical data can be created or modified.
Read‑Only practice access is only available to practices that are no longer using Elation for active charting. It is not a user type that can be applied selectively in an otherwise active Elation EHR practice.
### What you can do with Read‑Only practice access
If your practice has been configured in Read‑Only status and you have an approved Read‑Only user account, you can:
* **Sign in to Elation EHR**
* Use your existing Elation login (email and password) to sign in to your Read‑Only practice, once the configuration is complete.
* **View historical patient records**
* Open charts and review the data that was captured while your practice was actively using Elation EHR, including:
* Visit notes
* Documents and scanned files
* Lab and imaging results
* Other chart history
* **Download or print individual charts**
* Download or print charts for individual patients to respond to record requests, legal audits, or other documentation needs.
* This allows you to continue meeting your medical record obligations without using Elation as your live EHR.
### What you cannot do with Read‑Only practice access
Read‑Only practice access does not include the ability to:
* Create new visits or visit notes
* Edit or delete existing clinical data in the chart
* Prescribe medications or send refills (including controlled substances)
* Place new lab or imaging orders from Elation
* Send letters or referrals via Elation's fax service
* Send or receive new patient portal messages (Elation Passport)
* Continue receiving new lab results, external documents, or other integration feeds
* Use Elation Billing or other billing workflows as an active billing system
In other words, Elation in Read‑Only practice status functions as a secure archive viewer, not an active EHR or billing platform.
### Setting up a Read‑Only practice
If you are planning to end your active Elation EHR subscription and would like to explore Read‑Only practice access:
| 1 | **Discuss options with your Elation representative** Before your service end date, speak with your Customer Success Manager or Account team about: Whether Read‑Only access is available for your practice. • How many users will need Read‑Only access. • Whether you also need a bulk data export as part of your off‑boarding plan. |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | **Confirm your service end date and Read‑Only details** As part of the cancellation process, your Elation team will: Confirm your last day of active EHR service. • Review whether you will move into Read‑Only status. • Confirm the list of Provider Level Users who should have Read‑Only access. |
| 3 | **Practice configuration** Your Elation practice may be labeled in our systems to indicate Read‑Only status. • Provider‑level accounts that need Read‑Only access will be configured as Read‑Only providers and enabled. |
| 4 | **Using Read‑Only after your service ends** Once your active service ends and Read‑Only configuration is complete, your named Read‑Only users can sign in and view historical data as described above. |
If you already have Read‑Only practice access and need to change which users can log in, please reach out to your Elation representative or submit a request via **I need help** -> **Contact Elation Support**.
## Quick reference: Read‑Only capabilities
### Read‑Only website when Elation EHR is not available (active practices)
**You can:**
* Log in at [https://app-ro.elationemr.com](https://app-ro.elationemr.com) with your regular EHR credentials.
* View existing patient charts and historical data.
* Print information from charts as needed.
* View your Elation Calendar and start integrated video visits for appointments already scheduled as video visits.
**You cannot:**
* Enter or edit information in charts.
* Send prescriptions or refills.
* Place new orders or send faxes via Elation.
* Rely on the Read‑Only site to be available in every type of incident, since some issues can affect both the main EHR and the Read‑Only environment.
### Read‑Only practice status (after your active subscription ends)
**You can:**
* Sign in as a configured Read‑Only user on your practice in Read‑Only status.
* View historical charts and documents.
* Download or print individual charts for record requests.
**You cannot:**
* Create or edit any clinical documentation.
* Use Elation to prescribe, order labs, send faxes, or send messages.
* Continue receiving new data via integrations or fax.
* Use Elation Billing as an active billing solution.
## Frequently Asked Questions (FAQ)
### Can I use the Read‑Only website to fully run my clinic when the main EHR site is not available?
No. The Read‑Only website is designed to let you view existing information and your schedule, but it is not a full replacement for the live EHR.
When the main site is not available:
* Use the Read‑Only website to reference charts and appointments.
* Use your temporary workflows (paper charting, phone calls, external fax) for prescribing, ordering, and communications.
* Once Elation EHR is back to normal, enter your documentation and complete orders in Elation.
### How up‑to‑date is information on the Read‑Only website?
Under normal conditions, the Read‑Only website stays closely aligned with the data in your live EHR. If the main EHR site is not available, the Read‑Only website may temporarily show a static snapshot of your data from just before the issue began. New data created while the main site is unavailable may not appear until normal service is restored.
### Can our active practice buy Read‑Only access for certain users instead of full EHR licenses?
No. Read‑Only practice access is only available to practices that are no longer using Elation for active charting and have ended their active EHR subscription.
Active practices should continue to use standard provider and staff user types under their active EHR subscription.
### How do we share records when our practice is in Read‑Only practice status?
When your practice is in Read‑Only practice status:
* Use your Read‑Only access to view and download or print specific charts.
* Send those records using your own fax, mail, or secure exchange tools outside of Elation.
Elation's fax and patient messaging features are not available in Read‑Only practice status.
### What if we do not choose Read‑Only when we end our active subscription?
If you are ending your active Elation EHR subscription and do not choose Read‑Only practice access, you can usually request a data export as part of your off‑boarding plan.
Your Elation representative can review:
* What export options are available
* How long data will be retained
* Which export or Read‑Only options best meet your regulatory and business needs
## Related Articles
* [Support Guide – Elation Downtime Recommendations](/articles/Elation-Downtime-Recommendations)
* [User Accounts Guide – Troubleshooting EHR login issues](/articles/User-Accounts-Guide-Troubleshooting-account-login-issues)
* [Patient Chart Guide – Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
# Elation-Spruce- Message Sync Integration Guide
Source: https://help.elationhealth.com/articles/Elation-Spruce-Integration-Guide
A detailed guide on how to use Spruce integration with Elation.
## What is Spruce?
Spruce is a secure, HIPAA compliant communication platform that enables patients and their providers to readily connect. With Spruce, patients and providers can seamlessly discuss symptoms over messages, then have a phone call or virtual video appointment with their provider - all in one space. Both patients and providers can have peace of mind knowing that they can receive and give care in a secure, simple and adaptable way.
## What is the Elation-Spruce integration?
The Elation-Spruce integration allows you to
* automatically create charts for patients in Spruce when you create their chart in Elation
* easily keep patient contact information up to date in both systems
* automatically transfer your conversations from Spruce into Elation so that all of the patient's clinical data is easily stored in one place, your Elation EHR.
Read our [Telehealth Guide- Using Spruce alongside Elation for patient encounters](/articles/Using-Elation-Spruce-telehealth) article for more detailed information on how to utilize the different features in Spruce to complete Telehealth visits for documentation in Elation.
## How do I get started?
If you are interested in using the Elation-Spruce integration please
[click here to notify Elation](https://help.elationemr.com/s/contactsupport)
and a member of the Implementation Team contact you about next steps.
## What information is synchronized?
Integrating Spruce to Elation offers additional benefits, such as Spruce Contact creation from Elation, contact information sync between systems, and correspondence syncing.
| **Elation** | | **Spruce** | **Notes** |
| ------------------------------ | - | ----------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Chart Creation | → | Contact Creation | Charts must be created in Elation to sync over to Spruce. Once the chart is created in Elation, the Contact will be created in Spruce instantaneously. |
| Demographic Edits | ↔ | Demographic Edits | Demographic edits can be made either in Elation or Spruce. Each time a change is made to a patient’s demographics in one platform, these changes will be reflected in the other platform. Only the following demographic information will sync: Patient first and last name • Phone numbers (up tp 2 different phone number types) • Email address • Date of birth • Gender |
| Visit Note or Report created\* | ← | Conversations | Conversations can be synced from Spruce to Elation through either manual syncing (Selective Sync) or Automatic Sync \*Select Sync will create a Simple Note and Automatic Sync will create a *Miscellaneous*Report |
## Creating Contacts in Spruce from Elation
Patients must have a Contact in Spruce in order to be invited to communicate via SMS, Secure Message or Video. When you create a new chart in Elation, a new Contact for the patient will be created in Spruce immediately and this will also create the patient link. You will receive a message in your Spruce
*Inbox*
with a note describing this automation for record keeping purposes.
Creating a new Contact in Spruce does not automatically create a new chart Elation chart. Patient/Contact creation only occurs from Elation to Spruce.
![Spruce Inbox showing a "Patient imported from Elation" notification for Joanna Smith, with the automated message displaying her imported demographics: ID, DOB 3/1/1956, gender Female, and contact info.]()
## Linking patients
If you have a Contact in Spruce for a patient that already has a chart in Elation, link these two together by following the steps below. This will ensure the Spruce messages for the patient will sync to the correct Elation Chart.
1. Select the patient's Contact in Spruce to open the contact card.
2. Scroll down to *Integrations* and click **Link Contact to EHR**.
3. Select **Elation** from the drop down menu.
4. Search for the patient by the name or the Chart ID number\*\* used for that patient in Elation.
* This search must have the full first or last name in order to pull up the patient. It is not case sensitive.
5. Once the correct chart appears, select it and verify that the information from Elation matches the information you have in Spruce.
6. Click **Link** to connect the Elation chart with the Spruce contact.
To remove a link follow the above instructions and when under Integrations hover over the integration you want to unlink and you will see it will say "Remove Link" when you are hovered over.
To see Spruce's demonstration of this workflow, please click [here](https://www.loom.com/share/9a83b4ae4501408ca52c889f789abcc3) .
## Demographics Updates
Once the patient is linked between Elation and Spruce, any updates in either system for the following demographics fields will be pushed to the other system immediately:
* Patient first and last name
* Phone numbers (up tp 2 different phone number types)
* Email address
* Date of birth
* Gender
## Message Syncing
There are two ways messages from Spruce can sync into Elation: Selective or Automatic.
### Selective Sync (Recommended)
Selective sync allows you to choose one or more messages you would like to sync into Elation. This option allows you to control which messages you would like to copy to Elation. The message(s) chosen for syncing will populate into Elation as a Simple visit note. When using this option, you can select which patient chart in Elation the messages are filed under. The patient you are currently viewing in Spruce will be the default. To use Selective Sync:
1. Open the conversation in Spruce
2. Hover over any messages until three small vertical dots\*\* appear to the right of the message and click on them.
3. Select the **Select Message** option from the menu.
4. Squares will appear to the left of each message that you can click to select the individual messages you would like to copy to Elation, they are selected when blue.
5. Click **Sync to Elation** at the top of the conversation, below the patient name
6. A box will pop up and if this patient is already linked to their patient chart in Elation it will be populated under patient
* If the patient name is blank, search for the patient by full first and/or last name.
* You can also edit to a different patient than what was prefilled
7. Enter a **Note Subject** if desired.
8. Click **Done** in Spruce to exit the select message view
9. Open or refresh the patient’s chart in Elation and sign off on the visit note in the Requiring Actions queue.
*
**Please Note** : If your practice utilizes Patient Passport, signing off on visit notes will automatically send the visit summary to the patient.
To see Spruce's demonstration of this workflow, please click [here](https://www.loom.com/share/ae02d980185e41a684cbafb225c94195) .
![Spruce conversation for Sal Mak showing a selected internal note (highlighted blue), the "Sync to Elation" button highlighted, and the "Sync Messages to Elation" dialog with patient pre-filled and Save button highlighted.]()
![Elation patient chart showing "Requiring Action" queue with 1 item: an unsigned Spruce Conversation note dated Feb 17, 2022, created by Elation Doctor, MD, awaiting provider sign-off.]()
### Automatic Sync
Automatic sync will sync all new SMS and Secure Messages in Spruce automatically to Elation every 24 hours. With automatic sync, the messages from Spruce will populate into Elation as **Miscellaneous (MISC)** Reports.
To access in Elation, click on the **Reports** tab, then the MISC category to access all Spruce conversation reports for a patient.
**Please Note** : Whether using Selective Sync or Automatic Sync, the visit note or miscellaneous report will appear in the **Requiring Action** queue of the patient’s chart, and will require provider sign off to file in the patient’s chronological record.
## Helpful Videos and Links About Using Elation and Spruce
* Spruce Integration Help Center article: [https://help.sprucehealth.com/article/470-elation-integration](https://help.sprucehealth.com/article/470-elation-integration)
* Elation-Spruce Link Charts Video: [https://www.loom.com/share/9a83b4ae4501408ca52c889f789abcc3](https://www.loom.com/share/9a83b4ae4501408ca52c889f789abcc3)
* Elation-Spruce Selective Sync Video: [https://www.loom.com/share/ae02d980185e41a684cbafb225c94195](https://www.loom.com/share/ae02d980185e41a684cbafb225c94195)
* Spruce Help Site: [https://help.sprucehealth.com/](https://help.sprucehealth.com/)
* Elation Support: [Click here to contact Support](https://help.elationemr.com/s/contactsupport)
* Spruce Support: [support@sprucehealth.com](mailto:support@sprucehealth.com)
* In-App Spruce Support: Search for *Spruce Support*
*© Spruce Health*
## Related Articles
* [Telehealth Guide- Using Spruce alongside Elation for patient encounters](/articles/Using-Elation-Spruce-telehealth)
# Elation Integrated Video, powered by Zoom - Connecting with patients using video
Source: https://help.elationhealth.com/articles/Elation-Telehealth-powered-by-Zoom
Elation integrated video allows you to easily add a virtual option to your existing in-person care model.
## Overview
This article covers setting up your virtual visit with Elation Integrated Video, from activating your account to hosting and documenting video visits.
### What is Elation Integrated Video, powered by Zoom?
Elation Integrated Video is a HIPAA-compliant video integration, powered by Zoom ©, that allows you to see patients using two way, real-time, interactive audio and visual communication.
Elation Integrated Video is Elation's native, Zoom-powered telehealth option. If your practice uses Spruce for telehealth instead, see the [Telehealth Guide - Using Spruce alongside Elation](/articles/Using-Elation-Spruce-telehealth).
*Copyright ©2022 Zoom Video Communications, Inc.*
### Why is Elation Integrated Video valuable?
Elation Integrated Video allows you to easily add a HIPAA-compliant, virtual option to your existing in-person care model. With Elation integrated video, your practice can use one streamlined process for both in-person and virtual visits, without having to implement or maintain a separate technology solution. This will also allow you to meet the communication requirements for [telehealth billing](/articles/Telehealth-Coding-and-Workflows-Recommendations) to maximize the payments you receive for services rendered to your patients.
## Workflow Instructions
### How to activate my Elation Integrated Video account
**1**
Go to **Settings** .
**2**
If the option to activate virtual visits is unavailable in your **Virtual Visit** settings, see the section below titled [If you do not have the option to activate Virtual Visits in Settings](#no-virtual-visit-option) for instructions on how to request activation.
Select **Virtual Visit** in the Settings options.
**3**
Click the **Activate** button to enable your integrated video.
* After activation, you will be prompted to update your custom virtual visit instructions. Select the **Use this text** button to ensure that your patients automatically receive the video link with their appointment reminders.
#### If you do not have the option to activate Virtual Visits in Settings
If the option to activate virtual visits is unavailable in your **Virtual Visit** settings, it may be because you are a staff account, an on-call provider, or the feature is already active. If none of these conditions apply, the **Integrated Video** feature may not be enabled for your account. Elation must enable this feature before you can activate it.
**To request activation:**
| **1** | Have an Admin level user in your practice click **I need help** at the top of your Elation account. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Select **Contact Elation Support** . |
| **3** | In your message, include: Confirmation that you would like to enable Elation Integrated Video • If you are reaching out on behalf of another user, the name of the user that needs it enabled |
| **4** | A member of the Elation team will enable the feature and follow up with next steps. |
Only Admin level users can submit this request on behalf of the practice.
Enabling Elation Integrated Video may come with additional fees. The Elation team will provide details when processing your request.
Once the feature is enabled, the Integrated Video option will be available for activation in the **Virtual Visit** settings.
### How to set Virtual Visit Instructions
To set default text to appear in the **Visit instructions for patients** box in their appointments:
**1**
Go to **Settings** .
**2**
Select **Virtual Visit** in the Settings options.
**3**
Go to the **Virtual visit Preferences** section and locate your name.
Virtual visit instructions are set per provider. Each Provider Level User sets and saves their own instructions here, and instructions do not carry over between providers.
**4**
If you activated your Zoom integration, DO NOT remove your **Virtual visit instructions** from the Virtual Visit Settings — this will remove your ability to start your video visits with your patients.
If you activated your Zoom integration, do not remove your customized Zoom link from the **Virtual visit instruction**. Patients will not be able to connect with you without this link.
Include additional instructions on how to connect to the virtual visit, as needed, to ensure patients can connect to their appointment.
Updating your **Virtual visit Instructions** in Settings will change your virtual visit instructions for all upcoming appointments (starting the next day).
Adjust the **Virtual visit instructions** to your liking.
**5**
The instructions box automatically saves your changes.
Patients must be opted in to SMS to receive these instructions by text message — see the [SMS (Text message) Opt-In Guide](/articles/SMS-Text-Message-Opt-In-Guide) for details.
### How to complete a virtual visit using Elation integrated video
#### How to start my video visit using Elation integrated video
**1**
To launch your video, go to **Practice Home** .
**2**
The **Start Video** button will appear in any appointment where the place is set to **Virtual** and your Elation integrated video link is present in the **Virtual Visit Instructions** field.
Click the **Start Video** button from any virtual visit appointment. You will be automatically logged into the virtual visit as the provider/host!
Make sure you click the **Start Video** button and not the link in the virtual visit instructions which is meant for the patient! The **Start Video** button enables you to automatically login as the host of the visit, rather than as a patient.
You can also launch video visits from your mobile device using Elation Go, our iOS app. Learn more [here](/articles/elation-go-the-mobile-app-for-practices).
#### How to let another Staff Member join the visit
If you have a staff member or another collaborating physician that you would like to join the visit, feel free to have them click the **Start Video** button as well. They will be placed directly into the video visit, bypassing the waiting room!
The first user who clicks the **Start Video** button will be the host of the meeting, meaning that they will control the waiting room. You can reassign host privileges to another user by clicking **More** next to their name in the participant list and then clicking **Make Host**.
#### How patients join the video visit using their waiting room link
Patients will receive their virtual visit instructions, including the patient-facing Elation integrated video link, through Elation's [automated appointment reminders](/articles/appointment-reminders). To join their virtual visit, patients will simply click on the link provided in the appointment reminder to be placed in the waiting room.
You can also manually send them the virtual visit instructions anytime by clicking on the **Send** button next to the virtual visit instructions in the appointment details popover. These will be sent by either text or email depending on whether the patient has an email or mobile phone number on file.
This [patient-facing guide](/files/telehealth-patient-guide.pdf) will show you how patients can join the virtual visit. You can share this with any patient by adding the guide to your virtual visit instructions under **Settings** >> **Virtual Visits** >> **Virtual Visit Preferences** .
#### How to manage my Waiting Room
You can manage when visits start and end by admitting patients from and placing patients back into the waiting room. You will not need to **Leave Meeting** or **End Meeting for All** between patient visits!
| **1** | Once the patient clicks the video link and joins, you will be alerted in the integrated video window that the patient has entered the Waiting Room through an audio and visual cue. If you prefer to only be notified visually, you can turn off the sound upon entry in your video settings. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Admit** next to the patient's name to move your patient from the Waiting Room into the video call and begin your visit! If there are multiple patients in the waiting room, you can choose to **Admit** only one of them and hold the other patient in the waiting room until you are ready to see them. For privacy reasons, patients in the waiting room are not able to see each other or chat with one another. • Send patients back into the waiting room by clicking **More** next to their name and clicking **Put in Waiting Room**. |
Choosing to **Remove** a patient from a meeting will prevent a patient from being able to enter the Waiting Room again until you end your current video session and start a new one. We recommend against using **Remove** , unless you are sure that the patient does not need to come back into the video visit again.
#### How to document in Elation during my video visit
Using Elation Integrated Video, you can easily document in Elation while hosting the video visit on the same device! We recommend turning on **Minimal View** so you can easily document in Elation while seeing your patient on video at the same time. This view minimizes your patient view and also ensures that your video window stays on top of all other windows/programs on your desktop (so you never lose sight of your patient).
![Elation EHR patient chart open with a small video window in Minimal View showing the provider's camera feed in the top corner, demonstrating simultaneous documentation and video visit.]()
Switch between **Minimal View** and **Full Screen View** as needed — **Full Screen View** allows you to focus on an enlarged patient video, which may be helpful for physical examinations.
For Windows users: Click on the minimize icon in the top right.
For Mac users: Use keyboard shortcuts to help you move between Minimal View (Command(⌘) + M) and Full Screen View (Shift + Command(⌘) + M). This will allow you to seamlessly increase and decrease the size of your patient's video.
### Optimize your experience with advanced video settings
To optimize your Elation integrated video experience, you can adjust your video session settings! Below are a few notable features that your practice can take advantage of:
* **Share Screen —** Control whether or not your patients can share their screen. By default, you and your patients will be able to share your device screens with one another, in case you want to share key pieces of information with one another during the visit — e.g. trends in lab values!
![Zoom meeting toolbar with Share Screen button highlighted and "Advanced Sharing Options..." selected, showing screen-sharing permission controls for the video visit.]()
* **Chat —** As the video visit host, you will be able to chat with your patients as well as specify who your patients can chat with. You may choose to chat with — Everyone in the Waiting Room (in case you are running behind schedule and want to send a generic message to everyone in the waiting room!), Everyone in the Meeting, or individuals in the meeting. The default selection is set to chat with Everyone (In Meeting). We recommend allowing your patients to chat with the **Host Only**.
![Zoom meeting Chat settings panel with "Participant Can Chat With" options shown, "Host only" selected, highlighted in red to indicate the recommended setting.]()
Most settings are session-specific, meaning that they will revert to the default once you relaunch the meeting. Participant chat settings are an exception to this rule. If you choose to limit your patients to chatting with the **Host Only**, this selection will hold across video sessions.
**Next Step**
**Activate your Elation integrated video account today and start seeing your patients virtually**
## Related Articles
* [Elation Integrated Video: Frequently Asked Questions](/articles/Elation-Integrated-Video-FAQ)
* [Telehealth: Billing & Workflow Recommendations](/articles/Telehealth-Coding-and-Workflows-Recommendations)
* [Patient Guide — How to join a virtual visit](/files/telehealth-patient-guide.pdf)
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Elation Go: The Mobile App for Practices](/articles/elation-go-the-mobile-app-for-practices)
# Elation-Thea Health- eConsult Integration Guide
Source: https://help.elationhealth.com/articles/Elation-Thea-Health-eConsult-Integration-Guide
This article describes the Elation integration with Thea Health, an eConsult platform for clinicians to consult with specialists.
## What is Thea Health?
[Thea Health](https://theahealth.com/elation/)
is an eConsult platform that allows clinicians to conduct virtual, text based consultations with specialists, without having to leave their EHR. With Thea Health, clinicians are able to gather consultation information from specialists, which helps save the patient time and cost of having to attend an additional visit.
## What is the Elation-Thea Health integration?
The Elation to Thea Health integration will increase efficiency for practices and their patients by eliminating the need for additional patient visits with a specialist. Clinicians who need advice from a specialist can share patient information with specialists with the click of a button in Elation. Once the Clinician and Specialist complete their consultation, all communications, patient information and any images will be saved as a PDF consultation summary and sent back to the Elation patient chart. This in turn will reduce the cost of care for the patient.
## How do I get started?
If you are interested in using the Elation to Thea Health integration, send Elation an email using
[integrations@elationhealth.com](mailto:integrations@elationhealth.com)
and a member of the Elation Team will reach out to you on next steps for setting up the Thea Health integration and connect you with a Thea Health representative to set up custom workflows.
You must install the Thea Health browser extension on the web browser you use for Elation to utilize the integration features.
## What information is synchronized?
The Elation to Thea Health integration is bidirectional, which means that information between the systems will sync both to and from each system. Patient demographics and visit note encounter details are sent to Thea Health for consultations. All communications with the specialist, patient information and any images from Thea Health will be sent back to Elation as a report once a consultation case is closed.
## Using the Elation-Thea Health integration
The integration workflow is detailed below when you need to begin a consultation via Thea Health:
1. Start in an open visit note in the Elation patient chart
2. Click **eConsult** to open the Thea Health browser extension
* The patient demographics and information from your current visit note will be pulled into Thea Health for the specialist to reference
3. Type your questions and comments for the specialist in the Thea Health window that appears on your Elation page. Once submitted, the specialist will respond typically within 24 hours in the Thea Health application.
4. When the consultation in Thea Health is complete, the specialist will click **Close Case** and the correspondence shared between the clinician and the specialist will be combined into a PDF consultation summary report for Elation.
5. The report will be uploaded automatically to Elation and can be found in the **Requiring Action** section of the patient chart and in the **Reports** queue of your Practice Home page.
![Four-step Elation–Thea Health eConsult workflow: clinician clicks eConsult in Elation (1), Thea Health sidebar opens and question is sent to specialist (2), specialist receives notification and responds in Thea Health (3), correspondence automatically syncs back to Elation as a report (4).]()
## Getting Support
If you need assistance with your Elation-Thea Health configuration or have questions about the Thea Health Application, contact Thea Health by emailing [support@theahealth.com](mailto:support@theahealth.com).
## Related Articles and Resources
* [Thea Health website](https://theahealth.com/elation/)
* [Elation Integrations and Partners](/index)
# Elation-Updox Integration Guide- Using Updox alongside Elation to manage documents and patient engagement
Source: https://help.elationhealth.com/articles/Elation-Updox-Integration-Guide
This article describes the integration between Elation EHR and Updox.
## What is Updox?
[Updox](https://www.updox.com/)
© is a communications platform that centralizes communications for EHRs and patients through a single system. Updox’s features and functionalities include:
* Electronic fax
* Internal messenger
* Telehealth video chat
* Secure Text/SMS
* Patient mass communication
* Automated appointment reminders
## What is the Elation-Updox Integration?
With the Elation-Updox integration, you can:
* send all documents and communication records from Updox to Elation to keep a single source of truth for all patient data
* utilize the appointments and demographics data in Elation to power Updox’s appointment reminders
* utilize the demographics data in Elation to power Updox’s patient communication features
## How do I get started?
To request an Updox account and/or begin the integration process between Elation and Updox,
[click here to fill out a form](https://info.updox.com/elation-updox-integration)
which notifies the Updox Sales Team of your interest. Updox will assign an Onboarding Success Manager to your account to assist you with setting up your Updox account and turning on the Elation-Updox Integration.
## What information is synchronized between Elation and Updox?
| Data | Sync Direction |
| ------------------------------------------------------------------------------------------------------------------------------- | --------------- |
| Provider Information | Elation → Updox |
| Practice Locations | Elation → Updox |
| Patient Charts | Elation → Updox |
| Demographics | Elation → Updox |
| Appointments\* \*Only the **Scheduled**, **Confirmed** and **Canceled** **Appointment Status** will sync from Updox to Elation. | Elation → Updox |
| Documents (Reports) | Updox → Elation |
## Provider Information
The synchronization of Provider Level User accounts is unidirectional from Elation to Updox. When a Provider Level Account is activated in Elation, that Provider’s name will automatically be pushed to Updox within a few minutes.
## Practice Locations
The synchronization of Practice Location information is unidirectional from Elation to Updox. Additions to your Practice Locations list and edits to Practice Location information must be made in Elation and then the information will automatically be pushed to Updox within a few minutes upon save. The following table shows a mapping of the Patient Demographics fields that are sent from Elation to Updox and their matching field names. Fields that are not listed are not sent from Elation to Updox.
| Elation Field Name | Updox Field Name |
| ------------------ | ----------------- |
| Name | Name |
| Address | Address 1 |
| Suite | Address 2 |
| City | City |
| State | State/Province |
| Zip | Postal Code |
| Phone | Appointment Phone |
| Fax | Fax Phone |
## Patient Charts
### Creating Charts
The synchronization of patient charts is unidirectional from Elation to Updox. This means patient charts can only be created in Elation. Afterwards, only patients with the **Active**
[Patient Status](/articles/Patient-Status)
will appear in the Address Book in Updox. Chart additions and updates will take only a few minutes to sync to Updox upon save.
### Merging Charts
Each chart can only have a one to one connection between Elation and Updox and this connection is established upon chart creation. If you happen to see a duplicate chart for the same patient in Elation, please make sure you find the chart that is connected between the two systems and keep the connected chart when performing a merge.
* For example, patient John Smith has two charts in Elation but one Patient record in your Updox Address Book. The best way to find out which of the two charts in Elation is connected to the Patient record in Updox is by updating one of the connected demographics fields in Elation for each chart with something unique to see which version is sent to the Patient record in Updox. (For example, update the Ste or apt # field in Elation to 5th floor for one chart and 6th floor for the other chart and see what floor appears in Updox. Afterwards revert the Ste or apt # field back to the original information). The Elation chart that has the data you see in Updox must be the chart that you keep in Elation when performing a chart merge.
Here are the proper merge steps for Elation charts:
1. Open the duplicate chart that is not connected to the integration
2. Click on the patient's name to open their Demographics
3. Click on the **Merge Chart** button
4. Find & select the chart you want to keep (the one that is connected to the integration)
5. Click **Merge Chart**
6. Confirm you understand the transfer of data and then click **Yes, merge charts**
### Deleting Charts
Deleting a chart in Elation will not delete the Patient record in Updox; it will only mark the patient as inactive. Please take caution when deleting charts in Elation while using the Updox integration as charts have a one to one connection via the integration. If the patient is still active in your practice, the deleted chart must be restored in order for the patient's information to sync properly across the two systems.
You can restore a deleted patient chart yourself using the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice). Go to **Reports** > **User Activity Log**, filter by the patient or by the **Delete** action, and click the **Restore** button next to the deleted chart. [Admin Level Users](/articles/administrative-privileges) can view and restore activity for all users in the practice.
## Patient Demographics
The synchronization of Patient Demographics is unidirectional from Elation to Updox. All edits must be made in Elation and the information will automatically be pushed to Updox within a few minutes upon save. The following table shows a mapping of the Patient Demographics fields that are sent from Elation to Updox and their matching field names. Fields that are not listed are not sent from Elation to Updox.
| Elation Field Name | Updox Field Name |
| ------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------- |
| Legal First Name | First Name |
| Legal Last Name | Last Name |
| Middle Name | Middle Name |
| Date of birth | Date of Birth |
| Sex at birth | Sex |
| Home Phone | Home Phone |
| Mobile Phone | Cell Phone |
| Email | Email |
| Address | Address 1 |
| Ste or apt # | Address 2 |
| City | City |
| State | State |
| Zip | Zip |
| Elation Patient ID | EHR Patient ID |
| Preferred Language | Patient Communication Language\* \*Only 'English' and 'Spanish' will be synchronized as these are the only two languages Updox supports. |
| Patient Status = Active | **Active** checkbox is checked |
| Patient Status = Prospect | *Not synchronized* |
| Patient Status = Inactive | **Active** checkbox is NOT checked |
| Patient Status = Deceased | **Active** checkbox is NOT checked |
## Documents (Reports)
The synchronization of documents is unidirectional from Updox to Elation and will appear in Elation as Reports in the patient’s chart. The Reports will appear in Elation within a few minutes upon send.
The following table lists the Reports fields that are pushed from Updox to Elation and show how the Updox fields map to the Elation fields. Fields that are not listed are not sent Updox to Elation:
| Updox Field Name | Elation Field Name |
| --------------------------- | ------------------------------------------------------------------------------------------------------------------ |
| Document Name | Report Title |
| Document Type | Report Category |
| Provider | Assigned Provider |
| Date of item | Document Date |
| Date & Time Sent from Updox | File Received Date & Time |
| Notes\* | For customers with the metadata setting turned on, Notes will appear in the metadata page at the end of the Report |
The Document Types options you see in Updox use the [Report Categories](/articles/report-types) you choose to use in Elation. Once a day, each morning, Updox will sync the most up to date list of Report Categories as it is configured in your Elation account. If you edited your Report Categories today, you will not see the changes until tomorrow.
## Appointments
The synchronization of appointments is unidirectional from Elation to Updox. Practices must create and update appointments in Elation for the appointment to push to the corresponding Provider calendar in Updox. Appointment additions and edits will take only a few minutes to sync to Updox upon save.
The following table lists the Appointment fields that are pushed from Elation to Updox and show how the Elation fields map to the Updox fields. Fields that are not listed are not sent from Elation to Updox:
| Elation Field Name | Updox Field Name |
| ------------------ | ------------------------------------------------------------------------------------------------------------------------- |
| Patient Name | Patient Chart # |
| Date | Appointment Date |
| Start Time | Appointment Time |
| Duration | Appointment Duration |
| Appointment Type | Appointment Type |
| In Person/Virtual | 'In Person' or 'Virtual' designation next to the Appointment Type |
| Provider | Calendar Name |
| Status | Status\* \*Only the **Scheduled**, **Confirmed** and **Canceled** **Appointment Status** will sync from Updox to Elation. |
| Location | Location |
## Sending documents from Updox to Elation
1. Select the pages you want to send from you Updox Inbox by checking off the box under each page
2. Click the **Send… selected page** button in the sidebar
3. Search for and select the name of the patient the documents belong to
4. Check off the **Send to EHR** box & click **OK**
5. Fill out the following fields:
6. Document Name
7. Document Type
8. Provider
9. Date of item
* If you leave this field blank, Updox will default the date of the item to \*\*today \*\* s’ date
* The time of the Report will always appear as 12am in Elation
5. Notes
* Notes entered will only appear in the metadata page that is included at the end of each document that is sent to Elation as long as you have this Setting turned on in Updox.
* If you wish to turn off the metadata page in Updox, go to Menu -> Admin -> Practice Settings -> and check off the **Do not add last page of metadata on PDFs or imported documents** box.
6. Click **Send**
7. The report will be sent to Elation within a few minutes. The report will appear in the Requiring Actions section of the patient’s chart. If you are already in the chart you may need to refresh the chart to see the report.
## Managing appointments
Updox allows you to customize appointment reminder text and preferences based on Provider Calendars, Practice Locations and Appointment Types. If you use Updox for advanced appointment reminders, the appointment data shared by Elation will power the appointment reminder configurations in Updox.
*
Turn off your Elation appointment reminders if you are using Updox’s appointment reminders and vice versa. If appointment reminders are on in both systems then patients will receive both sets of appointment reminders.
When patients confirm and cancel their appointment in either system, Elation or Updox, that updated appointment status will appear in both Elation and Updox.
*
Only the Scheduled, Confirmed and Canceled statuses sync between Elation and Updox
If you need to see canceled appointments in the calendar, make sure that Setting is turned on in both systems:
* The Activity Log under each appointment in Elation will display an appointment that was canceled by Updox as Canceled.
## Managing contacts
Contacts in Elation are defined as providers that can be used for Letters or Referrals. Contacts can be self-created or can be pulled in from the main Elation Directory. The synchronization of contacts is unidirectional from Elation to Updox and happens once every evening.
The following table lists the Contacts fields that are pushed from Elation to Updox and show how the Elation fields map to the Updox fields. Fields that are not listed are not sent from Elation to Updox:
| **Elation Field Name** | Updox Field Name |
| ---------------------- | ---------------------------------------------------------------------------------------------------------------------------------- |
| Type | Category |
| First Name | First Name |
| Middle Name | Middle Name |
| Last Name | Last Name |
| Address - Street | Address 1 |
| Address - City | Address 2 |
| Address - State | State |
| Address - Zip | Zip |
| Phone | Work Phone\* \*If **Cell Phone** is not available then the **Phone** field in Elation will map to **Work Phone** in Updox instead. |
| Fax | Fax Number |
| Email | Email |
| Cell Phone | Cell Phone |
## Getting Support
### Updox
If you need assistance with Updox or the Elation-Updox integration, contact Updox using one of the following methods:
* Go to [https://www.updox.com/support/](https://www.updox.com/support/)
* Email [support@updox.com](mailto:support@updox.com)
### Elation
If you need assistance with Elation, contact Elation using one of the following methods:
* Click the **I need help** -> **I need help from Elation Team Member** button at the of your Elation account
* Fill out our [Support Contact Form](https://help.elationemr.com/s/contactsupport)
## Frequently Asked Questions (FAQ)
### I added a new Report Category to Elation but I do not see it in Updox. Why is this happening and what should I do?
The Document Types options you see in Updox use the
[Report Categories](/articles/report-types)
you choose to use in Elation. Updox will only sync this information once every morning. If you edited your Report Categories today, you will not see the changes until tomorrow.
In the meantime, you can select any Document Category that is visible in Updox, send the document over to Elation and then change the Report Category by clicking **Actions** --> **Edit Details**.
### I sent a document from Updox to Elation and the time on the report says 12am in Elation. Can I change this?
It is not possible to change the time of the report at this time. All reports sent from Updox will be time stamped at 12am.
**I see an appointment on the calendar in Updox but I don't see that appointment in Elation. Why?**
We recommend checking if the appointment is marked as Canceled in Updox. If it is, check your Elation Settings (under **Settings** --> **Calendar & Booking** --> **Calendar view**) to see if canceled appointments are visible in your Elation calendar. If it is not a canceled appointment, reach out to
[Updox Support](#updox_support)
for further assistance.
### There’s an extra page of details at the end of every Report sent from Updox. How do I turn this off?
If you wish to turn off the metadata page that is sent from Updox, go to Updox -> Menu -> Admin -> Practice Settings -> and check off the
**Do not add last page of metadata on PDFs or imported documents**
box.
### If I add a new patient to my Updox Address Book, will that create a chart for them in Elation?
Adding a new patient to the Updox Address Book will not create a chart for them in Elation. Patient Charts only synchronize from Elation to Updox.
*Copyright © Updox. All rights reserved.*
## Additional Resources
* [Elation + Updox Information Page](https://info.updox.com/elation-updox-integration)
# Elation-Zocdoc Integration Guide
Source: https://help.elationhealth.com/articles/Elation-Zocdoc-Integration-Guide
This article details the integration between Elation and Zocdoc, an online scheduling platform for patients.
\*\*Contents \*\*
* [What is Zocdoc?](#description)
* [What is the Elation-Zocdoc integration?](#elation_zocdoc_integration)
* [How do I get started?](#getting_started)
* [New Zocdoc User](#new_user)
* [Existing Zocdoc User](#existing_user)
* [Availability Setup](#availability_setup)
* [What information is synchronized?](#info_sync)
* [Elation to Zocdoc](#elation_to_zocdoc)
* [Zocdoc to Elation](#zocdoc_to_elation)
* [Editing appointments in Elation](#editing_appointments)
* [Getting Support](#getting_support)
* [Frequently Asked Questions](#faq)
**What is Zocdoc?**
Zocdoc© is an online platform that allows patients to find and book appointments with healthcare providers in their area. Zocdoc helps patients find available appointments quickly based on criteria such as accepted insurance, distance, provider speciality, and more.
**What is the Elation-Zocdoc integration?**
The integration between Elation and Zocdoc allows your practice to efficiently view and manage calendar availability and Zocdoc bookings. The Zocdoc calendar pulls real-time availability from provider calendars in Elation to display available appointments to patients. When a patient books an appointment with a provider on Zocdoc, their Elation calendar will update and reflect the Zocdoc booking.
**How do I get started?**
At least one Provider Level User at your practice will need to have an account with Zocdoc to start the integration.
**Zocdoc User Setup**
To connect your ZocDoc account to your Elation account, submit a request here:
[https://www.zocdoc.com/partner/elationhealth](https://www.zocdoc.com/partner/elationhealth)
. Zocdoc will reach out to you once the form has been completed.
If you do not have an account with Zocdoc, please register for an account through this Zocdoc-Elation landing page so that ZocDoc knows you are an Elation user when you register: [https://www.zocdoc.com/partner/elationhealth](https://www.zocdoc.com/partner/elationhealth)
**Availability Setup**
***
Before the Zocdoc integration is turned on, please set your available working hours in Zocdoc to ensure that patients do not schedule appointments with you outside of your office hours.
**What information is synchronized?**
The integration between Elation and Zocdoc primarily focuses on appointments, insurance, and basic patient demographic information syncing. When a patient books an appointment through Zocdoc, the appointment will appear on the Elation calendar for the provider who they scheduled with.
**Elation to Zocdoc**
***
Elation will send the following information to Zocdoc:
* Provider availability
* Based on the availability from the provider’s calendar on the Practice Home page
Providers must also [set available working hours in Zocdoc](#availability_setup) to ensure that patients do not schedule appointments outside of office hours.
* Appointment status updates
* When an appointment status is updated in Elation, it will reflect in Zocdoc
**Zocdoc to Elation**
When appointments are scheduled in Zocdoc, Elation will receive information regarding the appointment, the patient’s demographics, and insurance.
\*\*Appointments \*\*
When appointments are scheduled in Zocdoc, Elation will receive:
* Time of the appointment
* Duration of the appointment
* Which provider the appointment is scheduled with
**Demographics**
The following demographic fields will sync from Zocdoc to Elation:
| **Elation Field Name** | Zocdoc Field Name |
| ---------------------- | ----------------- |
| Legal first name | First |
| Legal last name | Last |
| Date of birth | Date of birth |
| Sex at birth | Sex |
Zocdoc will try to find a matching chart in Elation for the patient based on the criteria in the table below. If they do not find an exact match, then they will create a new patient chart in Elation.
\*\*Insurance \*\*
The following insurance fields will sync from Zocdoc to Elation:
| **Elation Field Name** | Zocdoc Field Name |
| -------------------------------------- | -------------------------------------- |
| Insurance Card Photos (front and back) | Insurance Card Photos (front and back) |
| Insurance carrier name | Carrier |
| Plane name | Plan |
| Member ID | Member ID |
**Editing appointments in Elation**
If you need to edit an appointment, you must edit the appointment in Elation. Edits made to the appointments in Elation will sync and be reflected on the Zocdoc calendar.
**Getting Support**
If you encounter any issues with your Elation-Zocdoc integration, please reach out to Zocdoc by emailing
[service@zocdoc.com](mailto:service@zocdoc.com)
.
**Frequently Asked Questions**
\*\*What if not all providers at my practice want to integrate with Zocdoc? \*\*
Zocdoc can set up the integration for your practice to meet your specific needs. If not all providers at your practice want to integrate with Zocdoc, then the integration can be set up for those specific providers who would like to integrate and will not affect providers who do not want to integrate with Zocdoc.
© 2023 Zocdoc, Inc.
# Lab Orders & Results - Using the electronic Lab Order Form
Source: https://help.elationhealth.com/articles/Electronic-Lab-Order-Form
📖 **RECOMMENDED READING**
[Click here for a list of lab vendors that offer a bidirectional lab interface with Elation](https://www.elationhealth.com/integrations/?ucterms=partner_service:laboratories-bidirectional) .
## Overview
Use this article to learn how to create and transmit lab orders if you have a live bidirectional lab interface with the vendor, known as eOrdering.
Here is an example of what your electronic Lab Order Form looks like in this situation. The buttons that allow you to complete the order will include:
* **eOrder**
* **eOrder & Print**
* (if applicable) **Sign & Hold**
**NON-ELECTRONIC ORDERING** If you don’t have a bidirectional interface with the lab vendor that you wish to order from, [click here for instructions on how to create a regular Lab Order](/articles/Regular-Lab-Order-Form) .
📖 **MISSING A LAB?**
Only lab vendors with an active integration with your Elation account are available for electronic ordering in the Lab Order Form.
If a lab vendor you previously used no longer appears:
| **1** | Go to **Settings** → **Labs** and locate the lab vendor\*\*.\*\* |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Check the **Electronic Orders? column** to confirm the interface status is **Live** . Any other status indicates the interface is not currently active. |
| **3** | If the lab vendor is missing from your list or the interface status has changed unexpectedly, follow the troubleshooting steps in [Managing lab vendors → Troubleshooting a lab or imaging interface that stopped working](/articles/Managing-lab-vendors#troubleshooting_interface) . |
## Workflow Instructions
### Creating a lab order
**1**
Create a Lab Order use any of the following options:
1. At the top of the patient's chart, click Orders -> Lab Order.
2. In any visit note or non-visit note draft, click Lab.
3. In an existing signed Lab Order, click Actions -> Reorder to re-order the same test(s) as the signed Lab Order.
**2**
Type the first few letters of the lab vendor's name to filter your list of lab vendors.
If you cannot find a test in the test search, search for the test using different terms (e.g. the Complete Metabolic Panel is known as **CMP** for Labcorp). If you have a question about a specific test or test code, please contact your lab representative for assistance. Custom tests and test codes are not supported for electronic orders. If the test isn't in the vendor's compendium at all, you can still print an order for it: create a separate lab vendor entry for the same vendor labeled something like "\[Vendor] - Print Only" (**Settings** → **Labs** → **+ Add Lab Vendor**, then confirm **Printed Orders** is enabled on it). From a new Lab Order, select that print-only vendor entry instead of the electronic one, type the full test name to manually add it, then use **Print & Close** or sign and print it afterward from **Actions** → **Print**.
If you've already entered diagnoses in the patient's \*\* Problem List or visit note, these diagnoses will automatically appear in the dropdown menu for you to select. Use the [Problem List Guide](/articles/managing-your-problem-list) to learn more about this feature.
Fill out the Lab Order Form. Fields with an asterisk are required. The chart below explains the core fields in the form. Any vendor-specific eOrdering requirements are also highlighted. [Click here to see definitions for the remaining fields and buttons](#Glossary).
**Field / Button**
**Instruction**
**Vendor Specific Requirements**
\***Lab**
Type the first few letters of the lab vendor's name to filter your list of lab vendors.
Select the vendor with whom you are placing the order.
* Use the Labs Settings page to add additional vendors if needed.
Scarlet Health Requirements Electronic lab orders for Scarlet Health are routed through the Bioreference lab interface. Choose Bioreference as the lab vendor when creating lab orders for Scarlet Health.
**Site**
Designate whether the specimen will be collected at any vendor patient service center, a specific vendor patient service center, or in-house. If **Any site** is selected, all patient service centers will receive your order.
* Additional location details can be set on the Labs Settings page, if needed.
\***Tests**
If you cannot find a test in the test search, search for the test using different terms (e.g. the Complete Metabolic Panel is known as **CMP** for Labcorp). If you have a question about a specific test or test code, please contact your lab representative for assistance. Custom tests and test codes are not supported for electronic orders. If the test isn't in the vendor's compendium at all, you can still print an order for it: create a separate lab vendor entry for the same vendor labeled something like "\[Vendor] - Print Only" (**Settings** → **Labs** → **+ Add Lab Vendor**, then confirm **Printed Orders** is enabled on it). From a new Lab Order, select that print-only vendor entry instead of the electronic one, type the full test name to manually add it, then use **Print & Close** or sign and print it afterward from **Actions** → **Print**.
Enter the test(s) you want the patient to complete. You must select a test from the lab vendor’s proprietary compendium, which is maintained and updated monthly by the vendor.
Scarlet Health Requirements Because Scarlet Health shares an interface with Bioreference, you must include the test "TH31-8" in any lab order that is intended for Scarlet Health.Scarlet Health cannot handle specimens that are collected in-house by a healthcare provider or must be collected over an extended time period (e.g. stool specimens, pap smear and biopsy collections). Review each test in your Lab Order to make sure Scarlet Health can support the specimen collection requirements before sending the Lab Order to Scarlet Health.Instruct the ordering Provider to regularly check their email inbox for notifications from Scarlet Health regarding ineligible Lab Orders.
**Add Dx**
If there are diagnoses that need to be associated with a specific test, use this field to add those diagnoses. Test-level diagnosis codes will take precedence over order-level diagnosis codes. ![Lab requisition form showing the TSH test with "Add Dx" button clicked, revealing a tooltip labeled "Add test specific Dx" and an active text field to enter a test-specific diagnosis code. Diagnosis R94.6 is already linked to TSH.]()
\***Dx for All**
If you've already entered diagnoses in the patient's \*\* Problem List or visit note, these diagnoses will automatically appear in the dropdown menu for you to select. Use the [Problem List Guide](/articles/managing-your-problem-list) to learn more about this feature.
Add diagnoses that are relevant to all the test(s) in the order. Order-level diagnosis codes are secondary to test-level diagnosis codes.
**Coll**
**If you selected \*\* Any site** or \*\* a specific vendor patient service center\*\* for the Site\*\*, optionally specify when the test should be performed in the **Schedule Collection** **Date** field. **If you selected \*\* In-house draw** for the Site\*\*, specify the **Document Collection** date and time that the specimen collection was completed. [Click here to learn about placing a lab order on hold until specimens collection is completed](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection).
\***Patient Condition**
Specify fasting requirements, if any, for the test(s).
**Bill Type**
Specify whom to bill for the lab test(s). As a best practice, ensure the patient's demographic and insurance details in the chart are as comprehensive as possible, as this information may be sent to the lab vendor along with the lab order, depending on the specified **Bill Type**. If you would like to specify a default **Bill Type** for all of your lab orders:
1. Go to **Settings** -> **Lab Orders**.
2. Go to the **Lab Order Settings** section.
3. Use the **Default Bill Type** dropdown to select the default bill type. Your selection will be automatically saved.
Labcorp Requirements For Labcorp, the following insurance and demographics details must be included when eOrdering with Labcorp and the Bill Type is set to **Third Party**. AddressCityStateZipGuarantor - First nameGuarantor - Last nameGuarantor - Relationship Guarantor - AddressGuarantor - CityGuarantor - StateGuarantor - ZipInsurance - Carrier NameInsurance - Carrier AddressInsurance - Carrier CityInsurance - Carrier StateInsurance - Carrier ZipInsurance - Group IDInsurance - Member IDCoverage Type Quest Requirements For Quest, Bill Type must be specified and the following insurance and demographics details must be included when eOrdering with Quest Diagnostics and the Bill Type set to **Third Party**. Insurance - Carrier NameInsurance - Carrier AddressInsurance - Carrier CityInsurance - Carrier StateInsurance - Carrier ZipInsurance - Member IDPrimary Insurance Policyholder (if not ‘Self’)Patient’s relation to policyholder (if not ‘Self’)Primary Insurance Policyholder - First name (if not ‘Self’)Primary Insurance Policyholder - Last name (if not ‘Self’)
**Field / Button**
**Instruction**
**Vendor Specific Requirements**
\***Lab**
Type the first few letters of the lab vendor's name to filter your list of lab vendors.
Select the vendor with whom you are placing the order.
* Use the Labs Settings page to add additional vendors if needed.
Scarlet Health Requirements Electronic lab orders for Scarlet Health are routed through the Bioreference lab interface. Choose Bioreference as the lab vendor when creating lab orders for Scarlet Health.
**Site**
Designate whether the specimen will be collected at any vendor patient service center, a specific vendor patient service center, or in-house. If **Any site** is selected, all patient service centers will receive your order.
* Additional location details can be set on the Labs Settings page, if needed.
\***Tests**
If you cannot find a test in the test search, search for the test using different terms (e.g. the Complete Metabolic Panel is known as **CMP** for Labcorp). If you have a question about a specific test or test code, please contact your lab representative for assistance. Custom tests and test codes are not supported for electronic orders. If the test isn't in the vendor's compendium at all, you can still print an order for it: create a separate lab vendor entry for the same vendor labeled something like "\[Vendor] - Print Only" (**Settings** → **Labs** → **+ Add Lab Vendor**, then confirm **Printed Orders** is enabled on it). From a new Lab Order, select that print-only vendor entry instead of the electronic one, type the full test name to manually add it, then use **Print & Close** or sign and print it afterward from **Actions** → **Print**.
Enter the test(s) you want the patient to complete. You must select a test from the lab vendor’s proprietary compendium, which is maintained and updated monthly by the vendor.
Scarlet Health Requirements Because Scarlet Health shares an interface with Bioreference, you must include the test "TH31-8" in any lab order that is intended for Scarlet Health.Scarlet Health cannot handle specimens that are collected in-house by a healthcare provider or must be collected over an extended time period (e.g. stool specimens, pap smear and biopsy collections). Review each test in your Lab Order to make sure Scarlet Health can support the specimen collection requirements before sending the Lab Order to Scarlet Health.Instruct the ordering Provider to regularly check their email inbox for notifications from Scarlet Health regarding ineligible Lab Orders.
**Add Dx**
If there are diagnoses that need to be associated with a specific test, use this field to add those diagnoses. Test-level diagnosis codes will take precedence over order-level diagnosis codes. ![Lab requisition form showing the TSH test with "Add Dx" button clicked, revealing a tooltip labeled "Add test specific Dx" and an active text field to enter a test-specific diagnosis code. Diagnosis R94.6 is already linked to TSH.]()
\***Dx for All**
If you've already entered diagnoses in the patient's \*\* Problem List or visit note, these diagnoses will automatically appear in the dropdown menu for you to select. Use the [Problem List Guide](/articles/managing-your-problem-list) to learn more about this feature.
Add diagnoses that are relevant to all the test(s) in the order. Order-level diagnosis codes are secondary to test-level diagnosis codes.
**Coll**
**If you selected \*\* Any site** or \*\* a specific vendor patient service center\*\* for the Site\*\*, optionally specify when the test should be performed in the **Schedule Collection** **Date** field. **If you selected \*\* In-house draw** for the Site\*\*, specify the **Document Collection** date and time that the specimen collection was completed. [Click here to learn about placing a lab order on hold until specimens collection is completed](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection).
\***Patient Condition**
Specify fasting requirements, if any, for the test(s).
**Bill Type**
Specify whom to bill for the lab test(s). As a best practice, ensure the patient's demographic and insurance details in the chart are as comprehensive as possible, as this information may be sent to the lab vendor along with the lab order, depending on the specified **Bill Type**. If you would like to specify a default **Bill Type** for all of your lab orders:
1. Go to **Settings** -> **Lab Orders**.
2. Go to the **Lab Order Settings** section.
3. Use the **Default Bill Type** dropdown to select the default bill type. Your selection will be automatically saved.
Labcorp Requirements For Labcorp, the following insurance and demographics details must be included when eOrdering with Labcorp and the Bill Type is set to **Third Party**. AddressCityStateZipGuarantor - First nameGuarantor - Last nameGuarantor - Relationship Guarantor - AddressGuarantor - CityGuarantor - StateGuarantor - ZipInsurance - Carrier NameInsurance - Carrier AddressInsurance - Carrier CityInsurance - Carrier StateInsurance - Carrier ZipInsurance - Group IDInsurance - Member IDCoverage Type Quest Requirements For Quest, Bill Type must be specified and the following insurance and demographics details must be included when eOrdering with Quest Diagnostics and the Bill Type set to **Third Party**. Insurance - Carrier NameInsurance - Carrier AddressInsurance - Carrier CityInsurance - Carrier StateInsurance - Carrier ZipInsurance - Member IDPrimary Insurance Policyholder (if not ‘Self’)Patient’s relation to policyholder (if not ‘Self’)Primary Insurance Policyholder - First name (if not ‘Self’)Primary Insurance Policyholder - Last name (if not ‘Self’)
**3**
Use any of the options below to sign the lab order:
* **eOrder**
* **eOrder & Print**
* (if applicable) **Sign & Hold**
### Transmitting the lab order
#### Transmitting the lab order electronically to the lab vendor
Clicking **eOrder** or **eOrder & Print** will immediately send lab orders electronically to the lab vendor. Afterwards, the signed order will be saved in the patient’s chart.
* The following information will be added to the signed lab order:
* Date & time of the lab order - Stores the date and time the lab order was signed.
* Signed by - Stores the name of Provider (and their delegate, if applicable) that signed the lab order.
* If any issues occur while sending the electronic order, a notification will appear in your **Requiring Action** queue.
**ON-HOLD ORDERS** If you click **Sign & Hold** to hold your order for specimen collection, then the lab order will not be sent to the interfaced lab vendor until a specimen collection date is documented. [Click here to learn about placing a lab order on hold until specimen collection is completed](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection) .
#### Transmitting the lab order to a patient
Attach a signed lab order to a Patient Letter to send a copy of the lab order to the patient via Patient Passport. [Click here for full instructions](/articles/elation-patient-passport-an-introduction#write_message).
### Printing specimen labels
To print specimen labels for the lab order:
1. Locate the order in the **Chronological Record** or under the **Reports** -> **Lab Reports** tab.
2. Click **Actions**
* To [print labels with a Dymo printer](/articles/Orders-Guide-DYMO-printer), select **Print DYMO Specimen Labels**.
* To print labels at the bottom of a regular sheet of paper (compatible with Labcorp forms), select **Print Specimen Labels**.
Below is an example of specimen labels in a printed Labcorp order.
![Printed LabCorp order form for patient "Sick, Patient" showing 4 ordered tests (Antigen Typing RBC, Prenatal Profile IV, Comp. Metabolic Panel, Lipid Cascade), diagnosis codes E11.9 and Z34.90, Bill Type set to Patient, and 8 specimen label stubs at the bottom of the page.]()
### Printing a lab order
To print a lab order (without specimen labels):
1. Locate the order in the **Chronological Record** or under the **Reports** -> **Lab Reports** tab.
2. Click **Actions** -> **Print**.
The print option is only available on signed lab orders. If you don't see an **Actions** menu on the order, confirm it has been signed first.
The printed order shows the ordering provider's name and the date/time they signed as the official signature — this is automatic once the order is signed. Elation does not currently support including a handwritten or image signature on the printout. Some lab vendors, including Quest, do not yet support eSignatures on the lab order requisition; if your vendor requires a pen-to-paper signature, you'll need to sign the printed copy by hand.
## Resources
### Glossary of Lab Order Form fields and buttons
**Field / Button**
**Explanation**
**View Order Sets**
View and apply commonly used [Lab Order Sets](/articles/Managing-lab-order-sets) to the lab order. Only vendor-specific order sets will be available for selection.
**Send STAT via Phone**
**This information will not be printed on the lab order or sent electronically to the lab vendor.** Reach out to the lab vendor separately to request results urgently.
**Send STAT via Fax**
**This information will not be printed on the lab order or sent electronically to the lab vendor.** Reach out to the lab vendor separately to request results urgently.
**Lab Requested Information**
Answer any test-specific ask-on-entry (AOE) questions that appear in the **Lab Requested Information** section after selecting a test. Any unanswered questions may prompt the lab to contact you for verification before the patient can proceed with the order.
**Show and print dual codes**
Show both ICD-9 and ICD-10 codes for selected diagnoses.
**Save as Order Set**
Save the tests, test-level diagnosis codes and order-level diagnosis codes listed as a new Order Set.
**Check Medicare Eligibility**
Click the **Check Medicare Eligibility** button that appears whenever ‘Third Party (e.g. Insurance)’ is selected as the **Bill Type** if you wish to verify Medicare coverage for the selected lab tests and diagnoses through the lab vendor’s Advanced Beneficiary Notice service. If the patient is not covered, the estimated test cost will be displayed, and a printable Advanced Beneficiary Notice (ABN) form will be generated for the patient to complete.
**Lab Instructions**
**This information is not transmitted in an eOrder.** Reach out to the lab vendor separately if you have any special instructions for them.
**Notify via**
**This information is not transmitted in an eOrder.** Add an internal note about how your practice should notify the patient about their lab results.
**Send a copy of test results to…**
**REMINDER** Labs are not obligated to share the results with the providers listed. This instruction is a courtesy request.
List the name(s) of provider(s) to whom the lab vendor should send a copy of the results.
**St. Order**
**This information is not transmitted in an eOrder.** Reach out to the lab vendor separately if you wish to designate a standing order.
**RMDR**
**This information is not transmitted in an eOrder.** Specify who to send an Elation alert to if results are not received by a specified date. The **Reminder date** is the date the reminder will be sent.
**Keep this confidential**
If you mark a record as confidential, that record will always have a special indicator when this order is shown in the patient's chart. This indicator will prompt members of your practice to take caution when printing or sharing the record. Learn more about confidential records in the [Patient Chart Guide- Managing confidential records](https://elation.lightning.force.com/articles/Knowledge/confidential-items-in-your-patient-chart) article.
**This information is not transmitted in an eOrder.** Check the **Keep this confidential** box to mark the order as a confidential record in the patient’s chart.
**eOrder**
Send the lab order electronically to the lab vendor immediately.
**eOrder & Print**
Send the lab order electronically to the lab vendor immediately and then print the lab order.
**Sign & Hold**
Simultaneously sign the lab order and put the lab order on hold. This option will only be active if you selected **in-house labs** for the Site and left the **Document collection** date blank. The lab order will not be sent to the lab vendor until the Document collection date is documented. [Click here to learn about placing a lab order on hold until specimen collection is completed](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection).
**Save as Draft**
Save the lab order as a draft and close the lab order window. The lab order draft will remain in the **Requiring Action** section of the patient’s chart until it is signed or discarded.
**Discard**
Delete the lab order draft.
**X**
Save the lab order as a draft and close the lab order window. The lab order draft will remain in the **Requiring Action** section of the patient’s chart until it is signed or discarded.
## Frequently Asked Questions
### Lab Order Form Usage
#### How many lab tests can I add to a single lab order?
You can add up to 40 lab tests per lab order.
#### How many diagnosis codes can I add to a single lab order?
You can add up to 120 unique diagnosis codes per lab order.
#### Do I need to add a test-level diagnosis code to every test in the lab order?
No, adding a test-level diagnosis code to every test in the lab order is not required. Tests without a test-level diagnosis code will automatically be linked to the order-level diagnosis codes.
#### Do I need to add order-level diagnosis codes to a lab order if it already has test-level diagnosis codes?
No, order-level diagnosis codes are not required if each test has an associated test-level diagnosis code. However, if any test lacks a test-level diagnosis code, you must either assign a test-level diagnosis code to that test or add an order-level diagnosis code.
#### How does the lab interpret test-level diagnosis codes versus order-level diagnosis codes?
Test-level diagnosis codes precede order-level diagnosis codes. See the example below:
![Lab requisition form for Jane Smith showing LabCorp selected, two tests (CBC w/Plts and BMP) in the highlighted Tests field, with BMP expanded to show test-level diagnosis codes C22.1 and H40.1190, and order-level Dx for All showing E11.9 Type 2 diabetes mellitus. Patient Condition set to Fasting - 12 hours.]()
* The CBC test was not assigned any test-level diagnosis codes, so it will be linked only to the order-level diagnosis code E11.9, which will be treated as the primary diagnosis code for the CBC test.
* The BMP test was assigned two test-level diagnosis codes and is also linked to the order-level diagnosis code E11.9:
* C22.1 will be treated as the primary diagnosis code since it is the first test-level diagnosis code.
* H40.1190 will be treated as the secondary diagnosis code as it is the second test-level diagnosis code.
* E11.9 will be treated as the tertiary diagnosis code because it is associated at the order-level.
#### Can I move a diagnosis code from the test-level to the order-level or vice versa?
Diagnosis codes cannot be dragged-and-dropped to relocate them. To change their placement, delete the code from the current location and re-add it to the desired one.
#### How can I tell whether a signed lab order was placed as "Any site" or "In-house draw"?
Check whether the order has a **Collection date**. Only In-house draws have a Collection date.
#### What do the different Bill Types mean?
* **Third Party** = Bill the Patient's insurance information on file
* **Patient** = Bill the Patient directly
* **Client** = Bill my practice
* **Worker's Comp** = Bill the patient's worker's compensation payer
* **Special Billing** = Allows you to designate that you have a special code that you would like to associate with this order.
### Special Ordering Scenarios
#### How can I create a lab order for patients without insurance?
If you choose **Patient** as the **Bill Type** then you do not have to enter insurance information for the patient. The patient would then be expected to pay at the lab center.
#### How do I create a standing order for a patient that needs to get the same tests done on a periodic basis?
Contact the lab vendor directly to set up a standing order for a patient requiring periodic testing as the Elation Electronic Lab Order Form does not support standing orders.
#### How do I change or cancel a lab order after it has been sent electronically?
Elation does not support canceling or modifying an eOrder from within the application once it has been transmitted to the lab vendor. Contact the lab vendor directly to change or cancel the order.
#### How do I create a lab order for Quest’s Patient Service Center (PSC)?
To specify that a lab order is for any Quest Patient Service Center (PSC), choose **Any Site** in the **Site** field of Lab Order Form. This will allow the patient to complete the Lab Order at any Quest location of their choice.
#### How do I create a lab order through Quest’s Uninsured Patient Program (UPP)?
To designate a lab order under the Quest Uninsured Patient Program (UPP), contact your Quest representative to obtain the required insurance name and address for eOrdering. Ensure this Insurance Carrier is set for any patient enrolled in UPP. When a lab order is submitted with the UPP insurance details, Quest's Insurance Master Database will recognize the address, match it to the corresponding Quest UPP payer code, and bill the patient accordingly.
### Permissions
#### Can staff members help me create lab orders?
Yes! Staff Level Users can draft lab orders for any patient. Once they are done drafting an order, Staff Level Users can click **Save as Draft & Close** to keep the lab order in the **Requiring Action** section of the patient's chart for providers to complete and sign off. When Staff Level Users draft lab orders, the orders are always assigned to the Provider Assigned in Practice that's designated in the patient's demographics.
**To allow staff members to sign and submit lab orders on your behalf:**
| **1** | Go to **Settings** → **Provider Managed Delegates** (under User Settings). |
| ----- | ------------------------------------------------------------------------------------------------------------- |
| **2** | Go to the **Sign Orders** section. |
| **3** | Click in the field that says **Add new order delegate** under **AUTHORIZED ORDER DELEGATES** . |
| **4** | Search for the name of the Staff Level User and click their name to add them as an Authorized Order Delegate. |
Once assigned, the staff member can sign and electronically send lab orders on your behalf. The signed order will display: **Signed off for \[provider's full name] by \[delegate's full name].**
#### Why can my staff only save lab orders as drafts and not submit them?
By default, Staff Level Users can only draft lab orders—they cannot click **eOrder** or **eOrder & Print** to submit orders electronically. This is expected behavior.
To allow a staff member to submit electronic lab orders on your behalf, a Provider Level User must assign them as an **Authorized Order Delegate**:
| **1** | The Provider Level User logs in to their own Elation account. |
| ----- | ------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** → **Provider Managed Delegates** (under User Settings). |
| **3** | Go to the **Sign Orders** section. |
| **4** | Click in the field that says **Add new order delegate** under **AUTHORIZED ORDER DELEGATES** . |
| **5** | Search for the name of the Staff Level User and click their name to add them as an Authorized Order Delegate. |
After this setup, the staff member will see the **Ordering on behalf of** field on the Lab Order Form, and can submit the order using **eOrder** or **eOrder & Print**. The order records the provider shown in the **Ordering on behalf of** field as the ordering provider.
* If the staff member is a delegate for a **single** provider, that provider is shown in the **Ordering on behalf of** field and is used automatically.
* If the staff member is a delegate for **multiple** providers, the **Ordering on behalf of** field is a dropdown. Providers are listed **alphabetically by last name**. If the patient's assigned primary physician is one of the staff member's providers, that physician is selected by default; otherwise the field is left blank and the staff member must select a provider before signing.
When a staff member is a delegate for multiple providers, always confirm the **Ordering on behalf of** field shows the correct provider before signing. The default selection is based on the patient's assigned primary physician and may not be the intended ordering provider.
Only users with Provider-level access can modify their own delegate settings.
**Premium EHR Only** - Admin Level Staff Users can designate all Staff Level Users as an Orders Delegate via the [Admin Managed Delegates feature](/articles/staff-permissions--staff-delegates#practice-level-delegates).
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Using the regular Lab Order Form](/articles/Regular-Lab-Order-Form)
* [Lab Orders & Results - Managing lab vendors](/articles/Managing-lab-vendors)
* [Lab Orders & Results - Managing electronic lab results](/articles/Viewing-results-from-lab-interfaces)
* [Orders Guide- Following up on outstanding orders & referrals](/articles/follow-up-outstanding-orders-referrals)
# California State- CAIR- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Electronically-submit-immunizations-from-the-patient-chart-to-California-s-immunization-registry-CAIR
This article will describe how you can submit vaccination data to the California Immunization Registry [CAIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the California State Immunization Registry known as CAIR.
## What is the CAIR Immunization Registry Interface?
The CAIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to CAIR- the California Immunization Registry. Practices can also query CAIR for vaccination history or forecast.
## Why is the CAIR Immunization Registry Interface valuable?
With the CAIR Immunization Registry Interface, practices no longer need to separately log in to CAIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to CAIR. You can also pull vaccination history for specific patients from CAIR to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & CAIR
The Elation Team will assist you with initiating an interface with CAIR. First you must notify CAIR of your intent to connect electronically via Elation EHR via one of the steps below. After you have notified CAIR, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
* Your CAIR Site ID for each office location
### (New to CAIR) Register to submit immunizations electronically via Elation
1. Navigate directly to the [CAIR registration page](https://igs.cdph.ca.gov/CAIR/Provider/Register).
2. Under **Site intends to** section, choose the second option, that your Site intends to **Submit immunization data through a Sending Facility.** (A “Sending Facility” is a vendor like Elation that submits records on your behalf.)
3. You will then be prompted to enter the **Sending Facility ID of your Data Submitter.** Elation’s Sending Facility ID is *SF-001728*.
4. Complete the required fields about your practice and your practice’s contact information (fields in red text are required for registration).
5. Under **Data Exchange Information**, enter the following information:
* What is the name (+version) of the EMR/EHR software used by this office? ElationEMR v3
* Which vendor developed the EMR/EHR software used by this office? Elation Health
* Is this EHR/EHR Certified? YES
* Can this EMR/EHR send HL7 formatted data? YES
* DE/Vendor Contact First Name: Elation
* DE/Vendor Contact Last Name: Support
* Company: Elation Health
* Position: (Leave blank)
* Phone: 415-231-5178
* Email: [integrations@elationhealth.com](mailto:integrations@elationhealth.com)
* Retype Email: [integrations@elationhealth.com](mailto:integrations@elationhealth.com)
![CAIR registration Data Exchange Information form filled with Elation Health v3, HL7 set to YES, vendor contact "Elation Integrations," phone 415-231-5178, and email integrations@elationhealth.com]()
1. Click **Continue** and review the CAIR Organization Access & Confidentiality Agreement. If you have reviewed the information and wish to continue,
2. Check the box to agree that your Organization will abide CAIR rules.
3. Enter the name of your Organization Representative
4. Enter the title of your Organization Representative
5. Click **Complete Site Registration**
### (Existing CAIR User) Register to submit immunizations electronically via Elation
If you are already registered with CAIR and have your CAIR ID, you can log into the [CAIR IZ Portal](https://igs.cdph.ca.gov/cair/) using your CAIR ID and zip code.
*
If you are not sure what your CAIR ID is or your zip code is not working with your CAIR ID, you will need to contact [CAIRDataExchange@cdph.ca.gov](mailto:CAIRDataExchange@cdph.ca.gov) or 800-578-7889 for assistance.
Once logged in, you can complete a form to notify CAIR you would like to start submitting immunization data electronically via Elation EHR. Under **Data Exchange Information**, enter the following information:
* What is the name (+version) of the EMR/EHR software used by this office? ElationEMR v3
* Which vendor developed the EMR/EHR software used by this office? Elation Health
* Is this EHR/EHR Certified? YES
* Can this EMR/EHR send HL7 formatted data? YES
* DE/Vendor Contact First Name: Elation
* DE/Vendor Contact Last Name: Support
* Company: Elation Health
* Position: (Leave blank)
* Phone: 415-231-5178
* Email: [integrations@elationhealth.com](mailto:integrations@elationhealth.com)
* Retype Email: [integrations@elationhealth.com](mailto:integrations@elationhealth.com)
## How to submit vaccination data to CAIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to CAIR. Learn more about how to use the Vaccine Form using the [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide).
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using CAIR
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the ['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR).
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
### How do I use the CAIR IZ Portal?
[This is a helpful video on manually documenting vaccinations in CAIR2](https://www.youtube.com/watch?v=guH29UKtQE4) and[this is the User Guide](http://cairweb.org/docs/CAIR2RegularUserGuide_092616.pdf). You can also contact CAIR at 800-578-7889, Hours: 9am-4pm Monday to Thursday, 10am-4pm Friday or at [CAIRHelpdesk@cdph.ca.gov](mailto:CAIRHelpdesk@cdph.ca.gov).
### How do I know if I am registered with CAIR? How do I find my CAIR ID?
If you have registered with CAIR using the [CAIR2 IZ Portal Registration form](https://igs.cdph.ca.gov/CAIR/Provider/Register) before, you may log into the [CAIR2 IZ Portal Login](https://igs.cdph.ca.gov/cair/) using your CAIR ID and zip code to confirm your site is registered to submit immunizations electronically to CAIR.
If you are not sure what your CAIR ID is or your zip code is not working with your CAIR ID, you will need to contact [CAIRDataExchange@cdph.ca.gov](mailto:CAIRDataExchange@cdph.ca.gov) or 800-578-7889 for assistance.
## Related Articles
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
# Fax Inbox Guide - Managing fax settings & fax usage
Source: https://help.elationhealth.com/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage
This article describes the Fax Usage & Settings section of the EHR Settings.
This article describes the Fax Usage & Settings section of your EHR Settings.
📖
**RECOMMENDED READING**
[Click here for an introduction to the Fax Inbox feature in the EHR](/articles/Fax-Inbox-Introduction)
.
***
**Overview**
## What settings can be configured for my faxes?
There are two settings that you can configure:
1. Specify whether documents in your fax inbox are sorted by default by **Newest** or **Oldest**.
2. Specify whether attachments should always be included on outbound Letters and Referrals. Click here to learn more about outbound faxes.
## What is fax usage?
Your practice’s fax usage for a month is the total number of fax pages sent and received by everyone at your practice.
[Click here for more information about fax usage and how to monitor it](/articles/fax-usage)
.
## Workflow Instructions
### Adjusting your default for fax sorting
To specify how you'd like documents in your fax inbox to appear:
1. Go to **Settings** in Elation.
2. Go to the **Fax Usage & Settings** page.
3. Select the radio button for **Default fax sorting** for **Newest** or **Oldest**.
### Adjusting your default for fax attachments
To specify that you want to always include attached documents with your outbound faxes:
1. Go to **Settings** in Elation.
2. Go to the **Fax Usage & Settings** page.
3. Adjust the toggle for\*\* Fax all attachments by default\*\* to **Yes**.
### Monitoring fax usage
[Click here for more information about fax usage and how to monitor it](/articles/fax-usage).
## Related Articles
* [Fax Inbox Introduction](/articles/Fax-Inbox-Introduction)
* [Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox)
* [Fax Inbox Guide - Actioning on documents within the Fax Inbox](/articles/Actioning-on-documents-within-the-Fax-Inbox)
* [Fax Inbox Guide - Filing documents from the Fax Inbox into a patient's chart](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
* [Letters & Referrals Introduction- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
# Fax Inbox Introduction
Source: https://help.elationhealth.com/articles/Fax-Inbox-Introduction
This article describes the Fax Inbox, located in your Practice Home, and all of its features.
This article describes the Fax Inbox, located in your Practice Home, and all of its features.
## Overview
### What is the Fax Inbox?
The Fax Inbox is a repository of all of the following:
* all [faxes received electronically through your assigned Elation fax number](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox), which was provided when you first started using Elation EHR.
* any documents you manually [upload to your Fax Inbox](/articles/Uploading-documents-to-the-Fax-Inbox).
* any reports that are re-filed from a patient's chart in Elation.
### What are the benefits of the Fax Inbox?
As a medical practice, you manage a large volume of patient reports and records. To assist with maintaining these records electronically, Elation assigns each customer a unique Elation fax number when they begin using Elation EHR. We recommend routing all your faxes to this number as a best practice. This will automatically convert faxes into electronic records, making it simple to file them into your patients' charts and reducing the need for physical paperwork.
## Features
### Fax Inbox Sections
The Fax Inbox is typically divided into two sections.
* **Incoming Documents** - stores all faxes received electronically through your Elation fax number.
* **Unfiled Images**- stores any reports that are re-filed from a patient's chart in Elation.
You can also manually upload documents from your computer into any of the two sections listed above.
### Fax Inbox Layout
1. You will see toolbar at the top of each [section](#sections) of the Fax Inbox with the following options:
* **Newest** - sort documents by the newest received documents first; the default is oldest first
* **Oldest** - sort documents by the oldest received documents first; this is the default
* **Recently Deleted** - see recently deleted faxes (and restore them if needed)
* **Upload Files** - upload documents from your computer to this section of the Fax Inbox
2. Underneath the toolbar is your documents
* Documents are grouped by either
* each fax transmission
* the same uploaded report/record
* The title of each listing is either
* the fax number or name of the sender (if available) for faxed documents
* the name of reports (as labeled on your computer)
* The number of pages of each listing is visible to the right of the title.
* The date and time the documents reached the Fax Inbox will be on the right.
3. When you expand a document you will see the following:
* A toolbar for you to take the following actions on the document:
* **Select All**
* **Rotate Left**
* **Rotate 180**
* **Rotate Right**
* **Add to Queue**
* **Delete**
* The first 5 images of the document
* If there are additional pages, click on the **More** button to see the next 5 images within that listing.
[Click here to learn more about actioning on documents within the Fax Inbox](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
.
## Workflow Instructions
### Managing documents in the Fax Inbox
You can take the following actions in the Fax Inbox:
* [Upload documents to the Fax Inbox](/articles/Uploading-documents-to-the-Fax-Inbox)
* [Action on documents within the Fax Inbox](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
* [Restore recently deleted documents](/articles/Restoring-documents-deleted-from-the-Fax-Inbox)
* [File documents to the patient’s chart](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
### Managing your Fax Settings
[Click here to learn more about Fax Settings](/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage)
.
### Managing your Fax Usage
[Click here to learn more about Fax Usage and how to manage your Fax Usage in the EHR](/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage)
.
## Frequently Asked Questions
### Another office said they sent a fax to me but I do not see it in my Fax Inbox. Did something go wrong?
It can take up to 30 minutes for a fax to reach your Fax Inbox once it has been sent by the other office. This is due to the processing time and integration time that comes with using electronic faxing. If you do not see the fax after 30 minutes, ask the sender to send it again in case there were any sending issues. If the sender is not having any sending issues, reach out to the Support Team using the
**I need help**
**->**
**Contact Elation Support**
button, provide us with the following information and we will gladly assist you with troubleshooting the issue:
1. The fax number the sender is using to fax to you.
2. The approximate date and time the fax attempt was made.
3. The number of pages of the fax transmission.
4. The number of fax attempts made.
5. Any error messages flagged by the sender's fax number or fax machine.
### Is there a way to limit the number of pages I receive on an incoming fax?
No, Elation does not have a setting to cap or automatically limit the number of pages on an incoming fax. Any pages sent to your Elation fax number will be received in full, provided the sending system successfully transmits them.
### Does Elation automatically file inbound faxes into a patient's chart based on the cover page (e.g. name, DOB)?
No. Elation does not support automatic "auto-charting" of inbound faxes based on information printed on the cover page. Incoming faxes are not OCR-matched or auto-filed to a chart; all inbound faxes are routed into the Fax Inbox, where staff review and manually file the pages into the correct patient chart.
### I accidentally deleted a document from my Fax Inbox, is there a way for me to retrieve it?
Click the
**Recently Deleted**
button at the top of the Fax Inbox to see all the recently (last 7 days) deleted faxes. Once you find the pages you want to restore, select all the pages and then click the
**Restore**
button at the top of the listing. Afterwards, click the
**Recently Deleted**
button again to return to the main Fax Inbox.
### Can I block a specific fax number from sending me faxes?
There's no setting within Elation to block an incoming fax number yourself. Fax delivery is handled by Elation's fax vendor, and any block they apply is across their entire network, not just for your practice — so blocks are only considered for confirmed spam or fraudulent faxes.
If faxes are coming from a legitimate sender (a lab, imaging center, or referring office), contact them directly and ask them to stop sending or update their routing. If you believe the faxes are spam or fraudulent, use **I need help** -> **Contact Elation Support** with the sending fax number and a few recent examples (with dates) so the request can be reviewed with the fax vendor.
## Related Articles
* [Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox)
* [Fax Inbox Guide - Uploading documents to the Fax Inbox](/articles/Uploading-documents-to-the-Fax-Inbox)
* [Fax Inbox Guide - Actioning on documents within the Fax Inbox](/articles/Actioning-on-documents-within-the-Fax-Inbox)
* [Fax Inbox Guide - Restoring documents deleted from the Fax Inbox](/articles/Restoring-documents-deleted-from-the-Fax-Inbox)
* [Fax Inbox Guide - Filing documents from the Fax Inbox into a patient's chart](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
* [Fax Inbox Guide - Managing fax settings & fax usage](/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage)
# Elation Health - Elation features for Privacy Requirements
Source: https://help.elationhealth.com/articles/Features-for-Privacy-Requirements
This article describes the Elation features that may be leveraged to meet your privacy requirements.
## Privacy Requirements
Certain state and federal laws may require restricting sensitive patient data when sharing patient information. While Elation offers comprehensive resources and support to help you navigate the complexities of data sharing, it is essential to understand that the responsibility of meeting regulatory and compliance requirements is relative to each provider and practice. Elation provides the tools and guidance to facilitate these processes; however, we are not accountable for ensuring that all provider-specific requirements or standards are met. Each healthcare provider must take responsibility for ensuring that their practices align with relevant laws, regulations, and guidelines.
## Related Features
Elation currently offers the following product features that may be leveraged to meet your privacy requirements.
* The VIP Chart Feature allows providers to restrict certain charts within a practice: [Patient Chart Guide- Marking charts as VIP for restricting access (Premium)](/articles/vip-chart-feature)
* Limiting access to patient charts based on patient criteria (Premium)
* Confidential records feature and tagging is currently the best practice to restrict sensitive information from being shared: [Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
* This feature allows you to run reports based on document needs: [Report Category Guide- Categorizing patient documents](/articles/report-types)
* The patient forms are what many providers leverage for their patient consent workflows: [Patient Forms Guide](/articles/Patient-Forms-Guide)
# Fax Inbox Guide - Filing documents from the Fax Inbox into a patient's chart
Source: https://help.elationhealth.com/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart
This article describes how to file documents from the Fax Inbox into a patient's chart.
📖
\*\* RECOMMENDED READING \*\*
[Click here for an introduction to the Fax Inbox feature in the EHR](/articles/Fax-Inbox-Introduction)
.
**Contents**
* [Overview](#overview)
* [How is the fax inbox organized?](#organization)
* [How do I transfer a document from the Fax Inbox to a patient’s chart?](#description)
* [Workflow Instructions](#workflow_instructions)
* [Queueing documents in preparation for filing](#queue_documents)
* [Filing a document to a patient’s chart](#filing_documents)
* [Reviewing assigned documents](#review_documents)
* [Frequently Asked Questions (FAQ)](#faq)
## Overview
### How is the fax inbox organized?
Within your fax inbox, you'll see a tab for your Elation fax line(s) and a tab labeled **Unfiled Images (non-fax)**.
* The fax line tab(s) will contain any inbound transmissions received by your Elation eFax number.
* The **Unfiled Images** tab will contain any reports that have been removed from a patient's chart but are awaiting re-filing.
Under any of these tabs, you can upload documents from your computer to Elation.
### How do I transfer a document from the Fax Inbox to a patient’s chart?
Use the workflows below to learn how to transfer documents from any of the Fax tabs into the appropriate patient's chart.
## Workflow Instructions
### Queueing documents in preparation for filing
![Unfiled Images tab open showing "Sample Lab Report Quest Diagnostics.pdf" expanded, with both pages marked "Added to Queue," the Select All button highlighted, and the File button highlighted in the Queue panel on the right.]()
To queue a document in preparation for filing:
| **1** | Click the name of the document to expand a preview of its pages. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Select all the pages of the document you want to file using one of the following methods: To select an individual page, click on the box in the upper left hand corner of each page preview . • To select all pages within the document, click **Select all** at the top of the document. |
| **3** | At the top of the document, click **Add to Queue** in the toolbar. You will see your selected pages appear on the right side of the Fax Inbox in the **Queue** section. Pages that have already been added to the Queue will become grayed out so that you know which pages have been selected. This effect also locks the pages for other users in your practice to block them from taking action on the pages you're actively working on. |
| **4** | (Optional) Take any of the following actions within the Queue if needed: Change the order of the pages by dragging and dropping the page previews. • Click **Print** to print all pages in the Queue. • Click **Empty Queue** to release all pages from the Queue back into the fax inbox. • Click **Delete Images** to delete all pages from your fax inbox entirely. Use this button with caution. |
| **5** | Click **File** to continue to the next step. |
### Filing a document to a patient’s chart
!["Assign & File Document into Patient Chart" form overlaid on a radiology report, with Patient, Provider, Date, Doc Type set to "Imaging Report," and Title filled as "Lumbar spine"]()
To file a document into a patient’s chart:
**1**
In the **Assign & File Document Into Patient Chart** form, fill in the following fields. Fields with an asterisk (\*) are required:
* **Patient**\* - The patient the document belongs to.
* **Provider**\* - The Provider responsible for reviewing, maintaining, and possibly signing the document.
* **Date**\* - The date of the document.
* **Document Type**\* - The type of report this document should be categorized as.
* [Click here to learn more about Report Categories and how to adjust your Report Categories list](/articles/report-types).
* **Tags** - The [document tag(s)](/articles/tag-reports-and-notes-with-document-tags) you want to associate with the document.
* **Title** - The name of the document.
**2**
To show the report in the **Urgent** inbox of the assignee's Practice Home queue, check off the **Mark Urgent** box.
**3**
Check off the **File on behalf of Provider** box if one of the following scenarios is true: Document has already been physically reviewed and signed by the provider outside of Elation.
Document does not require provider sign-off (ex. copy of the patient’s insurance card).
To indicate the report doesn't need to be signed, check off the **File on behalf of Provider** box.
**4**
(Optional) To delegate the sign-off responsibility to a Staff Level User or User Group, input their name in the **Delegate to** field. ![Assign & File Document form with "Emily Staff" entered in the highlighted Delegate to field, and the "Assign for Delegate Sign-Off" button visible at the bottom.]()
**5**
To complete the filing workflow, take the action below that matches your use case:
* If **File on behalf of reviewer** was selected - click **File Into Chart.**
* The document won't need to be signed; it'll be added directly to the Chronological Record of the patient's chart.
* If you specified a delegate - click **Assign for Delegate Sign-off.**
* The document will appear in the staff/staff user group's Reports queue and require sign-off.
* If neither of the above apply - click **Assign for Sign-off.**
* The document will appear in the Reports queue of the provider whose name was inputted earlier in the form. It will need to be signed.
Contact Support to request the **Delegate to Staff** feature.
To delegate sign-off to more than one Staff Level User, you must first create a [User Group](/articles/user-groups) that includes all staff who are delegates and then input this User Group into the **Delegate to** field.
**Locating faxes filed from the Fax Inbox**
Once a fax is filed and routed for sign-off:
* The document appears in the assigned provider’s or staff delegate’s **Reports** queue in **Practice Home**.
* The document also appears in the **Requiring Action** section of the patient’s chart until signed off.
After sign-off, or if **File on behalf of Provider** was selected during filing, the document is stored in the patient’s **Chronological Record**.
#### Reviewing assigned documents
If you see any reports in the **Reports** inbox of your **Practice Home**, this means the report has been assigned to you for review and sign off. To review and sign the assigned reports:
1. Click on the patient’s name to open their chart.
2. Review the report in the Requiring Action section at the top of the chart.
3. Click **Sign Off** if you're a Provider Level User or **Sign off on behalf of provider** if you're a Staff Level User.
📖
\*\*SEE ALSO \*\*
[Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax)
for details on sending faxes and troubleshooting failures to send.
## Frequently Asked Questions
### If multiple people are operating in the Fax Inbox, can someone else take action on the same pages that I'm filing?
When you add pages to the filing queue, other users in the Fax Inbox will see those pages as locked images. This experience will deter others from taking conflicting action on pages that are already being processed.
If a user wishes to take action on a locked image, they must first click **Unlock Image**.
![Two fax document pages showing "Currently edited by Karly Smith, MD (since 03/04/2022 11:10 am)" overlay with Unlock Image buttons, highlighted to illustrate locked image state.]()
### Will the Provider’s signature still be appended to clinical documents if the documents were filed or signed by a Staff Level User?
Yes, a Provider’s signature will always be appended to clinical documents that were filed or signed by a Staff Level User. The signature will have the following format: ***Signed off for \[PROVIDER NAME] by \[STAFF NAME] on \[DATE & TIME SIGNED]***.
### Can a Provider still sign off on a Report that was delegated to a Staff Level User?
Yes, a Provider can still sign off on a Report that was delegated to a Staff Level User from the Requiring Action section of the patient’s chart.
### After I delegate sign-off to a Staff Level User and click "Assign for Delegate Sign-off," can I change the delegate assignment to a different Staff Level User or User Group?
After you delegate sign-off and click **Assign for Delegate Sign-off**, you will not be able to change the delegate to a different Staff Level User or User Group. You will only be able to change the assignment to a Provider Level User.
### Can I restrict which staff can be selected as delegates for signing documents?
No, you cannot restrict which staff can be selected as delegates for signing documents. Any active Staff Level Users in the practice can be selected as a delegate. If you are using the Workspaces feature, then any Staff Level Users within a given Workspace can be selected as a delegate.
### Can I delegate sign off to multiple users?
Yes, you can delegate sign off to multiple users but those users must first be added to the same User Group. You cannot input the names of multiple users or multiple User Groups in the **Delegate to** field.
### Can I delegate to multiple user groups?
No, currently you can only delegate sign off to a single user group.
### Why is the Provider seeing a Report that was delegated to a user group?
If a Provider can see a Report that was delegated to a User Group in their Reports inbox, this means the Provider is a member of the delegated User Group. If your objective is to remove a Provider from the sign-off process, please remember to remove them from the User Group(s) that are used for delegation.
### Can I send a signed faxed document back to the office that faxed it to me?
There is no dedicated **Send** option for faxed documents in Requiring Action. Once you sign off on a faxed document, it becomes a signed record, so you can attach it to a new [Provider Letter](/articles/letter-and-referral-introduction) and fax it to the originating office's fax number.
## Related Articles
* [Fax Inbox Introduction](/articles/Fax-Inbox-Introduction)
* [Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox)
* [Fax Inbox Guide - Uploading documents to the Fax Inbox](/articles/Uploading-documents-to-the-Fax-Inbox)
* [Fax Inbox Guide - Actioning on documents within the Fax Inbox](/articles/Actioning-on-documents-within-the-Fax-Inbox)
* [Fax Inbox Guide - Managing fax settings & fax usage](/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage)
# Florida State- FL SHOTS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Florida-State-FL-SHOTS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Florida State Immunization Registry [FL SHOTS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Florida State Immunization Registry known as FL SHOTS.
## What is the FL SHOTS Immunization Registry Interface?
The FL SHOTS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to FL SHOTS; a Florida State Health Online Tracking System. Practices can also query FL SHOTS for vaccination history or forecast.
## Why is the FL SHOTS Immunization Registry Interface valuable?
With the FL SHOTS Immunization Registry Interface, practices no longer need to separately log in to FL SHOTS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to FL SHOTS. You can also pull vaccination history for specific patients from FL SHOTS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & FL SHOTS
The Elation Team will assist you with initiating interface with FL SHOTS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**.
## How to submit vaccination data to FL SHOTS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to FL SHOTS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using FL SHOTS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide.](/articles/Vaccination-Form-Guide#query_IR)
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide.](/articles/Vaccination-Form-Guide#query_errors)
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Georgia State- GRITS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Georgia-State-GRITS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Georgia State Immunization Registry [GRITS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with Georgia State's Immunization Registry (GRITS).
## What is the GRITS Immunization Registry Interface?
The GRITS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to GRITS; Georgia Registry of Immunization Transaction and Services. Practices can also query GRITS for vaccination history or forecast.
## Why is the GRITS Immunization Registry Interface valuable?
With the GRITS Immunization Registry Interface, practices no longer need to separately log in to GRITS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to GRITS. You can also pull vaccination history for specific patients from GRITS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & GRITS
The Elation Team will assist you with initiating interface with GRITS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. Does your practice participate in Vaccines for Children (VFC)?
2. What is your GRITS organization code?
3. What county is your practice in?
4. Who will be the primary contact with GRITS? Please provide a name and email.
## How to submit vaccination data to GRITS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to GRITS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using GRITS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
**Does the GRITS interface support vaccine inventory management?**
Yes, the GRITS interface supports vaccine inventory management. You will need to opt-in for this feature by following these steps:
1. Reconcile your physical inventory and what is recorded in GRITS
2. [Fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and notify us you want to use the inventory management feature with GRITS
3. A member of the Elation Team will work with you and GRITS to enable this feature
## Related Articles
* [Immunization Registry Interface Introduction](/articles/Immunization-Registry-Interface-Introduction)
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Patient Forms Introduction
Source: https://help.elationhealth.com/articles/Getting-Started-with-Patient-Forms
The Patient Forms feature allows you to customize electronic intake forms and import patient responses and consents directly into your Elation charts.
## Overview
### What are Patient Forms?
The Patient Forms feature lets you create and customize electronic intake forms that patients can complete at any point in their care journey.
You can build forms in several ways:
* Use pre-built templates, sections, and questions.
* Create your own questions and sections from scratch.
* Convert a PDF or image of a form into a structured form.
Patient Forms integrate seamlessly with features like **Appointment Reminders** and the **Booking Site** giving you flexibility in how and when forms are shared. You can send patient forms automatically with scheduled appointments or manually by emailing them directly to patients.
Once a form is completed, Elation automatically tracks it and stores a copy in the patient’s chart. You can easily reference the responses in the Clinical Profile or within your Visit Notes.
### What are the benefits of Patient Forms?
The Patient Forms feature helps you collect essential information from patients electronically—reducing the administrative burden of manual data entry and making intake faster, more accurate, and more convenient for both your staff and your patients.
Because forms can be completed anytime during the care journey, patients can fill them out at their convenience—whether they’re coming into the office or receiving virtual care. This streamlines the intake process and supports more efficient, high-quality care. Most practices send forms ahead of a scheduled visit to ensure everything is ready when the patient arrives.
### What kind of forms can I create?
Common use cases for Patient Forms include:
* **First encounter intake**: demographics, insurance information, and clinical history
* **Consent form** s: signatures for various services or treatments
* **Pre-visit screening**: health questionnaires and history updates before appointments
The question formats available are:
| **Question Format** | **Use Case** | **Example** |
| ------------------- | ----------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------- |
| Short answer | A single-line text field where the patient can type a brief, free-text response. | “What is the name and address of your preferred pharmacy?” |
| Patient signature | Allows patients to provide their electronic signature. | “Please sign below to consent to treatment.” |
| Dropdown Select | A list of options that appears when the patient clicks the dropdown menu. The patient can choose only **one** answer from the list. | “Select your primary language.” |
| Radio Select | A set of visible options displayed as circles. The patient can choose only **one** answer. | “What is your current smoking status?” |
| Checkbox | A list of options with checkboxes. The patient can choose **one or more** answers. | “Which symptoms are you experiencing?” |
| Free-text list | Allows patients to enter several responses, saved as individual items. | “List any supplements you’re currently taking.” |
[Click here to view sample uses cases for Patient Forms](/articles/Patient-Forms-Sample-Forms-and-Use-Cases)
.
## Setup
### Creating & managing Patient Forms
You must first create your Patient Forms before you can send forms to patients. [Click here for step-by-step instructions about creating and managing Patient Forms.](/articles/Patient-Forms-Guide)
### Adding report categories for completed forms
By default, completed Patient Forms are filed under the **Patient Form** **Report** category. However, you can always reassign them to a different report category that better fits your workflow. For instance, signed consent forms can be stored under the **Patient Consent Report** category.
If you need more report categories for organizing completed Patient Forms, an [Admin Level User](/articles/administrative-privileges) can add them by following these steps:
| **1** | Go to **Settings** -> **Report & Visit Note Categories** . |
| ----- | ------------------------------------------------------------------------------------ |
| **2** | Click **+ Add Report Category** . |
| **3** | Click the dropdown menu that appears on the left side of the page. |
| **4** | Scroll through the list or type in search words to find the desired report category. |
| **5** | Select the report category that you want to add and click **Save** . |
[Click here for more information about report categories](/articles/report-types).
## Workflow Instructions
### Sending forms to patients
[Click here for detailed instructions on how to send forms to patients](/articles/Sending-forms-to-patients).
### Tracking & reviewing completed forms
[Click here for information about tracking and reviewing completed forms](/articles/Managing-forms-responses).
## Patient Experience
### How patients receive and fill out forms
[Click here to learn about the patient’s experience when receiving Patient Forms](/articles/Receiving-and-filling-out-forms-as-a-patient).
Patients who have a **Patient Passport** account can also access and complete their assigned forms directly from the appointment details view in Passport — no email link required. Forms appear with their completion status, and incomplete forms have a direct link to open and submit them.
## Frequently Asked Questions
[Click here to view frequently asked questions about Patient Forms](/articles/Patient-Forms-Frequently-Asked-Questions).
## Related Articles
* [Patient Forms Guide - Creating and managing Patient Forms](/articles/Patient-Forms-Guide)
* [Patient Forms Guide - Sending forms to patients](/articles/Sending-forms-to-patients)
* [Patient Forms Guide - Managing forms responses](/articles/Managing-forms-responses)
* [Patient Forms Guide - Receiving and filling out forms as a patient](/articles/Receiving-and-filling-out-forms-as-a-patient)
* [Patient Forms Guide - Sample Forms and Use Cases](/articles/Patient-Forms-Sample-Forms-and-Use-Cases)
* [Patient Forms Guide - Frequently Asked Questions](/articles/Patient-Forms-Frequently-Asked-Questions)
# Hawaii State- HIR- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Hawaii-State-HIR-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Hawaii State Immunization Registry [HIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Hawaii State Immunization Registry (HIR).
## What is the HIR Immunization Registry Interface?
The HIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to HIR; the Hawaii State Immunization Registry. Practices can also query HIR for vaccination history or forecast.
## Why is the HIR Immunization Registry Interface valuable?
With the HIR Immunization Registry Interface, practices no longer need to separately log in to HIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to HIR. You can also pull vaccination history for specific patients from HIR to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & HIR
The Elation Team will assist you with initiating interface with HIR. To notify us of your interest, complete [this form from HIR](/files/immunization-hi-hir-form.pdf) and then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**. A member of the Elation team will collect the completed HIR form from you.
## How to submit vaccination data to HIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to HIR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
HIR is down daily from 3am to 7:10am Hawaii Time. Vaccinations submitted during this time will not appear in HIR until the registry is live again.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using HIR
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Hosted Database Introduction (Add-On)
Source: https://help.elationhealth.com/articles/Hosted-Database-Introduction
## Overview
### What is the Hosted Database?
The hosted database is a copy of your Elation application data. This data is extracted and transformed to make it easier to navigate and query using Structured Query Language (SQL). You can create custom reports by querying the data directly, clone it into a data warehouse, or connect it to an analytics tool, depending on your specific needs. The Hosted Database data is refreshed every 24 hours for timely access to your data. Additional refreshes are available for purchase if required.
### What is the value of the Hosted Database?
The Hosted Database gives you clear visibility into trends, operations, utilization, costs, and overall efficiency through self-service reports and dashboards. This level of access supports more informed clinical decision-making and patient tracking. The flexibility of having data readily available empowers you to tailor insights and reporting to your unique goals. You can even use [Elation Analyst](/articles/Elation-Analyst) for simple, AI-powered analytics.
## Setup
Hosted Database access is available for an additional cost. For pricing and more information, please contact our sales team.
* Small and Medium Businesses - [smbsales@elationhealth.com](mailto:smbsales@elationhealth.com)
* Enterprise Customers - [team-enterprisesales@elationhealth.com](mailto:team-enterprisesales@elationhealth.com)
If you’d like to refresh your data more frequently than every 24 hours, please contact our sales team for more information.
## Workflow Instructions
* [Click here for instructions on how to use the Hosted Database](/articles/hdb/what-is-the-hosted-database).
* [Click here for the current schema](https://dbdocs.io/hosteddb_support/hosted_database_snowflake).
## Related Articles
* [Hosted Database Guide - Using Elation Analyst](/articles/Elation-Analyst)
# How often does Elation release updates?
Source: https://help.elationhealth.com/articles/How-Often-Does-Elation-Release-Updates
Learn how frequently Elation deploys new code and product updates to the EHR.
## How often does Elation deploy new code?
Elation deploys updates to the EHR multiple times per day. Most changes are small, incremental improvements that ship as part of regular scheduled deployments, so you may notice minor updates appear during the workday without any interruption to your workflow.
Larger features and product changes are summarized in the monthly [Product Updates](/product-updates) so you can review what's new in one place.
## Will deployments interrupt my work?
No. Deployments are designed to be seamless and do not require downtime or a log-out. If a change affects a workflow you use, you'll typically see it reflected the next time you load or refresh the page.
## Where can I track what changed?
* Review the monthly [Product Updates](/product-updates) for a summary of new features and improvements.
* For questions about a specific change, contact the [Elation Support Portal](/articles/support-portal-introduction).
## Related Articles
* [Product Updates](/product-updates)
# Elation Patient Passport Guide - Inviting patients to Passport in bulk
Source: https://help.elationhealth.com/articles/How-to-Bulk-Invite-Patients-to-Passport
This article provides instructions on how to invite multiple patients at one time to Patient Passport.
📖
**RECOMMENDED READING**
* [Elation Passport for Patients Guide](/articles/elation-patient-passport-an-introduction)
* [Elation Passport for Patients - Patient's Point of View](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
## Overview
Bulk inviting patients to Passport is an efficient way to invite multiple patients from your practice at once to join [Elation secure online patient portal](/articles/elation-patient-passport-an-introduction). This process allows you to create a patient list compiled of patients who have not yet registered for Passport and send a [bulk letter invitation](/articles/introduction-to-bulk-letters).
Inviting patients to Passport in bulk will allow you save your practice time from inviting each patient individually from their chart as it allows you to invite multiple patients at once. As your practice grows and you gain new patients, you can repeatedly send out these bulk letter invitations to ensure new patients at your practice have been invited to Passport.
## Workflow Instructions
### Before you invite patients
* Please ensure you have filtered out inactive patients at your practice. You may do so through [patient tags](/articles/adding-patient-tags), or by manually reviewing the patient list that is generated before sending the bulk invitation.
* Review the patient list to remove patients who you do not want to provide Passport access to.
* You may add a patient tag to patient charts in the future to help flag to your practice members that these patients should not have Passport access.
* Clinicians should review their [sharing settings](/articles/elation-patient-passport-an-introduction#sharing_settings) to ensure that the correct amount of information is shared with patients. Clinicians can set default settings, which will apply to patients for whom you are identified as the primary physician and who have passport accounts, in the Patient Sharing Defaults section of their clinician User Settings.
You may override the default patient sharing settings per patient by clicking the **Passport** button in the Clinical Profile and selecting a different option under Patient Sharing Defaults.
### Inviting patients in bulk
Click the **Reports** button in the blue navigation bar.
Click **Patient List**.
At the top of the lefthand column with the patient list filters, you may select which provider, or your entire practice, that you would like to pull the list of assigned patients for
You can generate a report of your entire patient panel by leaving the filters blank and clicking **Generate List**.
Filter for patients using the following criteria:
1. Under General filters, click the checkbox next to **Patient Passport Status**.
2. Click the checkbox next to **Registered user** to uncheck the box
3. Click the checkboxes next to **Invited but not registered** & **Not invited** to create a list of patients that have not registered for Passport accounts.
4. Filter out patients that have been designated as inactive at your practice by filtering out those with the specific patient tag.
The **Send Bulk Letter** button will be greyed out until you select patients from the results list.
The grey icon next to a patient’s name represents that the patient has not been invited yet to join Passport.
The yellow icon next to a patient’s name represents that they have a pending invitation to join Passport and need to complete the registration.
Click **Generate List** once you have selected all of your filters to pull a list of patients to invite to Passport.
* Please review this patient list to ensure it only includes patients that you wish to provide Passport access.
* Click the checkbox at the top of the patient list to select all of the patients generated and select the orange **Send Bulk Letter** button.
When this letter is sent, patients receive a notification email from Elation stating there is an unread message from your practice. Patients who do not yet have a Passport account will be prompted to register before viewing the letter.
Fill in the fields of the bulk letter using the recommended values below:
* **Letter title (internal only):** `Bulk Passport invite [insert date]` — This label is visible only to your staff and helps distinguish campaigns from each other. It is not shared with patients.
* **Subject:** `Welcome to Patient Passport`
* **Letter body:**
> Welcome to Patient Passport, your secure online portal for staying connected with our practice. With Patient Passport you can:
>
> * View your visit summaries and health records
> * Send and receive secure messages with our office
> * Access your appointments and upcoming care
>
> To get started, click the button in this email to create your account. If you have any questions, contact our office directly.
* **Allow patient to reply:** Check or uncheck based on your practice’s preference.
* **Send this as a Patient Passport letter to:** Select your filtered patient list.
* **Generate printable PDFs of letters for:** Select **None** — this is an electronic communication and does not need a paper version.
Click **Next** in the bottom right of the page to move to the next window to preview the letter, confirm your sending options, and send the bulk letter.
Once you are ready to send the letter, click the **Send Bulk Letter** button in the bottom right of the page. This will redirect you to the [Bulk Letters Dashboard](/articles/introduction-to-bulk-letters#Dashboard) and your letter will be sent to the list of patients generated.
## Additional recommendations
Outreach to patients who could not be invited electronically
* We recommend reaching out to patients who do not have an email address listed in their demographics to obtain one so that they may be invited to Passport.
* You are able to create PDF versions of bulk letters, if you wish to provide paper handouts to patients with steps on how to join Passport.
* If a patient wishes to join Passport, there must be an email address in their demographics.
## Related Articles
* [Elation Patient Passport Introduction](/articles/elation-patient-passport-an-introduction)
* [Bulk Letter Guide - Mass communicating with patients](/articles/introduction-to-bulk-letters)
* [Patient Tags Guide- Classifying patients for administrative efficiency](/articles/adding-patient-tags)
# Best Practice - How to order durable medical equipment and orthotics
Source: https://help.elationhealth.com/articles/How-to-order-durable-medical-equipment
This article will describe the workflows related to ordering durable medical equipment in Elation EHR.
## What is durable medical equipment?
Durable medical equipment (DME) is equipment and supplies that are ordered by a healthcare provider for a patient for everyday or extended use. Types of DME may include oxygen equipment, wheelchairs, crutches, orthotics (such as braces and splints), or blood testing strips for diabetics. Orthotics are ordered through the same workflows described below.
## Why is it useful to order durable medical equipment through Elation
It is useful to order durable medical equipment through Elation because you can send the order electronically in Elation to a pharmacy or DME provider. When the DME order is sent as a letter, referral or prescription, the sent order will be documented in the Chronological Record for future reference.
## How to order durable medical equipment through Elation
Durable medical equipment can be electronically ordered by the prescription form sent to a pharmacy, or by an eFax through either a Provider Letter or Referral, which can be printed and given directly to the patient. You can order the DME through pharmacies or DME providers.
### Ordering from a pharmacy
You can order DME through a pharmacy with the same workflow you would use to send a prescription. Please follow the instructions detailed in the [Prescription Form Guide- ePrescribing & Ordering Medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) for how to order DME from a pharmacy.
![Prescription Form with "blood strip" entered in the Medication name field, showing a dropdown of OTC glucose blood test strip options, with Accu-Chek Compact Plus Strip highlighted.]()
### Ordering from other DME providers
You can order DME through a Provider Letter or Referral. Please follow the instructions below for how you can order DME through either of these options.
1. In a patient's chart, click **Referral** or **Letter** >> **to Provider**
2. Enter the fax number or email address that you would like to send the order to into the **To** field of the letter
3. Fill out the appropriate information into the body of the letter
4. Click **Sign & Send** to send this electronically, or you can click **Sign & More** to choose a printed option if you wish to give the order to your patient directly as a paper copy. The order will be saved to the patient's Chronological Record as a letter for future reference.
If you routinely order DME for a patient, you can add the DME company to the patient's [Provider List/Care Team in the Clinical Profile](/articles/Using-the-Provider-Directory) so that the specific DME provider for the patient is detailed in the chart.
## Frequently Asked Questions
### How can the DME provider contact my practice if they have questions about the order I sent?
We recommend using a [Print Header](/articles/print-headers) that includes your practice's phone number so that the recipient has easily available contact information for your practice directly on the order.
### How can I save a DME provider as a contact in Elation?
You have the option to save the contact information as a contact in the patient's chart the first time you send a letter or referral to a DME provider in Elation. Selecting the checkbox next to "Add to Provider List'' on the letter or referral will save this contact to the patient's Directory and Provider List/Care Team. Once added, the DME provider will also appear in the Clinical Profile (left hand column of the chart) under *Patient's Provider List* .
**Directory:**
![Letter addressed to DME Provider (fax 333-333-3333) with "Add to Provider List" checkbox checked, and an arrow pointing to the provider appearing in the Patient's Provider List as Walker, Lucy, MD.]()
\*\*Clinical Profile: \*\*
![Patient's Provider List section in the Clinical Profile showing DME Provider and Lucy Walker, MD listed, highlighted with a red box and arrow pointing to it.]()
## Related Articles
* [Prescription Form Guide- ePrescribing & Ordering Medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Letters & Referrals Guide- Managing & searching the provider directory](/articles/Using-the-Provider-Directory)
* [Templates Introduction- Template options in the EHR](/articles/templates-settings)
* [Templates Guide- Using templating softwares with Elation](/articles/using-templating-softwares-with-elation)
* [Print Headers Guide- Managing practice letterheads](/articles/print-headers)
# Billing Guide- Delayed Billing
Source: https://help.elationhealth.com/articles/How-to-set-up-Delayed-Billing
Delayed billing is a practice-wide setting that can allow your practice to review the bills of signed visit notes prior to submission to your practice management system (PMS).
### What is Delayed Billing?
For customers using [Elation Billing](/articles/Elation-Billing-All-in-One) (Elation's all-in-one billing solution) or certain Practice Management System (PMS) integrations with Elation ([see below for which PMS integrations can use this feature](#whoshoulduse)), bills (or claims) are sent to the PMS once a visit note is signed off on. Delayed Billing is a Setting that overrides this default behavior. Instead, upon visit note sign off, the bill will enter a queue in [Billing Home](/articles/Billing-Home) in Elation for further editing. From there, your practice can make any adjustments to the bill before sending it to your PMS.
This feature is valuable for practices with a coder or designated biller who edits bills after visit note sign off, as it allows the biller to ensure that the bill is comprehensive and accurate prior to submission to the PMS. Without delayed billing in these scenarios, the biller would need to make separate edits in the PMS and Elation to ensure both systems contain accurate billing data.
### Who should use Delayed Billing?
While the Delayed Billing setting is available to all practices, we only recommend using this setting if you are using [Elation Billing](/articles/Elation-Billing-All-in-One) (Elation's all-in-one billing solution) or when you are integrated with one of our Practice Management System (PMS) partners that support Delayed Billing. Today, practices that leverage Elation Billing, AdvancedMD, Candid, ConnxtMD, Tebra, or PracticeSuite can use the Delayed Billing feature.
If you have any questions about your specific PMS vendor, contact Support by clicking **I need help** --> **Contact Elation Support** from your Elation account and a member of the Support Team will be able to provide further guidance.
### How to turn on Delayed Billing
To turn on Delayed Billing for your practice, navigate to your Settings page and select **Billing Settings**. From there, you can scroll to the bottom of the page where you will see a section titled Delayed Billing. Click on the toggle and move it to green to turn on Delayed Billing.
Turning on Delayed Billing will only impact *future* Visit Notes that are signed after you enabled this feature. When a bill does not have a **Billing Reference #** populated in [Billing Home](/articles/Billing-Home), that indicates that the bill has not been sent over to your PMS.
At any point, you can turn this feature off and all future Visit Notes that are signed will be sent straight to your PMS.
![Delayed Bills settings section with the "Turn on delayed billing support" toggle switched on (green)]()
### How to send bills to the PMS when Delayed Billing is enabled
After turning on Delayed Billing, all future bills (or bills without a **Billing Reference #**) will be queued under [Billing Home](/articles/Billing-Home). You can navigate to Billing Home by clicking on "Reports" in the blue navigation bar and then selecting **Billing Home.** From there, you will see all bills pending synchronization to your Practice Management System (PMS).
1. From the queue, you can click on the patient's name to access the visit note and make changes to the bill by click **Actions** >> **Edit Bill**.
*
Only the provider that signed the visit note or their authorized [billing delegates](/articles/staff-permissions--staff-delegates) can edit bills.
![Chronological Record Actions menu open on a Feb 9, 2022 visit note, with "Edit Bill" highlighted in a red border under the actions list.]()
1. When you are ready to send bills in the queue to your PMS, you have three options:
* Click on the **Actions Menu** next to an individual bill and select **Send to PMS** to send a single bill.
* Use the checkboxes to **multi-select** the specific bills you want to send, then use the bulk action bar to send all selected bills at once. You can select bills across any status.
* Use the [**Bulk Send Bills to PMS** button](/articles/Billing-Home#additional_settings) to send all bills of a specific status at once (requires enabling the Bulk Send to PMS setting).
## Frequently Asked Questions (FAQ)
##### Certain bills did not send, what should I do?
Try the following troubleshooting steps:
1. Look at the bill and see if there is a number in the **Billing Ref #** field. If there is, it means your Practice Management System (PMS) received the bill and returned a corresponding billing reference number or claim number to Elation for reference. Use the search options in your PMS to look for this reference number or claim number to find your bill.
2. If you do not see **Billing Ref #** and you cannot find the bill in your PMS, click the **Bill didn't send? Click here** button in [Billing Home](/articles/Billing-Home). You will be shown a list of bills that were not sent and you click **Resend** to try sending the bills again.
If you do not see the bill you are looking for in your PMS after trying the steps above, contact Support by clicking **I need help** --> **Contact Elation Support** from your Elation account and a member of the Support Team will be able to provide further guidance.
##### Why can't I edit a specific bill?
Only the provider that signed the visit note or their authorized
[billing delegates](/articles/staff-permissions--staff-delegates)
can edit bills.
##### I turned on Delayed Billing but bills continue to go to the PMS after I sign my visit note. Why?
While the Delayed Billing setting is available to all practices, we only recommend using this setting when you are using [Elation Billing](/articles/Elation-Billing-All-in-One) (Elation's all-in-one billing solution) or integrated with one of our Practice Management System (PMS) partners that support Delayed Billing. Today, practices that leverage [Elation Billing](/articles/Elation-Billing-All-in-One) or any of the following PMS partners can use the Delayed Billing feature:
* AdvancedMD
* Candid
* ConnxtMD
* Tebra
* PracticeSuite
If you have any questions about your specific PMS vendor, [please click here to contact Support](https://help.elationemr.com/s/contactsupport) or click **I need help** --> **Contact Elation Support** from your Elation account and a member of the Support Team will be able to provide further guidance.
## Related Articles
* [Billing Home Guide- A dashboard for managing your bills](/articles/Billing-Home)
* [Billing Guide- Setting up CPT Codes and Place of Service](/articles/billing-settings---service-locations--procedure-codes)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Billing Guide- Frequently Asked Questions](/articles/Billing-Guide-Frequently-Asked-Questions)
* [Elation Billing- Using Elation's all-in-one billing solution to manage your claims](/articles/Elation-Billing-All-in-One)
* [Using the Claims Manager (Elation Billing)](/articles/using-the-claims-manager)
# Data Migration Guide - How to share your legacy EHR document files with Elation
Source: https://help.elationhealth.com/articles/How-to-share-legacy-EHR-document-files-with-Elation
This article describes how you can share your legacy EHR document files with Elation for import.
## Overview
### How do I share my legacy EHR document files with Elation?
You will use a file transfer application called CyberDuck to share your legacy EHR document files with Elation. CyberDuck is a free and easy to use application. Follow the workflow instructions below to connect to CyberDuck and share your files with Elation.
## Workflow Instructions
### 1. Downloading the CyberDuck application
Select the appropriate download link for your operating system below to download the CyberDuck application. Afterwards install the application to your computer/laptop.
* [For Windows Users](https://update.cyberduck.io/windows/Cyberduck-Installer-8.1.2.36557.exe)
* [For MacOS Users](https://update.cyberduck.io/Cyberduck-8.1.1.36550.zip)
### 2. Connecting to your designated server using CyberDuck
To connect to your unique S3 server as designated by Elation:
1. Open up the CyberDuck application.
2. Right-Click (Windows) or Two-Finger Click (Mac OS) and select **New Bookmark**
![Cyberduck app with a right-click context menu open, showing "New Bookmark" highlighted, as the next step to create a server connection.]()
1. A dialog box will open within CyberDuck. Input the following information:
2. Set the connection type to **Amazon S3**.
3. Expand ‘More Options’ and paste the information as provided in the .ZIP file sent from [support@elationhealth.com](mailto:support@elationhealth.com).
* Server Information
* Access Key ID
* Secret Access Key
* Path (including the forward slash)
![Cyberduck bookmark dialog with Amazon S3 selected, showing labeled arrows pointing to the Server, Access Key ID, Secret Access Key, and Path fields to paste values from Elation's ZIP file.]()
1. Close the dialog box once all the above fields have been filled out. You have not established a server connection via this bookmark and you are ready to [share your legacy EHR files with Elation](#move_files_to_CyberDuck).
### 3. Sharing a copy of legacy EHR files with Elation
To share your legacy EHR files with Elation, upload a copy of the files to the designated folder on your server using CyberDuck.
1. Double-click the newly created bookmark ([from instruction above](#connect_to_S3)). This bookmark will open a connection to Elation's file storage site for your practice.
2. Within a few seconds, you will see a folder in CyberDuck.
3. Drag and drop your data files into the folder.
* The amount of time it takes to upload your files will depend on the size of your data set. Allow the upload to complete prior to closing CyberDuck.
* CyberDuck will only store a copy of your data. You will continue to have the copy that was originally on your computer/laptop.
4. Once you have uploaded all your files to this folder in CyberDuck, send an email to your Data Services Manager and let them know your files are ready to be imported by Elation.
If your practice has opted into the **[Enhanced Bulk Document Import](/articles/Transferring-your-data-from-your-legacy-EHR-into-Elation#enhanced-bulk-document-import-paid-add-on)**, let your Data Services Manager know when you notify them that your files are ready. With this paid add-on, Elation uses OCR and AI to parse the text of your uploaded documents so they are keyword-searchable in the Chronological Record and available to Clinical Insights. Contact your Onboarding Manager or Customer Success Manager for pricing and eligibility details.
# Coding Guide - Managing periodic ICD-10 code updates
Source: https://help.elationhealth.com/articles/ICD-10-code-updates
## Overview
### What are ICD-10 code updates?
Every year, the Centers for Medicaid & Medicaid Services (CMS) updates the list of ICD-10 codes permitted for billing patient encounters. The yearly update includes ICD-10 code additions, revisions, and deletions. [Click here to review the latest ICD-10 code information from CMS](https://www.cms.gov/medicare/coding-billing/icd-10-codes).
### How does Elation maintain the latest ICD-10 code changes?
To ensure only valid ICD-10 codes are used, Elation automatically updates your account with the corresponding ICD-10 code changes on the date that the changes take effect. Once this update is complete,:
* Only valid ICD-10 codes will appear as search results within the problem lists, visit note assessment, and Billing Form.
* Deprecated ICD-10 codes will continue to remain in all historical records, including the patient’s Problem List.
* You will still be able to export deprecated ICD-10 codes to the **Assessment** section of the visit note, but you will not be able to export deprecated ICD-10 codes to the **Billing** section of the visit note since deprecated codes are non-billable. [Click here to learn more about managing deprecated ICD-10 codes](/articles/Managing-deprecated-ICD10-codes).
* To identify deprecated ICD-10 codes in the Problem List, use one of the two methods:
* Look for an orange dot to the left of the problem.
* Refer to a banner at the the top of the Problem List that tells you how many non-billable codes are in the Problem List.
## Workflow Instructions
### Managing yearly ICD-10 updates
To avoid exporting deprecated ICD-10 codes to your visit notes, we recommend
1. Updating any deprecated ICD-10 codes in your patients’ Problem List with one of the following options detailed in [this article](/articles/Managing-deprecated-ICD10-codes).
2. Review and update any deprecated ICD-10 codes in each patient’s Problem List as they come in for their next encounter.
3. Search for all patients with deprecated ICD-10 codes and update them before waiting for the patients’ next encounters.
4. Reviewing your Visit Note Templates and updating any deprecated ICD-10 codes with appropriate, current alternatives.
## Frequently Asked Questions
### Does Elation check ICD-10 code validity against a visit note's date of service?
No. Elation determines whether an ICD-10 code is valid based on the current date, not the date of service on the visit note you're working in. When CMS code changes take effect, Elation updates which codes appear as valid search results in the problem list, visit note assessment, and Billing Form based on that effective date, regardless of the date of service on the visit note.
This means a diagnosis code can appear as a valid search result on a visit note with a backdated or future-dated date of service, as long as the code is currently valid. It also means a code that becomes deprecated after you've already added it to a visit note stays in that visit note's historical record, but is no longer available to add to the Billing section going forward. See [Managing deprecated, non-billable ICD-10 codes](/articles/Managing-deprecated-ICD10-codes) to update codes that have been deprecated.
## Resources
* [CMS ICD-10 Details](https://www.cms.gov/medicare/coding-billing/icd-10-codes)
* [2025 Model Software/ICD-10 Mappings](https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2025-model-software/icd-10-mappings)
## Related Articles
* [Coding Guide - Managing deprecated, non-billable ICD-10 codes](/articles/Managing-deprecated-ICD10-codes)
* [Coding Guide - Managing periodic CPT code updates](/articles/Managing-periodic-CPT-code-updates)
# Idaho State- IRIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Idaho-State-IRIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Idaho Immunization Reminder Information System [IRIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Idaho State Immunization Registry known as IRIS.
## What is the IRIS Immunization Registry Interface?
The IRIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to IRIS, the Idaho Immunization Reminder Information System. Practices can also query IRIS for vaccination history or forecast.
## Why is the IRIS Immunization Registry Interface valuable?
With the IRIS Immunization Registry Interface, practices no longer need to separately log in to IRIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to IRIS. You can also pull vaccination history for specific patients from IRIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & IRIS
The Elation Team will assist you with initiating interface with IRIS. To notify us of your interest, complete [this form from IRIS](/files/immunization-id-iris-form.docx) and then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**. A member of the Elation team will collect the completed IRIS form from you.
## How to submit vaccination data to IRIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to IRIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using IRIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
'
[Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Illinois State- I-CARE- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Illinois-State-I-CARE-immunization-registry-user-guide
This article will describe how you can submit vaccination data to the Illinois State Immunization Registry [I-CARE] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE).
## What is the I-CARE Immunization Registry Interface?
The I-CARE Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE); a web based immunization record-sharing application. Practices can also query I-CARE for vaccination history or forecast.
## Why is the I-CARE Immunization Registry Interface valuable?
With the I-CARE Immunization Registry Interface, practices no longer need to separately log in to I-CARE to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to I-CARE. You can also pull vaccination history for specific patients from I-CARE to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & I-CARE
The Elation Team will assist you with initiating interface with I-CARE. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and confirm you have an I-CARE account.
You must have an established I-CARE account in order to begin the integration. If you do not have an I-CARE account, [follow the steps and sign the paperwork here to create an account](/files/immunization-il-icare-form.pdf) . If you have any questions about setting up an account, contact [DPH.ICARE@illinois.gov](mailto:DPH.ICARE@illinois.gov) .
## How to submit vaccination data to I-CARE using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to I-CARE. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using I-CARE
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Immunization Registry Interface Introduction
Source: https://help.elationhealth.com/articles/Immunization-Registry-Interface-Introduction
This article introduces the Immunization Registry Interface functionality available with Elation EHR and lists the active state and regional immunization registries and the type of connect we support.
## What is an Immunization Registry interface?
All Immunization Registries connected to Elation can receive vaccination data sent from Elation EHR. For select Immunization Registries, you can also query for vaccination records as well as see a forecast of vaccinations needed. Practices can connect with multiple Immunization Registries via Elation.
Immunization Registries are also known as Immunization Information Systems (IIS), and many states use their own names for them—such as CAIR (California), WebIZ (used by several states), and ImmTrac (Texas). Whatever your state's registry is called, you can connect to it through Elation's Immunization Registry interface.
## Why are Immunization Registry interfaces valuable?
Elation offers Immunization Registry interfaces to promote and prioritize the interoperability and exchange of patient immunization data across various healthcare platforms.
## Which Immunization Registries are connected to Elation?
The following state and regional Immunization Registry interfaces allow you to send data and query for data:
* [Alabama](/articles/Alabama-State-ImmPRINT-Immunization-Registry-Interface-User-Guide)
* [Alaska](/articles/Alaska-State-VactrAK-Immunization-Registry-Interface-Guide)
* [Arizona](/articles/Arizona-State-ASIIS-Immunization-Registry-Interface-User-Guide)
* [Arkansas](/articles/Arkansas-AR-WebIZ-Immunization-Registry-Interface-User-Guide)
* [California](/articles/Electronically-submit-immunizations-from-the-patient-chart-to-California-s-immunization-registry-CAIR)
* [Colorado](/articles/Colorado-State-CIIS-Immunization-Registry-Interface-User-Guide)
* [Connecticut](/articles/Connecticut-State-CT-WiZ-Immunization-Registry-Interface-User-Guide)
* [Delaware](/articles/Delaware-State-DelVAX-Immunization-Registry)
* [Florida](/articles/Florida-State-FL-SHOTS-Immunization-Registry-Interface-User-Guide)
* [Georgia](/articles/Georgia-State-GRITS-Immunization-Registry-Interface-User-Guide)
* [Hawaii](/articles/Hawaii-State-HIR-Immunization-Registry-Interface-User-Guide)
* [Idaho](/articles/Idaho-State-IRIS-Immunization-Registry-Interface-User-Guide)
* [Illinois](/articles/Illinois-State-I-CARE-immunization-registry-user-guide)
* [Indiana](/articles/Indiana-State-CHIRP-Immunization-Registry-Interface-User-Guide)
* [Iowa](/articles/Iowa-State-IRIS-Immunization-Registry-Interface-User-Guide)
* [Kansas](/articles/Kansas-KSWebIZ-Immunization-Registry-Interface-User-Guide)
* [Kentucky](/articles/Kentucky-State-KYIR-KHIE-Immunization-Registry-Interface-User-Guide)
* [Louisiana](/articles/Louisiana-State-LINKS-Immunization-Registry-Interface-User-Guide)
* [Maine](/articles/Maine-State-Immpact-Immunization-Registry-Interface-User-Guide)
* [Maryland](/articles/Maryland-State-ImmuNet-User-Guide)
* [Massachusetts](/articles/Massachusetts-State-MIIS-Immunization-Registry-Interface-User-Guide)
* [Michigan](/articles/Michigan-State-MCIR-Immunization-Registry-Interface-User-Guide)
* [Minnesota](/articles/Minnesota-State-MIIC-Immunization-Registry-Interface-User-Guide)
* [Missouri](/files/immunization-mo-showmevax-form.pdf)
* [Nebraska](/articles/Nebraska-State-NEIIS-Immunization-Registry-Interface-User-Guide)
* [New Hampshire](/articles/New-Hampshire-NHIIS-Immunization-Registry-Interface-User-Guide)
* [New Jersey](/articles/New-Jersey-NJIIS-Immunization-Registry-Interface-User-Guide)
* [New Mexico](/articles/New-Mexico-State-NMSIIS-Immunization-Registry-Interface-User-Guide)
* [New York City](/articles/New-York-City-CIR-Immunization-Registry-Interface-User-Guide)
* [Nevada](/articles/Nevada-State-NV-WebIZ-Immunization-Registry-Interface-User-Guide)
* [North Carolina](/articles/North-Carolina-State-NCIR-Immunization-Registry-Interface-User-Guide)
* [North Dakota](/articles/North-Dakota-State-NDIIS-Immunization-Registry-Interface-User-Guide)
* [Ohio](/articles/Ohio-State-ImpactSIIS-Immunization-Registry-Interface-User-Guide)
* [Oklahoma](/articles/Oklahoma-State-OSIIS-Immunization-Registry-Interface-User-Guide)
* [Oregon](/articles/oregon-state-alert-iis-interface-guide)
* [Pennsylvania](/articles/Pennsylvania-State-PIERS-Immunization-Registry-Interface-User-Guide)
* [Philadelphia (PA)](/articles/Philadelphia-City-PhilaVax-Immunization-Registry-Interface-Guide)
* [Rhode Island](/articles/Rhode-Island-KIDSNET-RICAIR-Immunization-Registry-Interface-User-Guide)
* [South Carolina](/articles/South-Carolina-State-SIMON-Immunization-Registry-Interface-User-Guide)
* [Tennessee](/articles/Tennessee-State-TennIIS-Immunization-Registry-Interface-Guide)
* [Texas](/articles/Texas-State-ImmTrac2-Immunization-Registry-Interface-User-Guide)
* [Utah](/articles/Utah-State-USIIS-Immunization-Registry-Interface)
* [Virginia](/articles/Virginia-State-VIIS-Immunization-Registry-Interface-User-Guide)
* [Washington](/articles/Washington-State-WAIIS-Immunization-Registry-Interface-User-Guide)
* [West Virginia](/articles/West-Virginia-State-WVSIIS-Immunization-Registry-Interface-User-Guide)
* [Wisconsin](/articles/Wisconsin-State-WIR-Immunization-Registry-Interface-User-Guide)
* [Wyoming](/articles/Wyoming-WyIR-Immunization-Registry-Interface-User-Guide)
The following state and regional Immunization Registry interfaces allow you to
*only*
send data. The ability to query for data will be made available at a later time:
* [District of Columbia](/articles/District-of-Columbia-DOCIIS-Immunization-Registry-Interface-User-Guide)
* [New York State](/articles/New-York-State-NYSIIS-Immunization-Registry-Interface-User-Guide)
* [Vermont](/articles/Vermont-IMR-Immunization-Registry-Interface-User-Guide)
## How to start using an Immunization Registry interface
Click on the name of the region or state above to learn more about the Immunization Registry interface you want to use and understand the steps needed to start the connection.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# MIPS (2024)- Improvement Activities Category
Source: https://help.elationhealth.com/articles/Improvement-Activities-MIPS-2024
This article describes the Improvement Activities Performance Category for MIPS 2024.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Introduction
The following information is provided for small practices (15 or fewer providers in a TIN) that report Traditional MIPS. Practices and providers that report using the APM Performance Pathways (APP- if you participate in an ACO), or submit and participate in MIPS Value Pathways (MVPs), those reporting options have different requirements. APP reporting offers full credit for Improvement Activities (no reporting needed), and MVPs have a smaller selection of Improvement Activities and Quality Measures to choose from.
Improvement Activities are one category of MIPS and worth 30% of the overall MIPS score if in a small practice and not reporting on the Promoting Interoperability category, and reporting Traditional MIPS . Total points for the Improvement Activities category caps at 40 and is dependent on a combination of scoring factors.
To earn full credit in this performance category as a small practice, you must generally submit one of the following combinations of activities:
* 2 medium-weighted activities (20 points each) OR
* 1 high-weighted activity (40 points)
Improvement activities have a minimum of a continuous 90-day performance period (during calendar year (CY) 2024) unless otherwise stated in the activity description. To submit Improvement Activities as an Eligible Clinician you can sign in and attest.
## Scoring
High-weighted activities receive 20 points and medium-weighted activities receive 10 points. There is a maximum of 40 points that can be earned from attesting to activities in this performance category. You’ll receive double points for each high- or medium-weighted activity you submit if you’re an individual clinician or group that holds a qualifying special status (small practices will receive double points).
## Improvement Activities
With over 100 Improvement Activities to choose from, it can be overwhelming to decide which one is best suited for your practice. If you are in a small practice you only need to select one high weighted activity and attest to the activity in the QPP portal during MIPS reporting. Many of the activities capture best practices that you or your practice may already be doing.
* [Improvement Activities Measures and Activities Tool Online](https://qpp.cms.gov/mips/explore-measures?tab=improvementActivities\&py=2023)
* \[QPP Improvement Activities Inventory Zip File]\([https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2237/2023%20Improvement%20Activities%20Inventory.zip”](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2237/2023%20Improvement%20Activities%20Inventory.zip”) with “[https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2644/2024ImprovementActivitiesInv.zip](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2644/2024ImprovementActivitiesInv.zip))
## Related Articles
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
# Troubleshooting Inbound Fax Failures in Elation EHR
Source: https://help.elationhealth.com/articles/Incoming-Fax-Troubleshooting-Steps
## Troubleshooting Inbound Fax Failures in Elation EHR
When an inbound fax doesn’t arrive where you expect, use this guide to verify your fax setup, isolate where the breakdown occurred, and recover the document quickly.
### How inbound faxing works in Elation
* Your practice has an electronic Elation fax number. Faxes sent to this number appear in your Fax Inbox in the EHR.
* You can keep your existing fax number by either porting it to Elation or forwarding faxes from your landline fax number to your Elation fax number.
* Fax forwarding only works with landline fax numbers; if you used an electronic fax service previously, Elation recommends porting that number to Elation instead of forwarding.
### Quick fixes checklist
* Confirm and share your Elation fax number with the sender. To locate it, open the Fax Inbox on your Practice Home page and note the 10‑digit number at the top.
* Check the Fax Inbox thoroughly:
* Verify you’re viewing the correct fax line tab if your practice has multiple lines.
* Review the **Unfiled Images (non-fax)** tab in case pages were removed from a chart and are awaiting re-filing.
* If pages appear out of order, adjust or confirm your default sorting in Settings → Fax Usage & Settings (Newest vs. Oldest).
* Ask the sender to retry once and confirm they dialed your Elation fax number exactly as provided. Minor digit errors are a common cause.
### If the sender used your old/non‑Elation number
* If you retained your old number, ensure automatic forwarding from that landline fax number is active to your Elation fax number; your phone carrier or the fax machine can be configured to forward to Elation.
* Forwarding from electronic fax services is not supported; port that number to Elation to receive faxes directly in your Fax Inbox.
* To isolate forwarding issues, ask the sender to send a test fax directly to your Elation fax number; if that arrives, the forwarding configuration needs attention.
### Downtime considerations
During periods when Elation services are degraded, inbound faxes will automatically route into your Fax Inbox once service returns to normal. For urgent documents, ask the sender to fax to an alternate destination you can access (e.g., external/personal fax).
### If the fax exists outside Elation
If a fax reached your external eFax or a physical machine, you can still bring it into Elation:
* Manually forward the pages to your Elation fax number from the physical fax machine or via your carrier’s forwarding flow.
* Upload the document from your computer into the Fax Inbox or upload directly in the patient chart when appropriate.
### When the fax appears in Fax Inbox but not in the patient chart
* File the document from the Fax Inbox into the correct patient chart using the filing workflow; the Fax Inbox shows your fax line tab(s) and the Unfiled Images area for documents awaiting re-filing.
* After filing, you can annotate and eSign the report in the chart if needed.
### Reduce the chance of future “missing” faxes
* Share your Elation fax number (not a retired number) with external collaborators and update it on forms, letterhead, and portals. You can port your existing number to Elation if continuity is essential.
* If you continue to operate a landline fax, confirm automatic forwarding rules are active and tested to your Elation fax number.
* Monitor your practice’s fax usage and settings in Settings → Fax Usage & Settings; inbound pages contribute to your monthly usage total.
### When to contact Elation Support
If you have verified the correct Elation fax number, checked the Fax Inbox tabs and sorting, tested direct sending to your Elation number, and the fax still isn’t arriving, contact Elation Support and include:
* Your Elation fax number
* The sender’s fax number
* Date/time of attempted transmission
* Number of pages and (if possible) the sender’s confirmation page
Contact Support from within Elation or visit [https://help.elationemr.com/s/contactsupport](https://help.elationemr.com/s/contactsupport).
## Related Articles
* [Fax Inbox Guide - Filing documents from the Fax Inbox into a patient's chart](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
* [Patient Chart Guide- Annotate and eSign Clinical Reports and Documents](/articles/Patient-Chart-Guide-Annotate-and-eSign)
# Indiana State- CHIRP- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Indiana-State-CHIRP-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Indiana State Children and Hoosiers Immunization Registry Program [CHIRP] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Indiana State Children and Hoosiers Immunization Registry Program (CHIRP).
## What is the CHIRP Immunization Registry Interface?
The CHIRP Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to CHIRP; the Indiana State Children and Hoosiers Immunization Registry Program. Practices can also query CHIRP for vaccination history or forecast.
## Why is the CHIRP Immunization Registry Interface valuable?
With the CHIRP Immunization Registry Interface, practices no longer need to separately log in to CHIRP to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to CHIRP. You can also pull vaccination history for specific patients from CHIRP to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & CHIRP
The Elation Team will assist you with initiating interface with CHIRP. To notify us of your interest please complete [this form for CHIRP](/files/immunization-in-chirp-form.pdf) and then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**. A member of the Elation team will collect the completed CHIRP form from you.
## How to submit vaccination data to CHIRP using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to CHIRP. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
CHIRP will only accept the \*\* \*\* New record (performed now)\*\* \*\* **Record Type** if the vaccination submission date is within 30 days of the vaccination administration date. Vaccines administered more than 30 days ago must be submitted as a ' *Historical record (performed previously* ' under **Record Type** .
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using CHIRP
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
Patients must have address information on file in order to use the query and forecast features.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Immunization Registry Interface Introduction](/articles/Immunization-Registry-Interface-Introduction)
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Insurance Card Image Upload Guide
Source: https://help.elationhealth.com/articles/Insurance-Card-Image-Upload-Guide
This article describes the Insurance Card Image Upload feature from the Patient Demographics window and Patient Forms.
Having the most up to date and accurate insurance information for your patient allows you to streamline the medical billing process and improve healthcare quality. With the ability to upload images of your patient's insurance cards directly into their Patient Demographics and collect insurance card images from Patient Forms, you will have immediate access to the information you need to recommend the best care plan for your patients and ensure you get paid for the services rendered.
## Overview
### What is the Insurance Card Image Upload feature?
The Insurance Card Image Upload feature is a function
1. in the Patient Demographics **Insurance, Payment & Membership** section that allows you to upload up 2 (two) insurance card images into each of the **Primary Insurance** and **Secondary Insurance** sections.
2. in Patient Forms that allows you to collect up 2 (two) insurance card images each, from patients, regarding their **Primary Insurance** and **Secondary Insurance** sections.
The supported image file types are JPEG (JPG/JPE), PNG and PDF (single page only).
### Why is the Insurance Card Image Upload feature valuable?
Having the most up to date and accurate insurance information for your patient allows you to streamline the medical billing process and improve healthcare quality. The Insurance Card Image Upload feature will allow you to store the front and back images of the patient's insurance card directly in their demographics to allow you to:
* easily reference the data that is displayed on insurance cards such as the patient's group and policy numbers as well as copay, coinsurance, deductible, claims mailing address, phone numbers for billing or authorizations and insurance electronic Payer ID
* reconcile new insurance cards with existing cards on file during the check-in process.
### How do I get started?
The Insurance Card Image Upload features will gradually be made available to Elation customers beginning January 2022. Keep an eye out for this updated experience in your EHR.
## Workflow Instructions
### Patient Demographics
#### How to upload an insurance card image
| **1** | Open the patient's chart and click on their name to open the Demographics window. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Go to the **Insurance, Payment & Membership** section and click **Insurance Card Side 1** or **Insurance Card Side 2** depending on which one you want to upload. ![Insurance, Payment & Membership section showing the "Insurance Card Side 1" and "Insurance Card Side 2" upload buttons highlighted with red boxes under Primary Insurance.]()
|
| **3** | Select the JPEG (JPG/JPE), PNG, or PDF file from your computer and click **Open** . |
| **4** | The **Edit Photo** window will allow you to crop or rotate the image you uploaded to adjust the image. When you are ready, click **Confirm** . |
| **5** | Once the images are uploaded, they will be visible in the Demographics Window. Click **Save & Close** to save the images to the patient's chart. ![Insurance, Payment & Membership section for Cooper Smith showing uploaded UnitedHealthcare card images (front and back) in Primary Insurance, with Group ID 98765, Member ID 123456789, and relation to policyholder set to Self.]()
|
#### How to manage uploaded insurance card images
Once an insurance card image is saved to the Demographics box, you can:
**1**
Click on the card to view a larger image.
**2**
Click the **pencil** icon to crop or rotate the image.
**3**
If you choose to **Remove & File** the image, click **Save & Close** in the Demographics to save your insurance changes and then the image will be filed into the **Reports** section of the patient's chart.
Click the **trash can** icon to delete the image, or move the image file to the **Reports** section of the patient's chart.
#### Troubleshooting insurance card upload errors
If you encounter an error while uploading an insurance card image, use the guidance below to identify and resolve the issue.
##### Identifying the type of error
**Validation errors** display a clear message describing the problem (for example, **unsupported file type**). These errors indicate an issue with the file you are trying to upload.
**System errors** display a long alphanumeric code without a clear explanation. These errors indicate a temporary technical issue.
##### Resolving validation errors
If you see a clear error message:
| **1** | Confirm the file is a supported type: JPEG (JPG/JPE), PNG, or single-page PDF. |
| ----- | --------------------------------------------------------------------------------------------- |
| **2** | Reduce the file size if the image is very large. |
| **3** | If using a scanner, adjust the scanner settings to save the document as an image file or PDF. |
##### Resolving system errors
If you see a long alphanumeric code without a clear explanation:
| **1** | Refresh the page and try the upload again. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Try a different browser ( **Chrome** or **Firefox** recommended). |
| **3** | If the error persists, click **I need help** → **Contact Elation Support** and include the following details: Which image you were uploading (front or back) • Which insurance record (Primary or Secondary) • File type and approximate file size • Screenshot of the error code • Approximate time of the upload attempt • Patient ID |
#### How to print uploaded insurance cards
To print the images of the insurance cards uploaded to the patient's demographics, click the **Print & Close** button at the bottom of the demographics window. The insurance card images will print at the end of the demographics as displayed below:
![Printed patient demographics for Joseph Davies showing Primary Insurance section with Blue Cross Blue Shield plan, member number R999999999, and both front and back insurance card images printed below.]()
### Patient Forms
#### How to add insurance card questions to Patient Forms
| **1** | Go to **Settings** >> **Patient Forms** and edit the Patient Form you would like. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Add** question to find the **Insurance Card Images - Primary** and **Insurance Card Images - Secondary** questions and click to add. Default Question Text is included with the questions to help guide patients on how to update good quality images. Feel free to adjust this text as needed. • Each question can only be added once. ![Insurance Information Form in Patient Forms editor showing the "Add question" dropdown open, with "Insurance Card Images - Primary" and "Insurance Card Images - Secondary" highlighted in a red box, and both questions already added to the form below.]()
|
| **3** | Click **Save Changes** to save the new questions to your Patient Form. |
Learn about the [Patient Forms feature in more detail here.](/articles/Getting-Started-with-Patient-Forms)
#### How patients upload insurance card images when completing Patient Forms
Once patients receive forms with the insurance card questions, they can use a file selector on the computer or mobile device to select and submit images of their insurance card. Patients will be able to see what the images look like and attach better images if the quality is not ideal.
* If the patient is using a mobile device with a camera, they can take pictures of their insurance cards from the form to attach them.
#### How to manage insurance card images from submitted Patient Forms
Submitted forms will appear in the **Outstanding Items** section of the patient's chart as usual. When you open a form with insurance card images, you will be able to:
**1**
Compare the information in the images to what you already have on file for the patient.
**2**
Click **Update Insurance** to update the information in your patient's chart with the information on the new card(s).
* You can click **Edit** again if you need to make any changes after updating.
**3**
You must update the Insurance Carrier Name, Plan Name, Group ID or Member ID information on file before you can export the images to the patient's demographics. This is to make sure your patients always have the correct insurance data stored in their chart.
Historical insurance card images will be filed into the **Reports** section of the patient's chart for record keeping if new images replace historical images.
Images can only be exported to the Demographics section; regardless if you select Clinical Profile or Visit Note during export.
Select (check off) the box for insurance card images and click **Export Selected** to export the images to your patient's demographics. ![Patient chart showing a submitted Insurance Information Form in Outstanding Items, with the Medical Forms panel open displaying uploaded Blue Cross Blue Shield card images, "Update Insurance" button highlighted, and insurance fields ready to export to demographics.]()
## Frequently Asked Questions (FAQ)
##### Can I upload other file types like .doc?
The Insurance Card Image Upload feature only supports JPEG (JPG/JPE), PNG & PDF files at this time. PDF files must be single page PDFs. We recommend converting existing document files to one of the supported files and then you will be able to upload the image to the Demographics window.
If you are using a scanner, try to adjust the scanner options to scan documents as an image file or a PDF.
##### Can I drag and drop the image directly into the Demographics window?
The drag and drop functionality is not available for this feature.
##### Can I move a copy of the insurance card from Reports into the Demographics?
There currently is no direct way to move an existing insurance card from the **Reports** section of the patient's chart into the Demographics window. We recommend viewing the insurance card in the **Reports** section and then right clicking on the image to click **Save Image As...** to save the image onto your computer. Afterwards, you can upload the .JPG file for the card to the Demographics window.
##### I can't select the insurance card images from the completed forms to export, why?
You must update the Insurance Carrier Name, Plan Name, Group ID or Member ID information on file by clicking **Update Insurance** before you can export the images to the patient's demographics. This is to make sure your patients always have the correct insurance data stored in their chart.
## Related Articles
* [Upgraded Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Patient Forms Guide](/articles/Patient-Forms-Guide)
# Prescription Monitoring Program (PMP/PDMP) Integration Introduction
Source: https://help.elationhealth.com/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP
Learn how to integrate with your State PMP/PDMP in this article.
## What is a Prescription Monitoring Program (PMP/PDMP)?
A Prescription Monitoring Program (also called a Prescription Drug Monitoring Program or Controlled Substance Monitoring Database) is a state-managed database that tracks controlled substance prescriptions dispensed in the state. Most states require pharmacists to record controlled substances dispensed in the state in the PMP and require providers to review the PMP before prescribing certain controlled substances.
## How does the PMP Integration work?
Once Providers are connected to the PMP integration via the EHR, they can click a **Check PMP** button to access PMP data directly from the EHR. A note will be documented in the patient chart after completing a PMP check for recording keeping purposes. The note about completing a PMP check can be exported to a visit note or to an office message.
## Are PMP integrations required?
Reach out to your state PMP to understand if an integration is required. [Click here for more information](https://www.pdmpassist.org/State).
* Practices in the state of Illinois are required to have a live EHR-PMP integration.
* Practices in the state of Washington with more than 10 providers are required to have a live EHR-PMP integration.
## Which PMP integrations does Elation offer?
Elation offers PMP integrations through two partners. For states that offer both integrations, please check with our partners to see which one best suits you and then follow the instructions in the respective articles to request the integration:
* [LogiCoy](/articles/Prescription-Monitoring-Program-Integration-LogiCoy)
* [Bamboo Health](/articles/Prescription-Monitoring-Program-Integration-Bamboo-Health)
The following table lists which partners are connected to which states:
* If you are in Guam or the states Nebraska, New York, or Wisconsin, you will not be able to use any of Elation’s PMP integrations at this time. We will notify you if a PMP integration becomes available for these states.
| State | Bamboo Health | LogiCoy |
| ------------------- | ------------- | ------- |
| Alabama (AL) | ✔️ | |
| Alaska (AK) | ✔️ | |
| Arizona (AZ) | ✔️ | |
| Arkansas (AR) | ✔️ | |
| California (CA) | ✔️ | ✔️ |
| Colorado (CO) | ✔️ | ✔️ |
| Connecticut (CT) | ✔️ | |
| Delaware (DE) | ✔️ | |
| Florida (FL) | ✔️ | |
| Georgia (GA) | ✔️ | |
| Guam (GU) | | |
| Hawaii (HI) | ✔️ | |
| Idaho (ID) | ✔️ | |
| Illinois (IL) | | ✔️ |
| Indiana (IN) | ✔️ | |
| Iowa (IA) | ✔️ | |
| Kansas (KS) | ✔️ | |
| Kentucky (KY)\* | ✔️ | ✔️ |
| Louisiana (LA) | ✔️ | |
| Maine (ME) | ✔️ | |
| Maryland (MD) | ✔️ | ✔️ |
| Massachusetts (MA) | ✔️ | |
| Michigan (MI) | ✔️ | |
| Minnesota (MN) | ✔️ | |
| Mississippi (MS) | ✔️ | |
| Missouri (MO) | ✔️ | |
| Montana (MT) | ✔️ | |
| Nebraska (NE) | | |
| Nevada (NV) | ✔️ | |
| New Hampshire (NH) | ✔️ | |
| New Jersey (NJ) | ✔️ | |
| New Mexico (NM) | ✔️ | |
| New York (NY) | | |
| North Carolina (NC) | ✔️ | |
| North Dakota (ND) | ✔️ | |
| Ohio (OH) | ✔️ | |
| Oklahoma (OK) | ✔️ | |
| Oregon (OR) | ✔️ | |
| Pennsylvania (PA) | ✔️ | ✔️ |
| Puerto Rico (PR) | ✔️ | |
| Rhode Island (RI) | ✔️ | |
| South Carolina (SC) | ✔️ | |
| South Dakota (SD) | ✔️ | |
| Tennessee (TN) | ✔️ | |
| Texas (TX) | ✔️ | |
| Utah (UT) | ✔️ | ✔️ |
| Vermont (VT) | ✔️ | |
| Virginia (VA) | ✔️ | |
| Washington (WA) | ✔️ | ✔️ |
| Washington, DC (DC) | ✔️ | |
| West Virginia (WV) | ✔️ | |
| Wisconsin (WI) | | |
| Wyoming (WY) | ✔️ | |
\*If you practice in the state of Kentucky in addition to any other state, you can use the Bamboo Health PMP integration if Kentucky’s PMP is the only PMP you want to connect to. If you need to connect to Kentucky’s PMP in addition to the PMP of other states then you must use the LogiCoy integration.
## How to set up a PMP integration
Follow instructions in the following articles to activate your integration with the selected partner:
* [LogiCoy](/articles/Prescription-Monitoring-Program-Integration-LogiCoy)
* [Bamboo Health](/articles/Prescription-Monitoring-Program-Integration-Bamboo-Health)
## Related Articles
* [Prescription Monitoring Program (PMP/PDMP) Integration- Bamboo Health](/articles/Prescription-Monitoring-Program-Integration-Bamboo-Health)
* [Prescription Monitoring Program (PMP/PDMP) Integration- LogiCoy](/articles/Prescription-Monitoring-Program-Integration-LogiCoy)
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
# Membership Management Introduction
Source: https://help.elationhealth.com/articles/Introduction-to-Membership-Management-with-Elation
Learn about Elation's Membership Management feature and how to start receiving membership payments from patients.
## Overview
### How do I manage patient memberships in Elation?
The Membership Management functionality provides a convenient and flexible way to create and manage recurring patient membership plans or fees directly within Elation. Additionally functionalities include:
* enrolling patients in individual or group memberships
* patient self-enrollment in plans
* automatically notifying patients when a payment is due
* automatically billing patients on a preset schedule
* charging a patient’s payment information on file (if preferred)
* allowing patients to split a single membership payment across multiple payment methods on file
* sending patients notifications if there are any changes to their plans
* reporting on memberships and payments
### What types of memberships can the feature support?
Elation’s Membership Management features supports
* one-time membership/fee charges for set amounts
* recurring membership/fee charges based on a preset schedule for set amounts
### Why should I use Elation's membership management features?
Elation’s Membership Management solution enables you to get paid quickly and reliably for patient membership subscriptions or fees, without the administrative overhead of using a third party membership management system because everything is managed in the EHR. This feature reduces the effort required to manage patient memberships or fees, supports your practice’s financial viability and helps you focus on providing excellent care.
### How much does this feature cost?
Elation’s Membership Management feature is tied to the [Patient Payment feature](/articles/using-elation-to-securely-collect-patient-payments), powered by Stripe. A fee of 2.99% per transaction will be deducted from every membership/fee payment collected through the Membership Management feature.
## Setup
To enable the Membership Management features:
Register for a Stripe account with Elation by following these instructions [here](https://docsend.com/view/u5pujrn5mrghwnkj).
Notify Elation you are interested in using the Membership Management feature using the **I need help** → **Contact Elation Support** button at the top of your Elation account and Elation will turn the feature on for you.
## Workflow Instructions
### Creating and managing plans
[Click here for instructions on creating and managing plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments).
### Enrolling patients in plans
* [Click here for instructions on enrolling patients in plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans).
* [Click here for instructions on patient self-enrollment.](/articles/Membership-Management-Patient-Self-Enrollment)
### Managing membership payments
[Click here for instructions on managing membership payments](/articles/Membership-Management-How-To-Receive-Payments).
## Resources
[Click here for a patient facing guide on how to use the membership features](/articles/Membership-Management-How-Patients-Receive-Communications).
## Related Articles
* [Membership Management - How to Manage Plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments)
* [Membership Management - How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans)
* [Membership Management - Patient Self-Enrollment](/articles/Membership-Management-Patient-Self-Enrollment)
* [Membership Management - How Patients Receive Communications](/articles/Membership-Management-How-Patients-Receive-Communications)
* [Membership Management - How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
* [Membership Management - Frequently Asked Questions](/articles/Membership-Management-Frequently-Asked-Questions)
* [Patient Payments Guide - Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
# Iowa State - IRIS - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Iowa-State-IRIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Iowa State Immunization Registry Information System [IRIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Iowa Immunization Registry Information System (IRIS).
## What is the IRIS Immunization Registry Interface?
The IRIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to IRIS; the Iowa Immunization Registry Information System. Practices can also query IRIS for vaccination history or forecast.
## Why is the IRIS Immunization Registry Interface valuable?
With the IRIS Immunization Registry Interface, practices no longer need to separately log in to IRIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to IRIS. You can also pull vaccination history for specific patients from IRIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & IRIS
The Elation Team will assist you with initiating interface with IRIS. To notify us of your interest,
[please click here to fill out our contact form](https://help.elationemr.com/s/contactsupport)
, select **Immunization Registry** as the
*Request Type*
, and send the following forms to Elation:
* [Immunization Registry Information System (IRIS) Authorized Site Agreement - Organization](/files/immunization-ia-iris-site-agreement.pdf)
* [IRIS Data Exchange On-Boarding Form](/files/immunization-ia-iris-onboarding.pdf)(if you do not already have an account with IRIS)
## How to submit vaccination data to IRIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit the data to IRIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using IRIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Kansas - KSWebIZ - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Kansas-KSWebIZ-Immunization-Registry-Interface-User-Guide
This article describes how you can submit vaccination data to the Kansas Immunization Registry [KSWebIZ] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Kansas State Immunization Registry known as KSWebIZ.
## What is the KSWebIZ Immunization Registry Interface?
The KSWebIZ Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to KSWebIZ, the Kansas Immunization Registry. Practices can also query KSWebIZ for vaccination history or forecast.
## Why is the KSWebIZ Immunization Registry Interface valuable?
With the KSWebIZ Immunization Registry Interface, practices no longer need to separately log in to KSWebIZ to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to KSWebIZ. You can also pull vaccination history for specific patients from KSWebIZ to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & KSWebIZ
The Elation Team will assist you with initiating an interface with KSWebIZ. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Name of the immunization registry you want to connect to.
* What county is your practice in?
* What are the names and emails of the users in your practice who will need access to KSWebIZ?
* Is your practice enrolled with Vaccines for Children (VFC)? If so, what is your VFC PIN?
* Is your practice part of a medical group? If so, what is the name of the medical group and how many practices are a part of the medical group?
* Is your practice a member of the Kansas Health Information Exchange (KHIE), Kansas Health Information Network (KHIN), or Lewis and Clark Information Exchange (LACIE)?
* Have the individual who is responsible for you facility’s security complete this [Kansas HL7 Security Agreement](/files/immunization-ks-hl7-security.pdf). (You will share the completed Agreement with Elation in a later step).
* Complete this [Site Enrollment Agreement](/files/immunization-ks-site-enrollment.pdf). (You will share the completed Agreement with Elation in a later step).
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Add Attachments** and attach the completed [Kansas HL7 Security Agreement](/files/immunization-ks-hl7-security.pdf) & [Site Enrollment Agreement](/files/immunization-ks-site-enrollment.pdf).
8. Click **Next**.
9. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to KSWebIZ using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to KSWebIZ. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using KSWebIZ
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Elation-Tebra Integration Guide- Using Elation as the source of truth for demographics and appointments
Source: https://help.elationhealth.com/articles/Kareo-Integration-Guide-Using-Elation-as-the-source
This article describes the Elation-Tebra® integration for customers who want to complete majority of their front office workflows, such as intake and scheduling, in Elation.
**Overview** This guide reviews one of two configurations for the Elation-Tebra integration. This version of the integration is for customers who want to complete majority of their front office workflows, such as patient intake and scheduling, in Elation and appointment information is not synchronized between Elation and Tebra. View the [Elation-Tebra Integration Guide- Using Tebra as the source of truth for insurance and appointments](/articles/Kareo-Integration-Guide-Using-Kareo-for-insurance-and-appointments) article if you wish to only enter insurance and appointments in Tebra.
## What is Tebra?
Tebra® is also referred to as Kareo® in some URLs and external links.
Tebra® is a Practice Management and Medical Billing Solution software that practices can use alongside Elation. Practices most commonly use Tebra to submit claims to Payers for services rendered and track the progress of claim payments.
## What is the Elation-Tebra integration?
The Elation-Tebra integration allows practices to send claims-related data from Elation to Tebra for practices to submit claims to Payers (through Tebra) for services rendered in Elation. The Elation-Tebra integration reduces the need for double documenting in two softwares and allows practices to store all their clinical data in Elation while using Tebra side-by-side to manage their revenue.
**Important Information** : This guide reviews one of two configurations for the Elation-Tebra integration. This version of the integration is for customers who want to complete all front office workflows, such as intake and scheduling, in Elation and appointment information is not synchronized between Elation and Tebra. View the [Elation-Tebra Integration Guide- Using Tebra as the source of truth for insurance and appointments](/articles/Kareo-Integration-Guide-Using-Kareo-for-insurance-and-appointments) article if you wish to only enter insurance and appointments in Tebra.
## How do I get started?
You must first have an account with Tebra before you can use this integration. Once you have worked with Tebra to set up your account, you can request to turn on the Tebra integration by clicking **I need help** -> **Contact Elation Support**.
### Mapping Providers
Each Provider level user must have an account in both Elation and Tebra in order for Elation to be able to map patient data across the two systems. Please work with Elation and Tebra to make sure you have the correct accounts needed for the integration.
### Mapping Practice Locations
Each Practice Location in Elation must be mapped to a Service Location in Tebra in order for your [Bills](#bills) to push from Elation to Tebra. Follow these steps to map your Elation Practice Location to the corresponding Service Location in Tebra:
1. Sign in to your Elation account and click on your email address at the top of your account
2. Go to **Settings** >> **Practice Locations**
3. Click the **Edit** button next to the Practice Location you want to map
4. Select a **POS code** and **Tebra name** for the Practice Location
5. Click **Save**
Follow the instructions in [this article](https://helpme.kareo.com/01_Kareo_PM/04_Settings/Service_Locations/Service_Locations) if you need to create/add a Service Location in Tebra.
## What information is synchronized?
The following information is synchronized between Elation and Tebra for this version of the integration:
| **Data** | **Sync Direction** |
| -------------- | ------------------- |
| Patient Charts | Elation **↔** Tebra |
| Demographics | Elation **↔** Tebra |
| Insurance | Elation **↔** Tebra |
| Appointments | Not synchronized |
| Bills | Elation **→** Tebra |
### Patient Charts
**Creating Charts**
Patient charts can be created in either system because Patient Demographics is bi-directional. Creating a patient chart in one system will also create the patient chart in the other system.
*
As best practice, we recommend creating Patient Charts in Tebra when possible because you will already be managing insurance information and appointments in Tebra. This will allow your front office staff to stay in one system (Tebra) for a majority of their work.
#### Merging Charts
Each chart can only have a one to one connection between Elation and Tebra and this connection is established upon chart creation. If you happen to see a duplicate chart for the same patient in either system, please make sure you find the chart that is connected between the two systems and keep the connected chart after performing a merge.
* For example, patient John Smith has one chart in Tebra but two charts in Elation. The best way to find out which of the two charts in Elation is connected to Tebra is by updating one of the connected demographics fields in Tebra to see which of the two charts in Elation receives the update. The chart that receives the update must be the chart that you keep in Elation when performing a chart merge.
Here are the proper merge steps for Elation charts:
1. Open the duplicate chart that is not connected to the integration
2. Click on the patient's name to open their Demographics
3. Click on the **Merge Chart** button
4. Find & select the chart you want to keep (the one that is connected to the integration)
5. Click **Merge Chart**
6. Confirm you understand the transfer of data and then click **Yes, merge charts**
#### Deleting Charts
Deleting a chart in Elation will not delete the chart in Tebra. Please take caution when deleting charts in Elation while using the Tebra integration as charts have a one to one connection via the integration. If the patient is still active in your practice, the deleted chart must be restored in order for the patient's information to sync properly across the two systems.
You can restore a deleted patient chart yourself using the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice). Go to **Reports** > **User Activity Log**, filter by the patient or by the "Delete" action, and click the **Restore** button next to the deleted chart. [Admin Level Users](/articles/administrative-privileges) can view and restore activity for all users in the practice.
### Patient Demographics
The synchronization of Patient Demographics is bi-directional. Any changes made in one system will be pushed to the other system. Creating a patient chart in one system will also create the patient chart in the other system. The following table shows a mapping of the Patient Demographics fields that are shared between Elation and Tebra and their matching field names. Fields that are not listed are not shared between Elation and Tebra.
| Elation Field Name | Tebra Field Name |
| --------------------------------------------------------------- | ------------------------------------------------------------------------------- |
| Legal First Name | First name |
| Middle Name | M |
| Legal Last Name | Last name |
| Date of birth | DOB |
| Sex at Birth | Sex |
| Phone- *Home* , *Mobile* or *Work* type only (and up to 2 only) | Home Phone, Mobile Phone or Work Phone (depending on what is stored in Elation) |
| Email | Personal Email |
| Address | Address Line 1 |
| Ste or apt # | Address Line 2 |
| City | City |
| State | State/Province |
| Zip | Zip/Postal Code |
| Provider assigned in practice | Primary Provider |
### Insurance
The synchronization of insurance information is bidirectional between Elation and Tebra. Customers can enter insurance information in Elation or Tebra.
Tebra uses a feature called an **Insurance** **Case** to store insurance policy information. Each period or type of insurance coverage in Tebra should be tied to its own *Insurance* *Case*. For example: If patient John Smith has medical coverage and separate insurance for an automobile accident, John Smith should have two *Insurance* *Cases* in Tebra, one *Insurance* *Case* for his personal medical insurance and the other **Insurance** **Case** for his automobile accident insurance. Make sure you set the primary \*\*Insurance Case \*\* as the the one you wish to share with Elation.
If patient Jane Doe has Aetna® insurance from 1/1/2021 to 12/31/2021 and then changes to Blue Cross® beginning 1/1/2022 then Jane Doe should have two *Insurance* *Cases* in Tebra, one *Insurance* *Case* for Aetna that is marked as **Inactive** and one *Insurance* *Case* for Blue Cross that is the new primary, active **Insurance Case**.
The following table lists the insurance related fields that are pushed from Tebra to Elation and show how the Tebra fields map to the Elation fields. Fields that are not listed are not shared between Elation and Tebra:
| Tebra Field Name | Elation Field Name |
| --------------------------------------------------- | ---------------------------------- |
| Plan Name | Plan name |
| Company Name (\*hidden behind *Plan Name* in Tebra) | Insurance carrier name |
| Policy Number | Member ID |
| Group Number | Group ID |
| Copay Amount | Copay |
| Deductible Amount | Deductible |
| Relationship to Primary Policy Holder | Patient's relation to policyholder |
| Insured Name | First Name & Last Name |
| Street Address | Address |
| City | City |
| State | State |
| Zip | Zip |
| SSN | SSN |
| DOB | Date of birth |
| Gender | Sex at birth |
*
If you need to add a new Insurance Company or Plan to your Tebra database, follow the instructions in [this article](https://helpme.kareo.com/Platform/Practice_Settings/Insurance/Add_New_Insurance_Company) .
#### Carriers & Plans
Insurance Carriers and plans details should be maintained in Tebra as Tebra can store more detailed information about Payers such as the Payer ID. It is most important for you to create Plans in Tebra (especially when it is for a Payer you already send claims to in Tebra) to avoid creating duplicate Payers in Tebra.
After the Carrier or Plan is created in Tebra and it is added to a patient's chart in Tebra, the Carrier and Plan will push over to Elation and you will be able to select them within Elation. If you need to add a new Insurance Company or Plan to your Tebra database, follow the instructions in [this article](https://helpme.kareo.com/Platform/Practice_Settings/Insurance/Add_New_Insurance_Companyhttp://).
*
The address for Carriers in Elation is pulled from the **Insurance Plan** setting of Tebra (and not the **Insurance Company** setting).
You can create Carriers in Elation as well but you must remember to update the Insurance Company's **Electronic Claims** setting in Tebra in order to send claims electronically to the Payer. Never create Plans in Elation- this will cause duplication of Insurance Companies in Tebra.
#### Adding insurance information
For patients who do not have any active insurance information in Tebra, follow the appropriate steps below to add insurance to their chart in Tebra (which then pushes the insurance information over to Elation). Tebra allows you to store more detailed information about the insurance policies such as policy start and end dates.
| Tebra Web Browser Application | Tebra Windows PC Desktop Application |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| Open the patient's chart in Tebra • Go to **Account** >> **Insurance** • Click\*\*"+ Add New Insurance Case" to add an \*\* Insurance\*\* *Case* • Go to the \*\* Policy #1: New Insurance\*\* section and fill in the patient's primary insurance policy information. • Click the \*\* Save Policy\*\* button once you have filled in all the information for the insurance policy you are adding • If the patient has secondary insurance coverage, click **+Add Another Policy** to add their Secondary Insurance information to the case. • Click \*\* Save & Finish\*\* at the very bottom of the page to save the case after you have added all the policies to the case | Open the patient's chart in Tebra • Go to \*\* Cases\*\* • Click\*\*"Add..." to add a **Case** • Go to the **Insurance** section and click **Add** to add a new insurance policy to the **Case** • If the patient has secondary insurance coverage, click **Add..** again to add their Secondary Insurance information to the case. • Click **Save** at the very bottom of the **New Case** window to save the case after you have added all the policies to the case • Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart |
You can add insurance information for the first time for patients in Elation but we recommend performing updates and removals in Tebra to track historical insurance information and to track the policy end date.
#### Correcting insurance information
If policy information was entered incorrectly follow the steps below to make corrections as needed in Tebra (which then updates the insurance information in Elation):
| Tebra Web Browser Application | Tebra Windows PC Desktop Application |
| --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Locate the patient's chart in Tebra • Go to **Account** >> **Insurance** • Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy • Click the **Edit** button next to the **Policy** you need to edit • Make the appropriate changes • Click **Save Policy** to save your changes to the policy information • Click **Save & Finish** to save your changes to the **Case** | Locate the patient's chart in Tebra • Go to **Cases** • Select the **Case** with the policy that needs corrections • Click the **Edit...** button • Select the **Insurance Policy** that needs corrections • Click the **Edit...** button • Make the appropriate changes • Click **Save** to save your changes to the policy information • Click **Save** on the **Case** to save your changes to the **Case** • Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart |
You can correct insurance information for patients in Elation via the [Patient Demographics](/articles/Patient-Demographics-Guide) but we recommend performing updates and removals in Tebra to track historical insurance information and to track the policy end date.
#### Updating insurance information with new policy
If all of the patient's policies within a given **Insurance Case** are no longer in effect, (ex. patient's old Primary & Secondary insurances changed), follow the steps listed below to mark the old policy as inactive and then add the new policies to the patient's chart. The new policy information will replace the old policy information in Elation. Use the [Update insurance information with new policy section](#updating-insurance-information-with-new-policy) if you are replacing an inactive insurance policy with an active one.
Tebra Web Browser Application
Tebra Windows PC Desktop Application
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Account** >> **Insurance**
3. Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy
4. Change the **Status** to **Inactive** & click **Save & Finish**
*
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
5. Follow the [Adding insurance information](#adding-insurance-information) steps to add the new insurance policy information to the patient's chart in Tebra
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Cases**
3. Select the **Case** that you want to mark as inactive
4. Click **Edit...**
5. Uncheck the **Active?** Box
*
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
6. Click **Save** to save you changes to the **Case**
7. Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart
8. Follow the [Adding insurance information](#adding-insurance-information) steps to add the new insurance policy information to the patient's chart in Tebra
You can replace insurance policy information for patients in Elation via the [Patient Demographics](/articles/Patient-Demographics-Guide) but we recommend performing updates and removals in Tebra to track historical insurance information and to track the policy end date.
#### Removing an inactive insurance policy from a list of policies
If the patient has both a Primary and Secondary insurance policy and one of them are no longer in effect, you can remove the inactive policy from their chart (ex. patient's Secondary insurance is no longer in effect) by following the steps listed below. The inactive policy will be removed from Elation. Use the [Update insurance information with new policy section](#updating-insurance-information-with-new-policy) if you are replacing an inactive insurance policy with an active one.
| Tebra Web Browser Application | Tebra Windows PC Desktop Application |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Locate the patient's chart in Tebra • Go to **Account** >> **Insurance** • Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy • Click the **Edit** button next to the policy that is no longer in effect • Enter the policy end effective date in the **Policy End** field • Update the **Status** to **Inactive** • Click **Save Policy** to save your changes on the policy • Click **Save & Finish** to save your changes on the **Insurance Case**. | Locate the patient's chart in Tebra • Go to **Cases** • Select the **Case** with the policy that is no longer in effect • Click the **Edit...** button • Select the **Insurance Policy** that is no longer in effect • Click the **Edit...** button • Enter the policy end effective date in the **Effective End** field • Uncheck the **Active?** box • Click **Save** to save your changes to the policy information • Click **Save** on the **Case** to save your changes to the **Case** • Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart |
You can delete an inactive insurance policy in Elation via the [Patient Demographics](/articles/Patient-Demographics-Guide) but we recommend performing updates and removals in Tebra to track historical insurance information and to track the policy end date.
#### Removing all inactive policies
If all of the patient's policies within a give **Insurance Case** are no longer in effect, (ex. patient's Primary & Secondary insurances are no longer in effect), follow the steps listed below to mark the insurance case as inactive which removes the insurance information from the patient's chart in Elation. Use the [Update insurance information with new policy section](#updating-insurance-information-with-new-policy) if you are replacing an inactive insurance policy with an active one.
Tebra Web Browser Application
Tebra Windows PC Desktop Application
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Account** >> **Insurance**
3. Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy
4. Change the **Status** to **Inactive** & click **Save & Finish**
*
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Cases**
3. Select the **Case** with the policy that is no longer in effect
4. Click the **Edit...** button
5. Uncheck the **Active?** box
*
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
6. Click **Save** on the **Case** to save your changes to the **Case**
7. Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart
You can delete all inactive insurance policies in Elation via the [Patient Demographics](/articles/Patient-Demographics-Guide) but we recommend performing updates and removals in Tebra to track historical insurance information and to track the policy end date.
### Appointments
Patient appointments do not synchronize between Elation and Tebra. Track patient appointments in Elation to ensure providers have visibility into their schedule.
### Bills
The synchronization of bills is uni-directional from Elation to Tebra. Once a provider signs a visit note in Elation, the billing information in the visit note will be pushed to Tebra as a **Charge**. The following table lists the fields that are pushed from Elation & Tebra and show how the Tebra fields map to the Elation fields.
| Elation Field Name | Tebra Field Name |
| ------------------------ | ----------------------------------- |
| CPT | Procedure Code |
| Modifier | Mod |
| Charge | Charge |
| Qty | Units |
| Dx | Diagnosis |
| Service Location (POS) | Service Location & Place of Service |
| Additional Billing Notes | Notes |
Tebra will only ingest the first 12 diagnosis codes (ICD-10 codes) entered in Elation. If different ICD-10 codes were used for different service lines, Tebra will ingest up to 4 ICD-10s per service line and then ingest the remainder of the ICD-10 codes (but only up to 12 total)
Procedure Codes, ICD-10 codes and Modifiers used in Elation must be in the Tebra database in order for Tebra to accept the charges. You will see a Bill Error if the code you added is not in Tebra. Reference the following articles if you need to add additional codes to your Tebra database:
## Getting Support
### Tebra
If you need assistance with your Tebra configuration or have questions about the Tebra Windows PC Desktop Application or Web Browser Application, contact Tebra here: [https://helpme.kareo.com/Contact\_Us](https://helpme.kareo.com/Contact_Us)
### Elation
If you need assistance with Elation or the Elation-Tebra integration, contact Elation using the **I need help** -> **Contact Elation Support** button at the top of your Elation account.
## Frequently Asked Questions (FAQ)
### How long does it take information to synchronize between the two systems?
Information between Elation and Tebra usually synchronizes within a few seconds but can take up to 5 minutes depending on how busy the servers are.
### I created a patient chart in one system but the patient chart did not surface in the other system. What should I do?
We recommend making an update to the demographics in the system you originally created the chart in to trigger another connection between the two systems.
If you are using the Tebra Windows PC Desktop Application, make sure you click the **Save** button at the bottom of the \*\*Edit Patient \*\* window after making any changes to the patient's Tebra chart (demographics, cases or insurance) to save the changes and push the changes to Elation.
If you continue to run into synchronization issues, use the **I need help** -> **Contact Elation Support** button at the top of your Elation account to reach our Support Team for further assistance.
### I see duplicate charts for a patient. What should I do?
Review the [Merging Charts](#merging-charts) section of this article to understand how to correct for duplicate charts issues.
### I updated/added demographics information to a patient's chart but the information did not synchronize between Elation and Tebra. What should I do?
We recommend making an update to the demographics again in the system you originally made edits in to trigger another connection between the two systems. If you are using the Tebra Windows PC Desktop Application, make sure you click the **Save** button at the bottom of the \*\*Edit Patient \*\* window after making any changes to the patient's Tebra chart (demographics, cases or insurance) to save the changes and push the changes to Elation.
If you continue to run into synchronization issues, use the **I need help** -> **Contact Elation Support** button at the top of your Elation account to reach our Support Team for further assistance.
### Can I update billing information in Elation after sending it to Tebra?
The default behavior is that billing information is sent to Tebra after a provider signs the corresponding visit note in Elation. Once billing information is sent to Tebra, you must make updates manually in both Elation and Tebra. Changes or updates in Elation will not automatically be pushed to Tebra.
If you prefer to have extra time to review and update billing information after signing the visit note, you can use the **Delayed Billing** feature to hold bills in Elation and manually send them to Tebra once the billing information is complete. Learn more about the **Delayed Billing** feature in this [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing).
### I received a "Bill Error" after trying to send charge details from Elation to Tebra. Why?
There are a few common reasons why you may receive a **Bill Error** after attempting to send a charge from Elation to Tebra:
* There are missing CPT Codes or ICD-10 codes on service lines
* There are invalid CPT Codes, ICD-10 codes or Modifiers on service lines
* The CPT Codes, ICD-10 codes or Modifiers you added to Elation is not in your Tebra database. Reference the following articles if you need to add additional codes to your Tebra database:
* [Add CPT/Procedure code](https://helpme.kareo.com/01_Kareo_PM/05_Codes/02_Procedure_Codes/Procedure_Codes)
* [Add Diagnosis code](https://helpme.kareo.com/01_Kareo_PM/05_Codes/06_Diagnosis_Codes/Diagnosis_Codes)
* [Add Modifier](https://helpme.kareo.com/01_Kareo_PM/05_Codes/03_Procedure_Modifier_Codes/Procedure_Modifier_Codes)
* You selected a Practice Location that is not mapped to a Tebra Service Location. Follow the instructions in the [Map Practice Locations section](#mapping-practice-locations) to map your practice locations.
To bills with errors, you can click the **Edit Bill** button to edit the billing information and then click **Save & Re-send** to attempt to send the charges to Tebra again. If you continue to run into errors after troubleshooting, use the **I need help** -> **Contact Elation Support** button at the top of your Elation account to reach our Support Team for further assistance.
### I am unable to find a Carrier or Plan in Elation but I see it in Tebra. What should I do?
New Carriers and Plans created in Tebra or Elation must be tied to a patient in order for the Carrier or Plan to synchronize between the two systems. If you added a new Insurance Company or Insurance Plan in Tebra, add it to the proper patient account in Tebra and then you will see the Carrier or Plan in your Elation database.
*Tebra © 2022 All Rights Reserved*
\*©2022 Aetna Inc \**All Rights Reserved*
© 2022 Blue Cross Blue Shield Association. All Rights Reserved.
## Related Articles
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Billing Guide- Setting up CPT Codes and Place of Service](/articles/billing-settings---service-locations--procedure-codes)
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
# Elation-Tebra Integration Guide- Using Tebra as the source of truth for insurance and appointments
Source: https://help.elationhealth.com/articles/Kareo-Integration-Guide-Using-Kareo-for-insurance-and-appointments
This article describes the Elation-Tebra® integration for customers for customers who want insurance information to be uni-directrional from Tebra to Elation and want appointment information to sync from Tebra to Elation.
**Overview** This guide reviews one of two configurations for the Elation-Tebra integration. This version of the integration is for customers who want insurance information to be uni-directrional from Tebra to Elation and want appointment information to sync from Tebra to Elation. View the [Elation-Tebra Integration Guide- Using Elation as the source of truth for demographics and appointments](/articles/Kareo-Integration-Guide-Using-Elation-as-the-source) article if you want to complete patient intake and track appointments in Elation.
## What is Tebra?
Tebra® is also referred to as Kareo® in some URLs and external links.
Tebra® is a Practice Management and Medical Billing Solution software that practices can use alongside Elation. Practices most commonly use Tebra to submit claims to Payers for services rendered and track the progress of claim payments.
## What is the Elation-Tebra integration?
The Elation-Tebra integration allows practices to send claims-related data from Elation to Tebra for practices to submit claims to Payers (through Tebra) for services rendered in Elation. The Elation-Tebra integration reduces the need for double documenting in two softwares and allows practices to store all their clinical data in Elation while using Tebra side-by-side to manage their revenue.
**Important Information** : This guide reviews one of two configurations for the Elation-Tebra integration. This version of the integration is for customers who want insurance information to be uni-directrional from Tebra to Elation and want appointment information to sync from Tebra to Elation. View the [Elation-Tebra Integration Guide- Using Elation as the source of truth for demographics and appointments](/articles/Kareo-Integration-Guide-Using-Elation-as-the-source) article if you want to complete patient intake and track appointments in Elation.
## How do I get started?
You must first have an account with Tebra before you can use this integration. Once you have worked with Tebra to set up your account, you can request to turn on the Tebra integration by clicking **I need help** -> **Contact Elation Support**.
### Mapping Providers
Each Provider level user must have an account in both Elation and Tebra in order for Elation to be able to map patient data across the two systems. Please work with Elation and Tebra to make sure you have the correct accounts needed for the integration.
### Mapping Provider Calendars
Provider Calendars in both Elation and Tebra are tied to Provider level user accounts. Each Provider Calendar in Tebra must have a matching Provider Calendar in Elation in order for appointments to push from Tebra to Elation. Please work with Elation and Tebra to make sure you have the correct accounts needed for the Provider Calendars you have in the two systems.
### Mapping Practice Locations
Each Practice Location in Elation must be mapped to a Service Location in Tebra in order for your [Bills](#bills) to push from Elation to Tebra. Follow these steps to map your Elation Practice Location to the corresponding Service Location in Tebra:
1. Sign in to your Elation account and click on your email address at the top of your account
2. Go to **Settings** >> **Practice Locations**
3. Click the **Edit** button next to the Practice Location you want to map
4. Select a **POS code** and **Tebra name** for the Practice Location
5. Click **Save**
Follow the instructions in [this article](https://helpme.kareo.com/01_Kareo_PM/04_Settings/Service_Locations/Service_Locations) if you need to create/add a Service Location in Tebra.
## What information is synchronized?
The following information is synchronized between Elation and Tebra for this version of the integration:
| **Data** | **Sync Direction** |
| -------------- | ------------------- |
| Patient Charts | Elation **↔** Tebra |
| Demographics | Elation **↔** Tebra |
| Insurance | Tebra **→** Elation |
| Appointments | Tebra **→** Elation |
| Bills | Elation **→** Tebra |
### Patient Charts
**Creating Charts**
Patient charts can be created in either system because Patient Demographics is bi-directional. Creating a patient chart in one system will also create the patient chart in the other system.
*
As best practice, we recommend creating Patient Charts in Tebra when possible because you will already be managing insurance information and appointments in Tebra. This will allow your front office staff to stay in one system (Tebra) for a majority of their work.
#### Merging Charts
Each chart can only have a one to one connection between Elation and Tebra and this connection is established upon chart creation. If you happen to see a duplicate chart for the same patient in either system, please make sure you find the chart that is connected between the two systems and keep the connected chart after performing a merge.
* For example, patient John Smith has one chart in Tebra but two charts in Elation. The best way to find out which of the two charts in Elation is connected to Tebra is by updating one of the connected demographics fields in Tebra to see which of the two charts in Elation receives the update. The chart that receives the update must be the chart that you keep in Elation when performing a chart merge.
Here are the proper merge steps for Elation charts:
1. Open the duplicate chart that is not connected to the integration
2. Click on the patient's name to open their Demographics
3. Click on the **Merge Chart** button
4. Find & select the chart you want to keep (the one that is connected to the integration)
5. Click **Merge Chart**
6. Confirm you understand the transfer of data and then click **Yes, merge charts**
#### Deleting Charts
Deleting a chart in Elation will not delete the chart in Tebra. Please take caution when deleting charts in Elation while using the Tebra integration as charts have a one to one connection via the integration. If the patient is still active in your practice, the deleted chart must be restored in order for the patient's information to sync properly across the two systems.
You can restore a deleted patient chart yourself using the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice). Go to **Reports** > **User Activity Log**, filter by the patient or by the "Delete" action, and click the **Restore** button next to the deleted chart. [Admin Level Users](/articles/administrative-privileges) can view and restore activity for all users in the practice.
### Patient Demographics
The synchronization of Patient Demographics is bi-directional. Any changes made in one system will be pushed to the other system. The following table shows a mapping of the Patient Demographics fields that are shared between Elation and Tebra and their matching field names.
*
As best practice, we recommend managing demographics in Tebra when possible because you will already be managing insurance information and appointments in Tebra. This will allow your front office staff to stay in one system (Tebra) for a majority of their work.
| Elation Field Name | Tebra Field Name |
| --------------------------------------------------------------- | ------------------------------------------------------------------------------- |
| Legal First Name | First name |
| Middle Name | M |
| Legal Last Name | Last name |
| Date of birth | DOB |
| Sex at Birth | Sex |
| Phone- *Home* , *Mobile* or *Work* type only (and up to 2 only) | Home Phone, Mobile Phone or Work Phone (depending on what is stored in Elation) |
| Email | Personal Email |
| Address | Address Line 1 |
| Ste or apt # | Address Line 2 |
| City | City |
| State | State/Province |
| Zip | Zip/Postal Code |
| Provider assigned in practice | Primary Provider |
### Insurance
The synchronization of insurance information is uni-directional from Tebra to Elation. Practices must enter insurance information in the **Account >> Insurance** section of the patient's chart in Tebra in order for the insurance information to push to Elation.
Tebra uses a feature called an **Insurance** **Case** to store insurance policy information. Each period or type of insurance coverage in Tebra should be tied to its own *Insurance* *Case* . For example: If patient John Smith has medical coverage and separate insurance for an automobile accident, John Smith should have two *Insurance* *Cases* in Tebra, one *Insurance* *Case* for his personal medical insurance and the other **Insurance** **Case** for his automobile accident insurance. Make sure you set the primary \*\*Insurance Case \*\* as the the one you wish to share with Elation.
If patient Jane Doe has Aetna® insurance from 1/1/2021 to 12/31/2021 and then changes to Blue Cross® beginning 1/1/2022 then Jane Doe should have two *Insurance* *Cases* in Tebra, one *Insurance* *Case* for Aetna that is marked as **Inactive** and one *Insurance* *Case* for Blue Cross that is the new primary, active **Insurance Case**.
The following table lists the insurance related fields that are pushed from Tebra to Elation and show how the Tebra fields map to the Elation fields. Fields that are not listed are not shared between Elation and Tebra:
| Tebra Field Name | Elation Field Name |
| --------------------------------------------------- | ---------------------------------- |
| Plan Name | Plan name |
| Company Name (\*hidden behind *Plan Name* in Tebra) | Insurance carrier name |
| Policy Number | Member ID |
| Group Number | Group ID |
| Copay Amount | Copay |
| Deductible Amount | Deductible |
| Relationship to Primary Policy Holder | Patient's relation to policyholder |
| Insured Name | First Name & Last Name |
| Street Address | Address |
| City | City |
| State | State |
| Zip | Zip |
| SSN | SSN |
| DOB | Date of birth |
| Gender | Sex at birth |
*
If you need to add a new Insurance Company or Plan to your Tebra database, follow the instructions in [this article](https://helpme.kareo.com/Platform/Practice_Settings/Insurance/Add_New_Insurance_Companyhttp://)
#### Carriers & Plans
Insurance Carriers and plans details should only be maintained in Tebra as Tebra is the source of truth for insurance and Tebra can store more detailed information about Payers such as the Payer ID. It is most important for you to create Plans in Tebra (especially when it is for a Payer you already send claims to in Tebra) to avoid creating duplicate Payers in Tebra.
After the Carrier or Plan is created in Tebra and it is added to a patient's chart in Tebra, the Carrier and Plan will push over to your **Insurance** Settings page in Elation. If you need to add a new Insurance Company or Plan to your Tebra database, follow the instructions in [this article](https://helpme.kareo.com/Platform/Practice_Settings/Insurance/Add_New_Insurance_Companyhttp://).
*
The address for Carriers in Elation is pulled from the **Insurance Plan** setting of Tebra (and not the **Insurance Company** setting).
#### Adding insurance information
For patients who do not have any active insurance information in Tebra, follow the appropriate steps below to add insurance to their chart in Tebra (which then pushes the insurance information over to Elation):
| Tebra Web Browser Application | Tebra Windows PC Desktop Application |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| Open the patient's chart in Tebra • Go to **Account** >> **Insurance** • Click\*\*"+ Add New Insurance Case" to add an \*\* Insurance\*\* *Case* • Go to the \*\* Policy #1: New Insurance\*\* section and fill in the patient's primary insurance policy information. • Click the \*\* Save Policy\*\* button once you have filled in all the information for the insurance policy you are adding • If the patient has secondary insurance coverage, click **+Add Another Policy** to add their Secondary Insurance information to the case. • Click \*\* Save & Finish\*\* at the very bottom of the page to save the case after you have added all the policies to the case | Open the patient's chart in Tebra • Go to \*\* Cases\*\* • Click\*\*"Add..." to add a **Case** • Go to the **Insurance** section and click **Add** to add a new insurance policy to the **Case** • If the patient has secondary insurance coverage, click **Add..** again to add their Secondary Insurance information to the case. • Click **Save** at the very bottom of the **New Case** window to save the case after you have added all the policies to the case • Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart |
#### Correcting insurance information
If policy information was entered incorrectly follow the steps below to make corrections as needed in Tebra (which then updates the insurance information in Elation):
| Tebra Web Browser Application | Tebra Windows PC Desktop Application |
| --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Locate the patient's chart in Tebra • Go to **Account** >> **Insurance** • Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy • Click the **Edit** button next to the **Policy** you need to edit • Make the appropriate changes • Click **Save Policy** to save your changes to the policy information • Click **Save & Finish** to save your changes to the **Case** | Locate the patient's chart in Tebra • Go to **Cases** • Select the **Case** with the policy that needs corrections • Click the **Edit...** button • Select the **Insurance Policy** that needs corrections • Click the **Edit...** button • Make the appropriate changes • Click **Save** to save your changes to the policy information • Click **Save** on the **Case** to save your changes to the **Case** • Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart |
#### Updating insurance information with new policy
If all of the patient's policies within a given **Insurance Case** are no longer in effect, (ex. patient's old Primary & Secondary insurances changed), follow the steps listed below to mark the old policy as inactive and then add the new policies to the patient's chart. The new policy information will replace the old policy information in Elation. Use the [Update insurance information with new policy section](#updating-insurance-information-with-new-policy) if you are replacing an inactive insurance policy with an active one.
Tebra Web Browser Application
Tebra Windows PC Desktop Application
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Account** >> **Insurance**
3. Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy
4. Change the **Status** to **Inactive** & click **Save & Finish**
*
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
5. Follow the [Adding insurance information](#adding-insurance-information) steps to add the new insurance policy information to the patient's chart in Tebra
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Cases**
3. Select the **Case** that you want to mark as inactive
4. Click **Edit...**
5. Uncheck the **Active?** Box
*
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
6. Click **Save** to save you changes to the **Case**
7. Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart
8. Follow the [Adding insurance information](#adding-insurance-information) steps to add the new insurance policy information to the patient's chart in Tebra
#### Removing an inactive insurance policy from a list of policies
If the patient has both a Primary and Secondary insurance policy and one of them are no longer in effect, you can remove the inactive policy from their chart (ex. patient's Secondary insurance is no longer in effect) by following the steps listed below. The inactive policy will be removed from Elation. Use the [Update insurance information with new policy section](#updating-insurance-information-with-new-policy) if you are replacing an inactive insurance policy with an active one.
| Tebra Web Browser Application | Tebra Windows PC Desktop Application |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Locate the patient's chart in Tebra • Go to **Account** >> **Insurance** • Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy • Click the **Edit** button next to the policy that is no longer in effect • Enter the policy end effective date in the **Policy End** field • Update the **Status** to **Inactive** • Click **Save Policy** to save your changes on the policy • Click **Save & Finish** to save your changes on the **Insurance Case**. | Locate the patient's chart in Tebra • Go to **Cases** • Select the **Case** with the policy that is no longer in effect • Click the **Edit...** button • Select the **Insurance Policy** that is no longer in effect • Click the **Edit...** button • Enter the policy end effective date in the **Effective End** field • Uncheck the **Active?** box • Click **Save** to save your changes to the policy information • Click **Save** on the **Case** to save your changes to the **Case** • Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart |
#### Removing all inactive policies
If all of the patient's policies within a give **Insurance Case** are no longer in effect, (ex. patient's Primary & Secondary insurances are no longer in effect), follow the steps listed below to mark the insurance case as inactive which removes the insurance information from the patient's chart in Elation. Use the [Update insurance information with new policy section](#updating-insurance-information-with-new-policy) if you are replacing an inactive insurance policy with an active one.
Tebra Web Browser Application
Tebra Windows PC Desktop Application
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Account** >> **Insurance**
3. Click the **Edit** button next to the **Insurance** **Case** that is tied to the insurance policy
4. Change the **Status** to **Inactive** & click **Save & Finish**
*
Making an *Insurance* *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make an **Insurance** **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
1. Locate the patient's chart in Tebra
2. Go to **Cases**
3. Select the **Case** with the policy that is no longer in effect
4. Click the **Edit...** button
5. Uncheck the **Active?** box
*
Making a *Case* inactive in Tebra will delete all of the Primary and Secondary insurance information in the Elation chart. Only make a **Case** inactive in Tebra if the insurance policies tied to the case are no longer in effect.
6. Click **Save** on the **Case** to save your changes to the **Case**
7. Click **Save** at the very bottom of the **Edit Patient** window to save your changes to the patient's chart
### Appointments
The synchronization of appointments is uni-directional from Tebra to Elation. Practices must enter and edit appointments in Tebra for the appointment to push to the corresponding Provider calendar in Elation. The instructions in [this article](https://helpme.kareo.com/Platform/Calendar/New_Patient_Appointment) will show you how you can add appointments to Tebra.
Appointments added to Elation will not appear in Tebra. Edits to appointments in Elation will not appear in Tebra either.
The following table lists the Appointment fields that are pushed from Tebra to Elation and show how the Tebra fields map to the Elation fields. Fields that are not listed are not shared between the Elation and Tebra:
| Tebra Field Name | Elation Field Name |
| ------------------------------------------------------------------------------------------------------------------ | ---------------------------------- |
| Patient | Patient name |
| Visit [Reason](https://helpme.kareo.com/01_Kareo_PM/07_Appointments/03_Appointment_Reasons/Add_Appointment_Reason) | Description - chief complaint (CC) |
| Start Date | Date |
| Start Time | Start time |
| Duration | Duration |
| Provider | Provider |
*
The **Appointment Type** for Tebra created appointments in Elation will always be "None". Adjust the **Appointment Type** in your Elation calendar for appointments to trigger the [Patient Forms](/articles/Patient-Forms-Guide#ptex) and [Virtual Visit instruction](/articles/Elation-Telehealth-powered-by-Zoom#VirtualVisitInstructions) features as needed.
### Bills
The synchronization of bills is uni-directional from Elation to Tebra. Once a provider signs a visit note in Elation, the billing information in the visit note will be pushed to Tebra as a **Charge**. The following table lists the fields that are pushed from Elation to Tebra and show how the Tebra fields map to the Elation fields. Field that are not listed are not shared between Elation and Tebra.
| Elation Field Name | Tebra Field Name |
| ------------------------ | ----------------------------------- |
| CPT | Procedure Code |
| Modifier | Mod |
| Charge | Charge |
| Qty | Units |
| Dx | Diagnosis |
| Service Location (POS) | Service Location & Place of Service |
| Additional Billing Notes | Notes |
Tebra will only ingest the first 12 diagnosis codes (ICD-10 codes) entered in Elation. If different ICD-10 codes were used for different service lines, Tebra will ingest up to 4 ICD-10s per service line and then ingest the remainder of the ICD-10 codes (but only up to 12 total)
Procedure Codes, ICD-10 codes and Modifiers used in Elation must be in the Tebra database in order for Tebra to accept the charges. You will see a Bill Error if the code you added is not in Tebra. Reference the following articles if you need to add additional codes to your Tebra database:
## Getting Support
### Tebra
If you need assistance with your Tebra configuration or have questions about the Tebra Windows PC Desktop Application or Web Browser Application, contact Tebra here: [https://helpme.kareo.com/Contact\_Us](https://helpme.kareo.com/Contact_Us)
### Elation
If you need assistance with Elation or the Elation-Tebra integration, contact Elation using the **I need help** -> **Contact Elation Support** button at the top of your Elation account.
## Frequently Asked Questions (FAQ)
### How long does it take for information to synchronize between the two systems?
Information between Elation and Tebra usually synchronizes within a few seconds but can take up to 5 minutes depending on how busy the servers are.
### I created a patient chart in one system but the patient chart did not surface in the other system. What should I do?
We recommend making an update to the demographics in the system you originally created the chart in to trigger another connection between the two systems.
If you are using the Tebra Windows PC Desktop Application, make sure you click the **Save** button at the bottom of the \*\*Edit Patient \*\* window after making any changes to the patient's Tebra chart (demographics, cases or insurance) to save the changes and push the changes to Elation.
If you continue to run into synchronization issues, use the **I need help** -> **Contact Elation Support** button at the top of your Elation account to reach our Support Team for further assistance.
### I see duplicate charts for a patient. What should I do?
Review the [Merging Charts](#merging-charts) section of this article to understand how to correct for duplicate charts issues.
### I updated/added demographics information to a patient's chart but the information did not synchronize between Elation and Tebra. What should I do?
We recommend making an update to the demographics again in the system you originally made edits in to trigger another connection between the two systems.
If you are using the Tebra Windows PC Desktop Application, make sure you click the **Save** button at the bottom of the \*\*Edit Patient \*\* window after making any changes to the patient's Tebra chart (demographics, cases or insurance) to save the changes and push the changes to Elation.
If you continue to run into synchronization issues, use the **I need help** -> **Contact Elation Support** button at the top of your Elation account to reach our Support Team for further assistance.
### Can I update billing information in Elation after sending it to Tebra?
The default behavior is that billing information is sent to Tebra after a provider signs the corresponding visit note in Elation. Once billing information is sent to Tebra, you must make updates manually in both Elation and Tebra. Changes or updates in Elation will not automatically be pushed to Tebra.
If you prefer to have extra time to review and update billing information after signing the visit note, you can use the **Delayed Billing** feature to hold bills in Elation and manually send them to Tebra once the billing information is complete. Learn more about the **Delayed Billing** feature in this [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing).
### I received a "Bill Error" after trying to send charge details from Elation to Tebra. Why?
There are a few common reasons why you may receive a **Bill Error** after attempting to send a charge from Elation to Tebra:
* There are missing CPT Codes or ICD-10 codes on service lines
* There are invalid CPT Codes, ICD-10 codes or Modifiers on service lines
* The CPT Codes, ICD-10 codes or Modifiers you added to Elation is not in your Tebra database. Reference the following articles if you need to add additional codes to your Tebra database:
* [Add CPT/Procedure code](https://helpme.kareo.com/01_Kareo_PM/05_Codes/02_Procedure_Codes/Procedure_Codes)
* [Add Diagnosis code](https://helpme.kareo.com/01_Kareo_PM/05_Codes/06_Diagnosis_Codes/Diagnosis_Codes)
* [Add Modifier](https://helpme.kareo.com/01_Kareo_PM/05_Codes/03_Procedure_Modifier_Codes/Procedure_Modifier_Codes)
* You selected a Practice Location in Elation that is not mapped to a Tebra Service Location. Follow the instructions in the [Map Practice Locations section](#mapping-practice-locations) to map your practice locations.
For bills with errors, you can click the **Edit Bill** button to edit the billing information and then click **Save & Re-send** to attempt to send the charges to Tebra again. If you continue to run into errors after troubleshooting, use the **I need help** -> **Contact Elation Support** button at the top of your Elation account to reach our Support Team for further assistance.
### I am unable to find a Carrier or Plan in Elation but I see it in Tebra. What should I do?
New Carriers and Plans created in Tebra or Elation must be tied to a patient in order for the Carrier or Plan to synchronize between the two systems. If you added a new Insurance Company or Insurance Plan in Tebra, add it to the proper patient account in Tebra and then you will see the Carrier or Plan in your **Insurance** Settings page in Elation.
*Tebra © 2022 All Rights Reserved*
\*©2022 Aetna Inc \**All Rights Reserved*
© 2022 Blue Cross Blue Shield Association. All Rights Reserved.
## Related Articles
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Billing Guide- Setting up CPT Codes and Place of Service](/articles/billing-settings---service-locations--procedure-codes)
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
# Kentucky State- KYIR/KHIE- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Kentucky-State-KYIR-KHIE-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Kentucky Immunization Registry (also known as the Kentucky Health Information Exchange) directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Kentucky Immunization Registry (KYIR). It is also known as the Kentucky Health Information Exchange (KHIE).
## What is the KYIR/KHIE Immunization Registry Interface?
The KYIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to KYIR; the Kentucky Immunization Registry (also known as the Kentucky Health Information Exchange). Practices can also query KYIR/KHIE for vaccination history or forecast.
## Why is the KYIR/KHIE Immunization Registry Interface valuable?
With the KYIR/KHIE Immunization Registry Interface, practices no longer need to separately log in to KYIR/KHIE to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to KYIR/KHIE. You can also pull vaccination history for specific patients from KYIR/KHIE to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & KYIR/KHIE
The Elation Team will assist you with initiating interface with KYIR/KHIE. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
* What Kentucky county is your practice in?
* Does your practice have a Group/Facility NPI? If so, what is the NPI?
* Does your practice administer vaccines?
* Do you have alternative physical locations that administer vaccines? If so, which locations?
* Does your practice participate in any of the following?: MIPS, APM (MIPS Alternative Payment Model), VFC (Vaccines for Children), ACO (Accountable Care Organization), PCMH (Primary Care Medical Home)
* If yes to MIPS, does your practice participate in Promoting Interoperability (PI)? If yes, what stage?
* If yes to APM, what APM program?
* If yes to VFC, what is your VFC PIN?
* Is your practice any of the following?: Federally Qualified Healthcare Center (FQHC), Rural Health Clinic (RHC), 42 CFR Part 2 Program (Controlled Substance Abuse Treatment)
* Does your practice already work with KHIE?
* What is the name, email, and title of the point of contact for this project?
* What is the name, email, and title of the secondary point of contact for this project?
* What is the name, email, and title of the individual authorized to sign legal paperwork with KHIE for this project?
* What is the name, email, and title of the point of contact for HIPAA/Privacy concerns for this project?
## How to submit vaccination data to KYIR/KHIE using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to KYIR/KHIE. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using KYIR/KHIE
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
# Lab Orders & Results Introduction
Source: https://help.elationhealth.com/articles/Lab-Orders-and-Results-Introduction
## Lab Orders
### Overview
#### What is a Lab Order Form in Elation?
The Lab Order Form allows you to efficiently request tests on a patient’s specimen—such as blood, urine, or tissue—to obtain important results that can guide diagnosis or treatment.
#### What are the benefits of using Elation’s Lab Order Form?
Elation’s Lab Order Form **standardizes and streamlines the lab ordering process.**
* Input all required patient and test details in structured fields to prevent data entry errors
* Leverage patient details (e.g. demographics and insurance) that are already saved in the chart for efficiency.
* Select tests and codes from standardized databases to avoid ambiguity
#### How do I send a lab order to a lab vendor?
Use one of the following methods to send the lab order to the lab vendor:
* Send the lab order electronically - known as eOrdering - using a Bidirectional Lab Interface. [Click here to see a list of all the lab vendors that support eOrdering as well as understand eOrdering specific workflows](/articles/Electronic-Lab-Order-Form).
* Fax the lab order directly from the chart using Elation’s Provider Letter feature. [Click here for Elation’s faxing instructions](/articles/efaxing-lab-and-radiology-orders).
* Print the lab order to hand to the patient or fax *outside* of Elation.
### Set-up Requirements
To begin using Elation’s Lab Order Form, follow the instructions below.
| Set up lab vendors (mandatory) |
| ----------------------------------- |
| Create Lab Order Sets (recommended) |
### Workflow Guides
Use the workflow guide that best matches the **interface status** of the vendor you’re ordering from:
* Creating lab orders for lab vendors without any type of lab interface.
* Creating lab orders for lab vendors with a pending or live results-only interface.
* Creating lab orders for lab vendors with a pending bidirectional lab interface.
* Creating lab orders for lab vendors with a live bidirectional lab interface.
## Lab Results
### Overview
#### What is a lab result in Elation?
Lab results are the outcomes of medical tests that analyze samples of a patient’s blood, urine, other bodily fluids, or tissues.
Lab results can be received via:
* Electronic transmission from a live lab interface.
* eFax through Elation's Fax Inbox.
* Paper and then uploaded to the patient’s chart.
* Patient Passport and then stored in the patient’s chart.
Refer to the Workflow Guides section below to learn more about how each type of result makes its way into the chart.
### Set-up
1. Set up lab interfaces (mandatory)
### Workflow Guides
#### Receiving lab results
Use the workflow guide that best matches the nature of the patient’s lab result:
* [Receive electronic lab results directly in the patient’s chart](/articles/Viewing-results-from-lab-interfaces).
* Triage [lab results received through your Elation Fax Inbox](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart).
* [Upload lab results](/articles/filing-documents-to-a-patient-chart) received outside Elation.
* [File lab results sent by your patient through Patient Passport](/articles/elation-patient-passport-an-introduction#attachments).
#### Sharing lab results
* [Sharing lab results with patients via Patient Passport](/articles/elation-patient-passport-an-introduction#attaching).
* [Sharing lab results with external collaborators via a Provider Letter or Referral](/articles/letter-and-referral-introduction).
## Close-the-Loop
### Overview
#### What does Close-the-Loop mean?
Close-the-Loop is a feature that helps your practice follow-up on a patient’s orders and referrals.
* Orders and referrals are marked as ‘Outstanding’ until someone updates them to ‘Fulfilled’ when the test results or consult notes are added to the chart.
* You can also set a reminder to appear in your Practice Home **Reminders** inbox if an order hasn’t been marked as ‘Fulfilled’ by the date you choose.
### Set-up
There are two versions of the Close-the-loop experience that you can request.
One option lists all of a patient’s outstanding referrals and orders together under the **Outstanding Items** chart section for easy access. The second option only shows the Close-the-Loop status when you scroll to each order and referral in the **Chronological Record** or **Reports** dialog. More details about this distinction can be found in the workflow instructions below.
To request the Close-the-Loop feature, click **I need help** -> **Contact Elation Support** and specify which version of the feature you prefer.
* \*\*Option 1:\*\**Please enable the Close-the-Loop feature. I want outstanding orders & referrals to always appear in the **Outstanding Items** section of my patient charts.*
* \*\*Option 2:\*\**Please enable the Close-the-Loop feature. I do not want outstanding orders & referrals to always appear in the **Outstanding Items** section of my patient charts.*
### Workflow Guides
[Click here for instructions on how to use the Close-the-Loop feature](/articles/follow-up-outstanding-orders-referrals).
## Frequently Asked Questions
### Does Elation have any interfaces with lab centers?
Yes, Elation has interfaces with many lab centers to receive electronic lab results. For some vendors, orders can also be sent electronically through Elation’s Lab Order Form. You can always find the latest list of interfaced partners and the type of integration possible on our [Partners](https://www.elationhealth.com/integrations/) page.
### Can I order other medical tests in Elation?
Yes! You can also order imaging (radiology), cardiac, pulmonary, and sleep tests in Elation. [Click here for more information about the different medical tests forms](/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients).
## Related Articles
* [Lab Orders & Results - Managing lab vendors](/articles/Managing-lab-vendors)
* [Lab Orders & Results - Creating lab order sets](/articles/Managing-lab-order-sets)
* [Lab Orders & Results - Using the regular Lab Order Form](/articles/Regular-Lab-Order-Form)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Lab Orders & Results - Managing electronic lab results](/articles/Viewing-results-from-lab-interfaces)
* [Orders Guide - Creating tests for Order Forms](/articles/Creating-tests-for-Order-Forms)
* [Orders Guide- Following up on outstanding orders & referrals](/articles/follow-up-outstanding-orders-referrals)
# Letters & Referrals Guide - Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Letters-Referrals-Guide-Frequently-Asked-Questions
This articles lists all the questions that customers commonly ask about the Letters feature and Referrals feature in the EHR.
## Fax Configuration
### What is my electronic fax number with Elation?
To locate the electronic fax number assigned to you by Elation, log in to your Elation EHR account and then click on the **Fax Inbox** at the top of the Practice Home page. The 10 digit number you see is your electronic fax number with Elation. Faxes to this fax number will automatically appear as images in your **Fax Inbox**. [Click here to learn more about the Fax Inbox](/articles/Fax-Inbox-Introduction).
### Do I need to have an electronic fax number with Elation in order to send faxes from the patient's chart?
No, you do not need to have an electronic fax number with Elation in order to send faxes from the patient's chart. Outbound faxes use fax numbers that are different from your Elation electronic fax number. Elation's outbound fax numbers start with the **650** area code.
### Do the faxes I send out of Elation come from my Elation electronic fax number?
No, outbound faxes do not come from your Elation fax number. Elation's outbound fax numbers start with the **650** area code.
### Can I customize the fax cover page sent with my Letters and Referrals?
No, the cover page is automatically generated by Elation and cannot currently be customized or removed on a per-practice basis. It includes basic fax cover information and, for larger record sets, standard language about viewing shared clinical information securely online.
## Drafting Letters and Referrals
### What is the difference between a Letter to Provider, a Letter to Patient, and a Referral?
The **Referral** form, available via the **Referral** button at the top of a patient's chart, has additional fields for information normally required for a patient referral — reason for referral, diagnosis codes, and prior authorization. Only Provider Level Users and their [Referral Delegates](/articles/staff-permissions--staff-delegates#referrals) can sign referrals.
The **Letter to Provider**, available via **Letter** → **To Provider**, is used for more generic correspondence such as sharing patient records between care settings. Any user can sign letters.
The **Letter to Patient**, available via **Letter** → **To Patient**, is used to communicate with patients who have active Patient Passport accounts. Any user can sign letters. Learn more in our [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction).
### How do I send information to a patient?
Patients must register for Patient Passport in order to see your message. Learn more about the Patient Passport feature in our [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction) and [FAQ](https://www.elationhealth.com/patient-passport/) .
Use the **Letter** → **To Patient** option at the top of the patient's chart to send a Letter/message to a Patient via Patient Passport. You will be able to attach records (like visit notes, labs results, and handouts) to the Letter to share with the patient.
### How do I send a fax to another office?
Use the **Letter** → **To Provider** option at the top of the patient's chart to fax patient information to another office or facility. In the Letter, type the recipient's fax number in the **To:** field. You can optionally save the number as a new contact for future use. [Learn more about faxing patient information here](/articles/letter-and-referral-introduction#Fax).
### If I send a Direct message or Elation Connect letter, can the recipient see my entire chart?
No, they only see the specific note, report, or attachments you chose to send.
### How do I send an email to another provider or office?
The recipient will receive a generic email from Elation, but they'll be required to log into a secure portal to see your message. [Learn more about securely sending patient information by email here](/articles/letter-and-referral-introduction#Email) .
Use the **Letter** → **To Provider** option at the top of the patient's chart to securely email patient information to another provider or office. First type in the recipient's name in the **To:** field to find them in the **Elation Provider Directory** and then click **Edit** to store their email address in the **Email** field. If you cannot find the recipient in the Elation Provider Directory, follow the instructions in the [Creating New Contacts Guide](/articles/Using-the-Provider-Directory) to create a contact for them.
### How do I send a Referral to another provider?
Use the **Referral** option at the top of the patient's chart to send a referral to another provider. [Learn more about the Referral feature here](/articles/letter-and-referral-introduction#HowToInitiate).
### How can an outside practice send me a referral for a patient who does not yet have a chart in Elation?
The best option depends on whether the referring practice's EHR supports Direct messaging:
* **Direct messaging (recommended, if available)**: Share your Elation [Direct Address](/articles/how-to-use-direct-messaging). When the referring practice sends a Direct message with a CCD/CCDA attached for a patient who doesn't yet have a chart, Elation automatically creates a new chart and imports the clinical data.
* **Fax**: Share your Elation electronic fax number. Since faxed referrals must be associated with a patient chart, consider creating a generic chart (e.g. "Office Fax Only") to receive faxes that aren't yet tied to an existing patient, then create a proper chart once you review the referral.
* **[Carequality](/articles/Carequality-Integration-Introduction#what-is-carequality)** and **[Elation Connect](/articles/secure-Provider-Portal)** are not appropriate for this scenario: Carequality only exchanges data for patients who already have a chart in your Elation panel, and Elation Connect invitations are only sent as part of an outbound Provider Letter or Referral, so there's no way to invite an outside provider to Connect before a chart exists.
### Can I save the Subject & Body of my Letter/Referral and use it again for future Letters/Referrals?
Yes, to save the **Subject** and **Body**/**Reason** as a template for future use: The template will be accessible to all users in your practice when drafting letters or referrals.
1. Click **Save as Template** at the bottom of the **Body** field in a **Letter** or **Reason** field of a **Referral**.
2. Give the template a name.
3. Click **Save**.
### How do I apply a template to my Letter/Referral?
Click on the **Templates** button and then click on the name of the template you want to add to your letter or referral.
### Can I schedule a future delivery date for the Letter/Referral I am drafting?
Yes, you can use the **Post Date** field to schedule the Letter/Referral to be sent on a specific date in the future. The message will be delivered at 12:00 am Pacific on the date you specify. For example, if you select June 1, 2023 as the post date then your message will be delivered on June 1, 2023 at 12:00 am.
### Can a Letter/Referral template automatically pull in the patient's name, DOB, or address?
No, Letter/Referral templates only save the **Subject** and **Body**/**Reason** text — there's no way to insert variables that automatically pull in patient-specific details like name, date of birth, or address. The patient's name and mailing address that appear on a printed or mailed Letter come directly from the patient's Demographics and render automatically; they aren't edited within the template or Print Header itself.
### Can I choose which Print Header is used for Letters and Referrals?
Yes, by default, Elation will apply the header that you chose under the **Print Headers Settings** as your preferred header. You can also change the Print Header for specific letters or referrals by selecting a different Print Header from the Print Header listed in the letter or referral. [Click here](/articles/print-headers) to learn more about customizing Print Headers for your practice.
### What is the Unread Alert setting used for?
The **Unread Alert** setting in letters or referrals is only applicable if the recipient is an Elation EHR provider, Provider Portal user, or Patient Passport user. Elation will alert you at the timeframe you specify if the recipient has not opened your Letter/Referral in their own account. This allows you to follow up with the recipient to make sure they receive your communication.
* Elation EHR providers have a logo next to their name.
* Elation Provider Portal users have a or (P) logo next to their name.
### How do I preview a Letter/Referral before sending it?
Click on the **Preview** button at the bottom of the letter or referral to see what it looks like before sending it to the recipient.
### Can I add multiple recipients to the same letter/referral?
No, only one recipient can be added to each letter or referral. If you need to send a letter or referral to more than one person, please create additional letters or referrals.
### How do I send a fax that is not specific to a patient?
Because outbound faxes need to be associated with a patient chart, you can [create a fake chart](/articles/Patient-Chart-Guide-Creating-a-new-patient-chart) with the first name **Outbound** and last name **Faxes** and create Letters within this chart.
### Can I send a Letter/Referral to a provider's Direct Address?
Yes, Elation allows you to send Direct Messages through Referral and Provider Letters. Learn more about the Direct Messaging feature in our [Direct Messaging Guide](/articles/how-to-use-direct-messaging#sending_DMs).
To create a generic Letter that you want to print out for a patient (such as permission for a leave of absence or a clearance for physical activity), simply put ***To Whom It May Concern*** in the **To:** field of the Letter and proceed with drafting the Letter. Then you can click one of the **Print** options to print a copy for the patient to take with them.
### I signed off on the wrong Letter by accident. Can I un-sign or amend it?
No, Elation does not currently support un-signing or amending a signed Letter or Referral.
If you're not sure which patient a signed Letter belongs to, an Admin Level User can check the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice) and filter by the signing user, the **Sign** action, and the **Letter** record type to find it. To flag the Letter to a colleague, open it and click **Actions** → **Office Message** to send a note that references it directly.
## Contact Record
### When should I create a contact vs. not?
When sending patient information to an external provider or medical organization, we recommend choosing from providers and/or organizations in the Elation Provider Directory and using the contact information in the database to send them patient records. Read this [Provider Directory Guide](/articles/Using-the-Provider-Directory) for more details on how to use contacts from the Provider Directory. You can also create your own contacts for those who are not providers or medical organizations but you frequently interact with them, such as a regulatory or government agency you fax documentation to. Reference the [Adding New Contacts for Letters and Referrals](/articles/Using-the-Provider-Directory) 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. However, if your fax has more than 40 pages of attachments then you must create a contact for them in order to send the fax.
### How do I create a patient contact?
The Letter to Provider and Referral features are not intended to be used to communicate with patients. Instead, use the **Letter** → **To Patient** feature to communicate with a patient via the Patient Passport feature. The patient will be automatically assigned as the contact when a Patient Letter is created. Learn more about the Patient Passport feature in our [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction).
### How do I create a provider or organization contact?
Follow the instructions in [this article](/articles/Using-the-Provider-Directory) to learn how to create a contact for providers or organizations. There is a video that walks you through the process as well.
### What are the different contact types?
1. Elation EHR contacts have a logo next to their name. When you use this contact in a letter/referral, Elation will [send letters/referrals and attachments to their Elation EHR account](/articles/share-documents-between-other-elationemr-users)
2. Elation Provider Portal contacts have ' a or (P) logo next to their name. When you use this contact in a letter/referral, Elation will send letter/referral and attachments to their [Provider Portal account](/articles/secure-Provider-Portal)
3. Providers in the Elation Provider Directory have a logo next to their name. When you use this contact in a letter/referral, Elation will send letters/referral and attachments to the **Direct Address** on file for them (if available) or send the letter/referral and attachments as a fax to the fax number tied to their contact.
4. Contacts with a blue 'Custom Contact' label next to their name are custom contacts created by your practice. When you use this contact in a letter/referral, Elation will send the letter/referral and attachments based on the contact information you saved for the contact. [Learn more about how the contact information is used here](/articles/letter-and-referral-introduction#HowItIsSent).
### How do I edit contact information for a contact?
You will not be able to edit contact information for Providers from Elation's Provider Directory. Use the use a different address", **use a different phone** or **use a different fax** buttons to add preferred contact information for Providers from Elation's Provider Directory. Elation will use the fax number you stored in the Preferred Fax number field to send your faxes to that contact.
To edit a contact's information, click on the **Edit** button next to their name. After you have edited their information, click **Save** to save your changes.
### How do I delete a contact?
Contacts that are part of Elation's Provider Directory (you will see a![Elation EHR contact icon: blue square with a person silhouette and "E" letter, indicating the contact is an Elation EHR provider]()
, ![Elation Provider Portal contact icon showing a "P" symbol, indicating the contact has a Provider Portal account]()
, or ![Elation provider directory contact icon indicating the contact is part of Elation's provider network]()
logo next to their name) cannot be deleted from the Provider Directory database. Custom contacts that you create (you will see a 'Custom Contact' ![Blue "Custom contact" label that appears next to custom practice-created contacts in the To: field of a Letter or Referral.]()
label next to their name) can be deleted. To delete a custom contact from your practice's private database:
1. Open a **Letter** → **To Provider**.
2. Go to the **To:** field and search for the name of the custom contact you want to delete and then select their name.
3. Click on the **Edit** button next to the contact's name.
4. Click the **Delete Profile** button at the top of **Profile Details**.
## Attachments
### How do I attach patient records to a Letter/Referral?
You cannot attach records that are still in **Requiring Action** or **Outstanding Items** .
By default, the Clinical Profile and Patient Demographics is automatically attached to Referral drafts. No records are automatically attached to Letters drafts. To attach all records in the patient's chart to a Letter/Referral draft, click the **Attach Everything in Chart** button towards the bottom of the Letter/Referral. To attach individual records in the patient's chart to a Letter/Referral draft:
1. Click the **Select Chart Items to Attach** button.
2. The **Most Recent** records you can attach will be displayed first. You can also choose specific records from the chart to attach by selecting a record category in the left column.
3. Check off records you want to attach & then click **Attach Items**.
The following records can be attached to a Letter or Referral:
* Patient Demographics
* Clinical Profile
* Immunization History
* Medication List (permanent medications only)
* Medication History (includes temporary and discontinued medications)
* Growth Charts
* Signed visit notes
* Signed non-visit notes
* Flowsheets (for customers using the [Prenatal Flowsheets](/articles/prenatal-flowsheets) feature only)
* Signed reports (such as lab reports, imaging reports, etc)
* Signed Referrals
* Signed Lab, Imaging, Cardiac, Pulmonary & Sleep Orders
* Patient Handouts (Patient Letters only)
* Signed (closed) office message threads
* Signed Provider Letters or Patient Letters
### Can I attach a superbill directly to a Letter or Referral?
No, a superbill isn't a standalone chart item you can select in **Select Chart Items to Attach**, since it's billing data embedded in the visit note rather than a separate attachable document. To share it, print or download the superbill (**Actions > Print > Claims Invoice (ICD-10)**) from the visit note, upload the resulting file into the patient's chart, and then attach it to the Letter or Referral from there.
### Are patient demographics notes shared on letters and referrals?
It depends on the recipient and your practice setting:
* **Patient-facing letters** never include the demographics **Notes** field (from the **Notes & Chart Management** section).
* **Provider-facing letters and referrals** that include a demographics page include the **Notes** field unless your practice has turned off **Share demographics notes with providers** in **Security & Privacy** Settings. Letters and referrals without a demographics page attachment are unaffected.
See [Security & Privacy Settings Overview — Demographics Notes](/articles/Security-and-Privacy-Settings-Overview#demographics-notes) for how to change the setting.
### How do I download the patient's full chart or export the patient's full chart?
You can download your patient's full chart by using the **Letter** → **To Provider** feature. Learn more about the workflow on our [Patient Chart Guide page](/articles/how-to-share-a-patients-entire-chart#DownloadChart).
### How do I share or download patient records from a specific date range?
When adding attachments to a Letter/Referral draft, you will not be able to filter for records by a specific time frame. We recommend scanning through the Attachments window to manually select each item that is relevant.
View the **Attachments** section of the Letter/Referral to see what records are attached to the Letter/Referral draft.
### How do I remove attachments from a Letter/Referral?
To remove an attachment from a Letter/Referral draft, click on the **X** button next to the name of the attachment in the **Attachments** section of the Letter/Referral.
### How do I know how many pages are attached to a Letter/Referral?
There is a page counter at the top of the list of attachments that tells you how many pages of records are attached to a Letter/Referral draft.
### How many pages can be faxed from my Elation account per Letter or Referral?
Up to 40 pages of documents can be faxed per Letter to Provider or Referral. If you are sharing more than 40 pages of documents with recipients, you can:
1. Break up the attachments into multiple Letters or Referrals.
2. Ask the recipient to retrieve the attachments via the [secure online Provider Portal](/articles/secure-Provider-Portal).
### Are the cover page and body of the Letter/Referral included in the 40 page attachment count?
No, the cover page and body of the Letter/Referral are not included in the 40 page count for drafted Letters/Referrals. All other attachments will be counted towards the 40 page limit.
### Why does Elation limit faxing to 40 pages?
The reason we limit faxes to 40 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 40 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](/articles/secure-Provider-Portal) for more details on how the recipient can view the records online. If you need to fax more than 40 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 free 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](/articles/fax-usage) about fax usage that you can use for reference.
### How do I remove the interactive chart automation so that recipients can only receive my attachments as fax?
The interactive chart automation can only be removed if you send the fax to a plain 10 digit fax number (in other words, the **To:** field only has the fax number, ex. 555-394-1298). This workflow will only support up to 40 pages of attachments for a single fax transmission. If you need to fax more than 40 pages of attachments, you must break up the attachments into multiple Letters or Referrals or [create a contact](/articles/Using-the-Provider-Directory).
### I am trying to attach a recent report/visit note but I cannot find it in the attachments list. Why?
Only signed records can be attached to Letters and Referrals. Please have the provider sign any documents or notes in Requiring Action or Outstanding Items if you need to attach them to Letters or Referrals.
### I am trying to send a fax to an 'Organization' contact but the Send buttons are grayed out. Why?
If your Letter or Referral has more than 40 pages attached, you can only send the Letter or Referral to an **Individual** type contact. Edit the contact's information and select **Individual** instead of an **Organization** and then you will be able to send the Letter or Referral.
## Referral Form
### What is the Referral form used for?
The Referral form is specifically used for patient referrals to other care settings and does not require a subject line. Use the **Reason** field to provide context for the referral.
Certain referrals, depending on the patient's insurance company's requirements, require you to disclose the reason for the referral — Elation provides a list of common referral reasons for ease of documentation.
The **Auth. #** field allows you to store the Prior Authorization Number provided by the insurance company for pre-approved referrals.
By default, the Clinical Profile and Patient Demographics is automatically attached to Referral drafts. This setting cannot be adjusted.
### How do I complete a Referral?
You have 5 options for completing your Referral:
1. **Sign, Send & Print Pt Copy** — Sends the Referral & prints a copy of the Referral with attachments.
2. **Sign & More** → **Sign & Send** — Sends the Referral.
3. **Sign & More** → **Sign & Print Referral Only (Pt Copy)** — Signs the Referral & prints the Referral without attachments.
4. **Sign & More** → **Sign & Print Referral & Attachments** — Signs the Referral & prints the entire Referral with attachments.
5. **Sign & More** → **Sign, Send & Create Follow-up Letter** — Sends the Referral & starts a new draft for the same recipient to assist with follow up.
### Can I allow my staff to sign off on referrals for me?
As best practice, only select Staff Level Users as delegates. If a Provider Level User selects another Provider Level User as a delegate, the selected Provider Level User will not be able to assign their own delegate permissions.
Yes, Provider Level Users can allow staff to sign Referrals on their behalf by adding the individual to their Authorized Referrals Delegate Settings from their own Elation accounts. Provider Level Users can assign Referrals delegates by following the instructions in this article: [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates)
### The Sign buttons are grayed out on the Referral form. 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 delegates](/articles/staff-permissions--staff-delegates).
To reuse the **Reason** of an old Referral for a new Referral for the same patient, find the old Referral in the patient's chart and click **Actions** → **Reorder**. A new Referral draft will open up with the **Reason** prefilled for your convenience.
### Is there a report that lists all of my practice's Referrals?
Not currently. There isn't a built-in report to generate a list of Referrals across your patient panel.
## Signing, Sending & Printing Provider Letters
### How do I complete a Provider Letter?
You have 4 options for completing your Provider Letter:
1. **Sign & Send** — Sends the Provider Letter.
2. **Sign & More** → **Sign, Send & Print Pt Copy** — Sends the Provider Letter & prints the body of the Letter without attachments.
3. **Sign & More** → **Sign & Print w/attachments** — Sends the Provider Letter & prints the entire Provider Letter; body of the Letter with attachments.
4. **Sign & More** → **Sign, Send & Create Follow-up Letter** — Sends the Provider Letter & starts a new draft for the same recipient to assist with follow up.
## Fax Failures
### How will I know if a fax fails to send?
The **sender** is defined as the following: For Referrals = The Provider Level User that sent the fax. If the Referral was sent by a [staff delegate](/articles/staff-permissions--staff-delegates) then the Letter will appear in the delegating Provider Level User's inbox.
For Letters to Providers = The user that sent the fax, regardless of their user level.
If a fax fails to send, the sender will automatically receive a notification in their **Urgent** inbox in their Practice Home page. The notification will include the error message disclosed by our fax provider and an expandable details section that provides additional context about the error along with troubleshooting instructions. Here is an example of what the error message and expandable details section looks like for one the error messages: ![Requiring Action inbox showing 1 urgent item: a failed fax for a referral from Kary Jones, MD to Patrick's Labs, with error "Fax Failed: Please confirm number with recipient (number not valid)." The expanded "Tell Me More" section explains the number may be out of service and recommends calling from a landline to verify a fax tone.]()
### What should I do when my fax fails to send?
When your fax fails to send, the sender will automatically receive a notification in their **Urgent** inbox in their Practice Home page. The notification will include the error message we received from our fax provider and an expandable details section that provides additional details about the error along with troubleshooting instructions. Click the **Tell Me More** button at the top of the notification to see the context about why the fax failed. Follow the troubleshooting instructions to resend the fax by clicking **Actions** -> **Refax** or reach out to Elation Support for assistance. If you do not wish to resend the fax, click the **Acknowledge** button to dismiss the notification. ![Fax failure notification in the Requiring Action inbox showing a referral to Patrick's Labs with error "Fax Failed: Please confirm number with recipient (number not valid)." The Tell Me More section is expanded, displaying troubleshooting guidance. The Acknowledge and Actions buttons are highlighted in the upper right.]()
### How many fax attempts will Elation make before marking the fax as failed?
Elation will attempt to resend the fax up to 5 times in a 30 second period. If Elation is unable to successfully complete the transmission, the fax will be marked as **Failed** and will appear in the sending provider's **Urgent** inbox in the Practice Home — including for faxes that have exhausted all automatic retries.
### After I send a Letter or Referral, how long will it take for the Sent/Failed status to display in the patient's chart?
It can take up to 20 minutes for the Sent/Failed status to appear in the patient's chart. This is due to the latency time between the various communication attempts between Elation and our fax provider.
### How do I resend a failed fax to the same fax number?
Anyone can click the **Resend** button on a failed fax to attempt to fax it again.
### How do I resend a failed fax to a different fax number?
You must create a new Letter or Referral with the new fax number in order to send the information you want to send to the new fax number. You will not be able to edit the fax number of previous fax transmissions, even if it failed to send.
### 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.
* A healthy fax tone is clear, high pitched and devoid of static.
* A healthy fax tone may ring like a normal telephone 2-3 times prior to the fax tone.
2. If you don't hear a fax tone at all — for example, if the failure notification mentions the receiving line not picking up — the destination number isn't currently set up to receive faxes. Ask the recipient's office to check their fax equipment or provide a working fax number, then create a new Letter or Referral with the corrected number to resend.
3. If the fax continues to fail even though you have verified a healthy fax tone, we recommend:
* Asking the recipient if they can adjust the settings on their fax machine to allow for longer fax transmissions.
* 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 the Support Team by filling out an **I need help** form from the top of your Elation account in the patient's chart and send us the details listed in the **Tell Me More** section of the failed fax notification, along with whether you heard a fax tone during your test call. You can also contact Support by [clicking here](https://help.elationemr.com/s/contactsupport) and filling out our contact form.
### The status of my fax in the patient's chart 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 a fax that looks like this:
### Why do I see an 'Opened' or 'Unopened' status next to my Letter/Referral instead of the Fax Sent status?
The **Opened** and **Unopened** statuses appear instead of the **Fax Sent** status if the recipient is an Elation EHR provider or Provider Portal user. This means the recipient has access to a secure account (such as the Elation EHR or the Provider Portal) to view records you sent them. For this reason, we tell you if the recipient has opened the communication in their account.
* Elation EHR providers have a logo next to their name.
* Elation Provider Portal users have a or (P) logo next to their name.
The **Opened** and **Unopened** statuses only appear under the following circumstances:
1. Patient Letter sent to a patient.
2. Referral or Provider Letter sent to an Elation EHR provider (they have a logo next to their name).
3. Referral or Provider Letter sent to an Elation Provider Portal user (they have a or (P) logo next to their name).
## Recipient Assistance
### Where can I find the Provider Security Code for a Letter or Referral that I sent to a contact's email?
To locate the **Provider Security Code** that Contacts with email addresses need, click on your email at the top of your Elation account and then click **Provider Security Code**.
### Where do I find the Reference Code for a Letter or Referral I sent to a contact's fax number?
The reference code that is sent to Contacts with a fax number is generated via an automation and senders will not be able to see the code. Only the recipient can see the reference code in the Cover Page of the fax and in the Body Page of the Letter/Referral: ![Fax cover page and letter body side by side, both showing the Reference Code "123-456-789" circled in red — on the cover page in a highlighted box, and in the letter body under "Interactive Chart Contents."]()
### Where can a recipient go to retrieve documents online?
* Recipients with a Reference Code can go to [https://www.app.elationemr.com/efax/](https://www.app.elationemr.com/efax/) to retrieve the specific fax and attachments tied to the code.
* Recipients with Provider Portal accounts can log in via [https://app.elationemr.com](http://app.elationemr.com/) using their login email and password and view all records ever sent to them.
### What does the recipient see when they receive my Letter or 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](/articles/access-patient-information-securely-shared-by-an-Elation-EHR-user). You can share the article with the recipient to guide them on accessing shared records as needed.
## Patient Letters
### Can I send a Letter to any patient?
Yes, you can use the **Letter** -> **To Patient** feature to send a Letter to any patient as long as they have an email address and mobile phone number on file. The email address and phone number on file will allow a patient to create a Patient Passport account to view any Letters you send them via the secure patient portal. Learn more about the Patient Passport feature in our [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction).
### What is the For MIPS Compliance section used for?
You can disregard this portion of the Patient Letter. The Patient Reminder used to be a MIPS requirement but is no longer measured by the program.
### What does the "Do not allow patient to respond to this letter" checkbox do?
The **Do not allow patient to respond to this letter** checkbox prevents patients from responding to the Letter you sent them.
### How do I prevent my patient from replying to an old message thread?
To prevent a patient from replying to a message thread in a Patient Letter, find the Patient Letter in their chart and click the button that is labeled with **End Conversation**.
### How do I complete a Patient Letter?
You have 3 options for completing your Patient Letter:
1. **Sign & Send** — Sends the Patient Letter.
2. **Sign & More** → **Sign & Print** — Sends the Patient Letter & prints the body of the Letter with attachments.
3. **Sign & More** → **Sign, Send & Create Follow-up Letter** — Sends the Patient Letter & starts a new draft to assist with follow up.
### How can I send a Letter to all of my patients in bulk?
You can use the Bulk Letter feature to send a message to all patients who have an active Patient Passport account or who are eligible to create one. [Learn more about the Bulk Letter feature here](/articles/introduction-to-bulk-letters) .
## Related Articles
* [Letters & Referrals Introduction- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
* [Letters & Referrals Guide- Managing & searching the provider directory](/articles/Using-the-Provider-Directory)
* [Letters & Referrals Guide- Sharing documents with other Elation EHR Users](/articles/share-documents-between-other-elationemr-users)
* [Letters & Referrals Guide- Creating New Contacts](/articles/Using-the-Provider-Directory)
* [Patient Chart Guide- How to share a patient's entire chart](/articles/how-to-share-a-patients-entire-chart)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Direct Messaging Guide- Secure clinical direct messaging in Elation](/articles/how-to-use-direct-messaging)
* [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates)
# Louisiana State- LINKS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Louisiana-State-LINKS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Louisiana Immunization Information System [LINKS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Louisiana State Immunization Registry known as LINKS.
## What is the LINKS Immunization Registry Interface?
The LINKS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to LINKS, the Louisiana Immunization Network for Kids Statewide. Practices can also query LINKS for vaccination history or forecast.
## Why is the LINKS Immunization Registry Interface valuable?
With the LINKS Immunization Registry Interface, practices no longer need to separately log in to LINKS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to LINKS. You can also pull vaccination history for specific patients from LINKS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & LINKS
The Elation Team will assist you with initiating interface with LINKS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and confirm that you already have a LINKS account.
## How to submit vaccination data to LINKS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to LINKS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ASIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### Can I send historical vaccination records to LINKS via Elation?
No, LINKS will not accept historical vaccination records. LINKS will only allow you to submit data for new vaccination records.
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# MDX Hawai’i - Elation Health: In-app tools
Source: https://help.elationhealth.com/articles/MDX-Hawai-i-Elation-Health-In-app-tools
For Hawaii Elation customers only, who care for MDX patients. This opt-in program provides in-app notifications to help you manage your patient panel and improve quality measure performance.
Through your participation in the MDX Hawai'i-Elation Health program, you are now part of a select group of providers who have access to a set of in-app tools aimed at streamlining the management of your MDX patient panel.
**These tools include:**
1.) \[MDX post-hospitalization discharge follow-up notifications]\(#MDX Post-Hospitalization Discharge Follow-up)
2.) \[Integration of an MDX-approved Annual Health Assessment Template]\(#Integration of an MDX-approved Annual Health Assessment Template)
3.) \[In-app identification of MDX patients]\(#In-app identification of MDX patients)
4.) \[Ability to mass recall MDX patients via Bulk Letter Feature]\(#Re-call using Elation's Bulk Letters functionality.)
## MDX Post-Hospitalization Discharge Follow-up
MDX Hawai‘i is pleased to announce an incentive program for post-hospitalization discharge follow-up activities.
As part of the MDX Hawai'i-Elation Health program, you are eligible to receive a\$150incentive if your practice schedules and sees patients that are discharged from the hospital within 30 days of the discharge date and completes medication reconciliation during the visit. You will be notified through Elation Health when one of your MDX patients has been discharged from the hospital so that you can take action in a timely manner!
Please note that, in order to receive credit for these actions, the CPT® code 1111F must be billed as a part of your followup visit.
![MDX discharge alert for Aloha Smith showing automated message from Elation Staff notifying discharge from Queen's Medical Center on 1/13/2020, with diagnoses R52 and R26.2, and instruction to complete post-discharge visit with CPT code 1111F within 30 days.]()
## Where will the post-discharge notifications appear?
## Discharge alerts will appear in the Practice Home’s Urgent queue. The alerts will be sent by "Elation Staff" as urgent messages to the assigned PCP and an admin staff member so that your practice can schedule the patient's follow-up visit within 30 days of discharge. The message will include the patient’s discharge facility, discharge date, admit date and the Dx and Dx description.
**Quick Tips!**
* While these alerts will appear in the assigned PCP’s queue, any user in the practice can view these messages by changing the **View Queue For** dropdown on the Practice Home toEveryoneor the PCP’s name until they are signed off on. Alerts will also appear at the top of the patient’s chart.
* If you have many outstanding Urgent messages, please make sure you change the **Showing:** filter to **NewestFirst**.
## How do I complete post-discharge medication reconciliation?
To complete a post-discharge medication reconciliation, follow the steps outlined below. You can access and apply thePost-discharge med review (MDX)template that was created on your behalf in collaboration with the MDX Hawai’i team to automate documentation and coding, and help you get credit for the med reconciliation services you provide.
1. Open a visit note
2. ClickVisit Note Templatesin the top-left hand corner of the visit note
3. FindPost-discharge med review (MDX)template in the visit note template window that opens, and clickExport to Noteto apply the template to the visit note.
* For a 2 column visit note, the text will be automatically populated into theSubjectiveandMedssections of the visit note. Note that the sections that the text are placed in may differ based on the visit note type used.
* The CPT code 1111F will be automatically applied to the billing section of the visit note
4. Fill out template in your visit note to document the facility, discharge date/time and method of reconciliation.
*Quick Tip! You can refer to the discharge alert message content to retrieve some of the documentation needed in your visit note, including discharge date and facility.*
5. Scroll to the Medication section of the visit note. Click **Import Current Meds** to bring a copy of the patient’s medications from Clinical Profile into the note.
6. Review medications in the visit note. A record of the changes you’ve made will be added automatically to the visit note.
* If a medication needs to be updated or discontinued, hover over the medication name in the visit note and click on “View”. A new window showing the medication’s history will appear. Hover over the latest version of the medication, and click **Actions >> Document Change** or **Actions >> Document Discontinue**.
* If new medications need to be documented, click on “+ Document Med Pt Is On” from the Clinical Profile. Complete fields in the respective window for a new, changed, or discontinued medication. Then click **Save and Close**.
* If a medication needs to be removed from the visit note,hover over the old instance of the medication and click the **X** button to delete it.
7.If you arenotusing the post-discharge med review visit note template,please ensure that 1111F is included in the billing section of your visit note after the medication reconciliation is completed, so that your practice gets credit for the service provided.
8. Click **Sign** on the discharge alert message to acknowledge that medication reconciliation has been completed and to incorporate the message into the patient’s Chronological Record.
## Integration of an MDX-approved Annual Health Assessment Template
MDX and Elation Health have collaborated on an AHA Visit Note template that will allow you to streamline documentation at the point of care, utilizing Elation’s existing tools, while ensuring you receive credit for your work.
To access and apply the AHA Visit Note template:
1. Open a visit note
2. ClickVisit Note Templatesin the top-left hand corner of the visit note
3. Search for the **MDX Annual Health Assessment (AHA)** template.
\*Quick Tip! Type **AHA** or **MDX** in the search bar to more easily identify the MDX AHA template. \*
4. Click **Export to Note** next to template name to apply the template to the visit note.
5. Once applied, the template will help guide you through the requirements to complete the MDX Annual Health Assessment. You can add notes, select from Yes/No options and more directly on top of the applied template within the visit note. Please ensure that you fill out the template completely to ensure you get credit for your actions.
A few important things to note about the Annual Health Assessment template:
* Billing codes for 65+ Annual Wellness Visit (CPT: 99397), General Medical Adult Examination without abnormal findings (ICD-10: Z00.00) and Medication Review (CPT: 1160F) will be auto-applied to your visit note when the template is applied. If you need to add or remove codes, please click **Edit Billing** in the billing section to do so.
* To complete documentation portions of the Subjective section (i.e. History), you can utilize the in-app \[add or import] buttons under each field of the Subjective to take advantage of Elation's auto-complete.
### In-app identification of MDX patients
Within each of the patient charts belonging to your MDX panel, you’ll now see an **MDX** patient tag next to their name. This will allow for improved identification of these patients pre, during, and post-visit activities:
With the patient tag, you can run patient lists on this cohort to identify patients within your MDX panel that:
1. Need appointments scheduled in 2019
2. Need AHAs scheduled in 2019
3. Need pro-active care management based on risk score
Here is an example of how to run a patient list for your **MDX** patients:
**NOTE:** In support of the **MDX 2020 Office Staff Incentive Program,** Elation has added 'MDX-High-Priority' patients tags to your patients who are eligible for this program.
1/ Use these tags to help identify patients for your office staff to prioritize for scheduling
![Patient chart for Lauren Test showing the "MDX-HIGH-PRIORITY" patient tag highlighted next to her name, demonstrating how the tag appears in a patient's chart.]()
2/ Run a Patient List based on these tags to enable bulk outreach to your patients
![Patient List filtered by "Patient Tags" with "Tagged with MDX-HIGH-PRIORITY" selected, showing 28 matching patients with HCC scores, dates of birth, and contact information.]()
### Re-call using Elation's Bulk Letters functionality.
You can use the results of the patient list to call patients OR send bulk appointment reminders to patients utilizing Elation’s Bulk Letters functionality. Check out this[help center article](/articles/Using-Elation-to-help-you-address-COVID-19-with-your-patients)for a step-by-step walkthrough on how your practice can bulk outreach to your patients through (1) pre-addressed mailers, (2) Elation's Patient Passport application or (3) email.
To assist you in your Bulk Letter campaign, Elation has pre-populated a sample letter template called 'MDX Annual Health Assessment - Patient Outreach' into your Elation account to help draft your message to your patients. You can customize this message as needed. For example, you may want to include your[online booking site link](/articles/Patient-Booking-Site)and/or specify if you are offering telehealth as an option for annual exams.
If you have questions on how to utilize these in-app tools, please contact our team using in the **I need help** -> **Contact Elation Support** button in the EHR.
*CPT copyright 2019 American Medical Association. All rights reserved.*
# Multi-factor authentication (MFA) – common scenarios FAQ
Source: https://help.elationhealth.com/articles/MFA-Scenarios-FAQ
This FAQ walks through real-world MFA situations and how to handle them safely.
This FAQ walks through real-world MFA situations and how to handle them safely. For an overview of MFA concepts and factor types, see [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA).
***
## Getting Started
### Does the entire practice need to enroll in multi-factor authentication at the same time?
Each user must independently set up an authentication factor but it does not have to be done at the same time.
### How do I update my authentication factor(s)?
[Click here for instructions on updating authentication factors](/articles/Updating-authentication-factors-for-MFA).
***
## Account Lockout and Login Issues
### Can I reset my own MFA factors without contacting my admin or Support?
Yes. If you are locked out and cannot reach a practice admin, use the [MFA self-service reset page](https://app.elationemr.com/mfa/reset) to reset your own factors.
To complete self-service reset you will need:
* Access to the **email address** associated with your Elation account.
* A **government-issued photo ID** (driver's license, state ID, or passport). The name on the ID must match the name on your Elation account.
* A device with a **camera** to take a selfie for identity verification.
* Your current **Elation password**.
Identity verification is handled by Stripe Identity. After verification you'll receive a short-lived reset link; confirming your password removes all MFA factors and unlocks your account so you can sign in and enroll new factors. Your practice admins are automatically notified by email whenever a self-service MFA reset is completed on their practice.
For full step-by-step instructions, see [Multi-Factor Authentication - Resetting authentication factors](/articles/Resetting-authentication-factors-for-MFA).
### I am not able to sign in to Elation to reset my authentication factor. What should I do?
If you find yourself locked out, you have two options:
* **Fastest:** Ask an Admin Level User in your practice to reset your authentication factors from the [Manage Accounts](https://app.elationemr.com/settings/allaccounts/) settings page ([instructions](/articles/Resetting-authentication-factors-for-MFA)).
* **If you cannot reach an admin:** Reset your own factors at the [MFA self-service reset page](https://app.elationemr.com/mfa/reset). You will need a **government-issued photo ID** (driver's license, state ID, or passport), a device with a camera to take a selfie, and access to the email address on your Elation account.
If you are the sole administrator of an Elation practice and cannot complete self-service reset, [contact the Support Team](https://app.elationemr.com/support/).
**PRO TIP:** After you have successfully logged in, set up additional authentication factors as a backup in case this happens again.
### I set up an authentication factor but cannot log in to my Elation account, what should I do?
If you find yourself locked out, you have two options:
* **Ask an Admin Level User in your practice** to reset your authentication factors from the [Manage Accounts](https://app.elationemr.com/settings/allaccounts/) settings page ([instructions](/articles/Resetting-authentication-factors-for-MFA)).
* **Use the [MFA self-service reset page](https://app.elationemr.com/mfa/reset)** to reset your own factors. This requires a **government-issued photo ID** and a selfie for identity verification.
For security reasons, Elation Support will not reset authentication factors on a user's behalf except in limited cases. If you are the sole administrator of an Elation practice and cannot complete self-service reset, [contact the Support Team](https://app.elationemr.com/support/).
**PRO TIP**: After you have successfully logged in, set up additional authentication factors as a backup in case this happens again.
### I lost my phone or got a new phone. What should I do?
If you can no longer access the device you used for MFA (for example, you lost your phone or replaced it with a new one), you will need to reset your MFA factors and set them up again.
#### Step 1: Contact your practice admin first
Your practice admin is your first line of support for MFA and login issues. They can:
* Reset your MFA from **Settings** → **Manage Accounts** → **Reset multi-factor** so you can enroll new factors.
* Confirm that your user account is active and not disabled.
If your practice does not have an active admin, or your admin cannot access **Manage Accounts**, you can reset your own factors at the [MFA self-service reset page](https://app.elationemr.com/mfa/reset). You will need a **government-issued photo ID** (such as a driver's license, state ID, or passport) and a device with a camera to verify your identity. Otherwise, contact Elation Support.
#### Step 2: Re‑enroll MFA on your new device
After your admin resets MFA:
1. **Sign in** - Sign in to Elation with your username and password.
2. **Set up factors** - Follow the prompts to set up at least one **reusable factor**, such as an authenticator app (recommended).
3. **Avoid single-device factors** - Avoid relying on only device‑bound factors (for example, Touch ID/Face ID or platform security keys) on a single device, since those do not transfer automatically when you change devices.
> **Tip: We strongly recommend configuring \*\* at least two factors** so you have a backup if you lose access to one. For guidance on choosing factors, see the Comparing authentication factors table in [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA).
***
## Authentication Factor Types and Compatibility
### Which Authenticator Apps can I use?
Any Authenticator App that uses the same TOTP (Time-Based One-Time Password) algorithm as Google Authenticator can be used. Common TOTP Apps include:
* Google Authenticator
* Microsoft Authenticator
* Symantec VIP Access (mobile app)
* Authy
* Duo Mobile
* 1Password (with integrated TOTP support)
* LastPass Authenticator
* FreeOTP
* andOTP
* OTP Auth
### Which Security Keys and Biometric Authenticators can I use?
Any software or hardware that verifies your identity using public-key cryptography can be used. Common examples include:
* Password managers that store a Security Key (e.g. 1Password, LastPass, etc.)
* Windows Hello (pin)
* YubiKey
* Feitian ePass / K27 / BioPass
* Google Titan Security Key
* SoloKey
* Thetis FIDO U2F Key
* OnlyKey
* MacBook Touch ID
* Apple Face ID
* Windows Hello fingerprint
* Windows Hello Face
* USB fingerprint readers
### Can I use SMS as an authentication factor?
Security research has shown that SMS is less secure than other authentication factors. It is possible for your cell phone number to be compromised in a **SIM Swap** attack, where a bad actor tricks your carrier to port over your phone number to them. When a bad actor has access to your phone number, they can then receive the security codes used for multi-factor authentication, increasing their chances of successfully gaining unauthorized access to your account. As a result, Elation decided to only support other more secure factors for multi-factor authentication.
### Can I set up more than one authentication factor for a single account?
Yes, you can set up more than one authentication factor for a single account and this is recommended practice. Note that you can only set up one of each type of factor (e.g. one Authenticator App, one Security Key). You can follow [these instructions](/articles/Multifactor-Authentication-MFA#options) to learn how to choose which factor you want to use when logging in.
### Can I log in to my account from different devices using a single authentication factor?
You can log in to your account from different devices using a single authentication factor if the authentication factor is not a Security Key or Biometric Authenticator as those are typically device specific. If you want to use a Security Key or Biometric Authenticator when logging in through your computer set up an additional authentication factor like Google Authenticator for logging in through other devices.
### I use Elation on multiple computers and my phone. Which MFA factors should I choose?
If you regularly access Elation from more than one device (for example, a work desktop, a laptop, and your phone), choose factors that are easy to use across all of them.
#### Recommended setup
* \*\*Primary factor: An authenticator app on your mobile device.
* \*\*Backup factor: Okta Verify, or a security key stored in a password manager.
This combination:
* Works on any browser where you can enter a one‑time code.
* Avoids getting locked into a single device's built‑in biometric or security hardware.
For guidance on choosing factors, see the Comparing authentication factors table in [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA).
You can also enable device‑specific options like Touch ID/Face ID on trusted devices. Remember:
* Some factors (for example, platform biometrics and certain security keys) are \*\* device‑specific\*\* and will not automatically work on another computer.
* The **remember this device** or **keep me signed in** behavior only applies to the specific device and browser where you chose it, and for a limited period of time.
For more details on factor types and timeouts, see [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA).
***
## Email Authentication
### If I choose to use Email Authentication, do I have to use the email address associated with my Elation account?
Yes, when using the Email Authentication option for multi-factor authentication, the email account must be the email address you use to log in to your Elation account.
To use a different email for Email Authentication, update your login email address from your **Account Details** Settings page in Elation first.
### Why am I unable to set up Email Authentication from my Elation Settings?
Email Authentication is deemed as the least secure authentication method; therefore, we want you to set up a more secure authentication factor when possible. However, if Email Authentication is the only authentication factor you can use, log out of your Elation account and you'll be able to set up Email Authentication from the login screen.
### I am setting up Email Authentication but I have not received the email with my Verification Code, what should I do?
The Verification Code can take a few minutes to arrive in your email inbox. If you've waited a few minutes and still do not see the email with the Verification Code, click **Send again** on the verify screen in Elation to prompt Elation to email the code to you again. If you continue to not receive the email, [click here](https://app.elationemr.com/support/) to contact the Support Team.
***
## Login Behavior and Sessions
### Why is Elation automatically logging me out even when I checked the 24 hour box?
MFA login must still comply with your device's and browser's security as well as Elation's timeout policy.
* The 24-hour MFA bypass is tied to **both your device and the browser** that was in use at the time you signed in.
* If log in from a different device, switch browsers, or use an incognito/private window, Elation will ask for your MFA again for security reasons- \*\*even if the 24-hour box was checked.
* The bypass does not override Elation's \*\* session timeout policy\*\*.
* If you are logged out due to inactivity (the standard timeout is 2 hours), you will be asked to re-authenticate when logging back in- \*\*even if the 24-hour box was checked.
For higher‑risk workflows (e.g., multiple staff working on the same visit note, stepping away from computer, etc.), it's still best practice to explicitly click **Save as Draft & Close** in your visit note to reduce any chance of data conflicts or loss.
### How often do I have to re-authenticate when using multi-factor authentication to log in?
By default, you are required to re-authenticate each time you log in. Check off the **Do not challenge me on this device for the next 24 hours** box if you want to bypass multi-factor authentication while logging in and out of Elation for the next 24 hours for that browser and device.
If your account is logged out due to inactivity, you'll need to re-authenticate unless you previously chose to skip authentication for 24 hours and that time hasn't fully elapsed.
### Will multi-factor authentication still allow me to be logged in to multiple places at the same time?
Yes, you can still be logged in to multiple places at the same time.
### Will I need to use my authentication factor when logging in to Elation Go (Elation's mobile application)?
Yes, you will need to use your authentication factor when logging in to Elation Go. This is great use case for setting up multiple authentication factors, especially if you are using a Security Key or Biometric Authenticator when logging in through your computer - these will not work on your phone. Setting up an additional authentication factor like Google Authenticator will allow you to login to Elation Go on your phone.
***
## Scribes, SSO, and Shared Accounts
### My scribe needs to login to complete my visit notes daily. How do I give them access to my authentication factor?
You cannot share accounts while using multi-factor authentication. It's important to highlight that shared, or generic, user accounts or passwords are strictly prohibited by [Elation's Terms of Use](https://www.elationhealth.com/terms-of-use/) and security policies. Individuals who use the EHR must log in using their own, unique account.
### My scribe can't log in. How should we set up MFA for scribes?
Each person who documents or works in Elation must use **their own user account** with their own MFA factors. Shared logins are not permitted for security and compliance reasons.
#### Recommended pattern
* **Scribes should have staff-level accounts** tied to the supervising clinician, with appropriate permissions configured by a practice admin. For more about provider vs staff capabilities, see [Provider vs staff level account privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges).
* Scribes set up MFA on their own accounts, just like any other user.
#### If a scribe cannot log in
1. **Verify credentials** - Confirm they are using **their own username and password**, not the clinician's.
2. **Admin assistance** - Ask the practice admin to:
* Confirm that the staff account is active (not disabled), and
* Reset the user's MFA from **Settings** → **Manage Accounts** if needed.
3. **Contact Support** - If your practice has no active admin or your admin cannot perform these steps, contact Elation Support.
For guidance on choosing factors, see the Comparing authentication factors table in [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA). For other security best practices, see [Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure).
### Can I use the single sign-on feature with multi-factor authentication?
If your organization uses its own single sign-on (SSO) provider to access Elation, all the security—like checking your password and asking for a verification code—is already handled by your company. As a result, you will not be required to use Elation's built-in MFA feature.
Learn more about the Single Sign-On feature through our [User Accounts Guide – Using Single Sign-On to access your Elation EHR account](/articles/single-sign-on) Help Center article.
***
## Patient Passport
### Will patients need to use multi-factor authentication for their Patient Passport account?
No, patients will not need to use multi-factor authentication for their Patient Passport account.
***
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
* [Multi-Factor Authentication - Updating authentication factors](/articles/Updating-authentication-factors-for-MFA)
* [Multi-Factor Authentication - Resetting authentication factors](/articles/Resetting-authentication-factors-for-MFA)
* [Multi-Factor Authentication - Quick Start Guide](/articles/Multi-Factor-Authentication-Quick-Start-Guide)
* [Provider vs staff level account privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges)
* [Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure)
# MIPS 2024 Guide- End of Year Reminders & Data Submission FAQs
Source: https://help.elationhealth.com/articles/MIPS-2024-Guide-End-of-Year-Reminders-Data-Submission-FAQs
This article lists important actions and deadlines for the 2024 MIPS performance year.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
As the 2024 MIPS performance year draws to a close, please refer to the following article for year-end tips and updates on the data submission process.
## Frequently Asked Questions
* [Am I required to submit anything for MIPS for the 2024 Performance Year?](#MIPS_eligibility)
* [I’ve confirmed I’m eligible for MIPS in 2024 - where do I submit my data?](#submission)
* [What kind of data do I need to submit to CMS?](#data)
* [When can I start submitting data? When is the deadline?](#deadline)
* [How do I submit my data?](#submit_data)
* [Prepare Your Data](#prepare_data)
* [Submit Data to QPP](#submit_to_QPP)
### Am I required to submit anything for MIPS for the 2024 Performance Year?
Your 2024 MIPS eligibility status determines whether you’re obligated to submit any data for the MIPS program. Only providers who have exceeded a certain threshold of Medicare patients and Medicare reimbursements are required to submit data.
Before proceeding with anything else, it’s critical that you check your latest eligible status. Please do so by [accessing this website](https://qpp.cms.gov/participation-lookup) and entering your NPI.
Instructions for interpreting your eligibility results can be found in [this help center article](/articles/MIPS-Eligibility-FAQ).
### I’ve confirmed I’m eligible for MIPS in 2024 - where do I submit my data?
MIPS data submission can be completed by logging into the [Quality Payment Program (QPP) website](https://qpp.cms.gov/login). Each practice needs at least one person to be responsible for submitting the practice’s data.
If someone from your practice submitted MIPS data in the past, they can use the same user account to submit your 2024 data.
If nobody in your practice has submitted MIPS data before, [access this webpage to set up HARP credentials](https://harp.cms.gov/register/profile-info). Once you have these credentials, you can use them later to log into the QPP website.
### What kind of data do I need to submit to CMS?
Each of the four MIPS categories has different data submission requirements. At a high level, you’ll be taking the following actions:
* **Improvement Activities** Category: Fill out a form directly in the QPP portal.
* **Quality** Category: Download a QRDA-3 file from the Clinical Quality Dashboard in Elation. Upload this QRDA-3 file to the QPP portal.
* **Promoting Interoperability** Category (if applicable): Reference the Promoting Interoperability Dashboard in Elation to fill out a form directly in the QPP portal.
* \*\*Cost \*\* Category: No action needed.
Quality measures are tracked based on provider/practice workflows and documentation according to the requirements determined by CMS. As a reminder, quality measures should be selected **early** in the year and not an afterthought or there will be no opportunity for improvement. Review this [Help Center Article](/articles/Quality-Category-MIPS-2024) on the Quality category as a refresher of how to meet quality in Elation.
### When can I start submitting data? When is the deadline?
The MIPS submission window will open between January 2, 2025 through March 31, 2025. You will need to complete data submission by March 31, 2025, 8 pm Eastern.
#### Logistical Recommendations
1. [Double check your eligibility](https://qpp.cms.gov/participation-lookup) to verify if you need to participate in MIPS.
2. If you find that you’re eligible (required):
3. Make sure each provider has saved your practice’s TIN under their [Elation user profile details](/articles/managing-user-accounts#manage).
4. Ensure at least one person in your practice has [HARP credentials](https://harp.cms.gov/register/profile-info) so that they can log into the [Quality Payment (QPP) portal](https://qpp.cms.gov/login).
### How do I submit my data?
#### Prepare Your Data
**Quality**: Download your QRDA-3 file from Elation. This is a standardized file with measure data that you can upload to the QPP. The QRDA-3 file can be found under **Reports** → **Clinical Quality Measures**.
![Reports menu open in Elation with "Clinical Quality Measures" highlighted by an orange circle, showing its location under the Reports dropdown for downloading the QRDA-3 file.]()
On the left side of the dashboard, select the correct program, providers, and year. Click **Generate Summary**. Lastly, click **Export** → **Download QRDA-3**.
![Clinical Quality Measures Export menu open with "Download QRDA-3" highlighted in an orange circle, showing the option to select after clicking Export.]()
**About QRDA files:** The QRDA file will be downloaded to your personal computer. Save the file as you would normally save a file, and retain this file for data validation and potential auditing purposes. The file is in a .xml file format and is not intended to be human-readable if you open it. However, it is decipherable by CMS for their analysis after you upload it to the QPP portal. You can read more about how to export QRDA files in this [Help Center Article](/articles/QRDA-Export-Guide).
**Improvement Activities:** Decide which Improvement Activities you are planning to report to the QPP. [Review this article to learn more about Improvement Activities.](/articles/Improvement-Activities-MIPS-2024)
**Promoting Interoperability**: This category is reweighted and **exempt** for any practice with fewer than 15 providers, in an Advanced APM, and other factors. For the 2024 performance year, Elation recommends folks to leverage their exclusions because one of the requirements is an electronic case reporting integration and we received no requests from practices for that in 2024.
#### Submit Data to The QPP
Now that you have saved and understood what data you are submitting to the QPP, head over to the [QPP and login](https://qpp.cms.gov/login) with your credentials. Once you have logged in, be sure to submit your data for Quality (i.e. upload the QRDA-3 file that you downloaded from Elation) and attest to your selected Improvement Activities. For more information on how to navigate inside the QPP portal, and what actions to take, review the [QPP User Access Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2955/QPP-Access-User-Guide.zip) published by the QPP.
## Related Articles
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
# MIPS (2024) Overview
Source: https://help.elationhealth.com/articles/MIPS-2024-Overview
This article describes the 2024 requirements for the Merit-based Incentive Payment System (MIPS).
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Introduction to the QPP and MIPS
The Quality Payment Program (QPP) is a federally mandated Medicare program by Centers for Medicare and Medicaid Services (CMS) that seeks to improve patient care and outcomes while managing the costs of services patients receive.
Clinicians may participate in the Quality Payment Program through one of three reporting options:
![Three-column comparison table of QPP reporting options: Traditional MIPS (original option), MIPS Value Pathways (specialty-focused groupings), and APM Performance Pathway (for APM participants), each showing key differences in measure selection, quality reporting, Promoting Interoperability, and cost evaluation.]()
The Merit-based Incentive Payment System (MIPS) is the primary way to participate in the Quality Payment Program. Advanced Alternative Payment Models (APMs) are optional programs that offer different incentive structures for high quality, cost efficient care. An example of participating in the APP is if your practice has signed up to work with an ACO, ACO’s are considered APMs and submit data through the APP.
MIPS is the standard fee-for-service (FFS) payment track that applies to around 95% of physicians. Under MIPS, CMS evaluates performance across four categories: Quality, Cost, Improvement Activities, and Promoting Interoperability. Here is a brief description of each category from CMS:
![Four MIPS performance categories: Quality (performance measures), Promoting Interoperability (CEHRT and patient engagement), Improvement Activities (clinical practice), and Cost (Medicare Part B claims).]()
## 2024 MIPS Eligibility
The following Clinician Types are eligible for MIPS:
* Physicians (MD, DO, DDS, DMD, DPM, OD)
* Osteopathic practitioners
* Chiropractors
* Physician assistants
* Nurse practitioners
* Clinical Nurse Specialists
* Certified nurse anesthetists
* Physical therapists
* Occupational therapists
* Clinical psychologists
* Qualified speech-language pathologists
* Qualified audiologists
* Registered dietitians or nutrition professionals
* Clinical social workers
* Certified nurse-midwives
If any of the following apply to the provider, they are not required to participate in MIPS:
1. Fewer than 200 Medicare fee-for-service patients
2. Less than \$90,000 in Medicare charges
3. Fewer than 200 Medicare fee schedule services
4. Participate in an Advanced APM
5. First-year Medicare provider
Use the [CMS’s Participation Lookup website](https://qpp.cms.gov/participation-lookup) to confirm eligibility.
### Interpreting Eligibility
Once practices find the **Associated Practice** that is using Elation, there are three possible outcomes, only one of which requires practices to participate in MIPS.
![Three MIPS eligibility scenarios: Row 1 (highlighted) both Individual and Group eligible — required to participate, submit as either for higher score. Row 2 Individual ineligible, Group eligible — individual not required, group optional. Row 3 both ineligible — neither required, no payment adjustment even if data submitted.]()
**Eligibility Note:** if you or your practice are associated with and participating in an APM (ACO or other APM type) contact the APM administrator to determine best practices for MIPS participation and data submission. MIPS APM participation may vary from traditional MIPS participation. MIPS quality data are generally submitted via the APM and that is important to understand.
## MIPS Performance Categories
Each of the four performance evaluation categories has different requirements that need to be met and each practice’s goal is to maximize points earned. This year, CMS has weighted the categories as follows:
![MIPS category weights when Promoting Interoperability data is submitted: Quality 30%, Cost 30%, Improvement Activities 15%, Promoting Interoperability 25%.]()
![Standard MIPS weighting for small practices: Quality 40%, Cost 30%, Improvement Activities 30%, Promoting Interoperability 0% (automatically reweighted).]()
### Quality (30%)
One of the highest weighted categories is Quality, which looks at Clinical Quality Measures.
Practices submitting via Traditional MIPS can submit as many measures as they want but are scored on their 6 top-performing quality measures. Data needs to be collected for these measures across at least 70% of their visits. Elation has 7 quality measures that are used in Traditional MIPS that we can report on and with a set of videos that cover workflows. You can also learn more about all the Clinical Quality Measures that Elation supports in the [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024) article.
One (1) of the 6 measures must be an outcome measure. The outcome measures available in Elation are:
Each measure is scored out of 10 points. Their score depends on how many patients are meeting the requirements of the measure. For each measure, a practice earns a percentage first, which is then converted to a score out of 10 based on benchmarks. The average score for each 6 measures determines how many points they earn out of 30. Their performance is also compared to their peers and against annual benchmarks to determine the absolute number out of 10. The better they perform against their peers, the higher their score per measure will be.
Practices who have 15 or fewer providers under a Tax ID Number will automatically earn 6 extra points towards their Quality numerator.
### Cost (30%)
Cost is captured via the codes that are submitted via claims and measure Medicare spending per beneficiary and total per capita cost. Practices don’t need to complete any specific actions in Elation or submit anything for this category. To optimize your scoring potential in this category, we recommend taking steps as a practice to minimize overall cost and hospitalizations for your patients.
### Improvement Activities (15%)
For this category, CMS publishes a [list of activities](https://qpp.cms.gov/mips/explore-measures?tab=improvementActivities\&py=2023) that are intended to improve care and outcomes. This is typically an easy category for practices to earn points. You can also learn more about Improvement Activities in our [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024) article.
Most practices need to pick and complete 2-4 improvement activities to receive the maximum score of 40 points in this category. Improvement activities are classified as either medium-weight (10 points) or high-weighted (20 points), and the number and type of activities to maximize points depends on a practice’s size.
### Promoting Interoperability (25%)
This category requires 4 objectives, 2 registry integrations, a security audit and a few attestations. Learn more about the Promoting Interoperability Performance Category in the [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024) article.
Promoting Interoperability includes an automatic exception for small practices (15 providers or less). The 25% will automatically be allocated towards the Quality and Improvement Activities measures.
## MIPS Adjustments
A practice’s performance across the 4 MIPS categories (or less if reweighted) will result in a MIPS final score of 0 to 100 points.
A practice’s MIPS final score will determine whether they receive a negative, neutral, or positive MIPS payment adjustment.
Performance in 2024 will determine adjustments to payments in 2026, equaling +/- 9% of practices’ 2026 payments (applicable only to Medicare Part B Physician Fee Schedule payments).
To receive a neutral adjustment (i.e. avoid penalty), practices must earn at least 75 total points if they are required to participate.
## MIPS Submission Timeline
After determining your MIPS eligibility and participation level, your practice can begin selecting and performing your measures and activities. To start, here is a timeline for each category:
| Quality | Cost | Improvement Activities | Promoting Interoperability |
| ---------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Clinicians must select [6 measures](/admin-compliance) , collecting data for each measure for the 12-month performance period (Jan 1 - Dec 31, 2024) | No action needed to collect or submit any data for cost measures. CMS calculates your Cost performance through your claims. | Clinicians must select between 2 and 4 activities, performing each activity for a continuous 90-day period in Calendar Year (CY) 2024 | Most clinicians must collect data using CEHRT on the required measures for the same continuous 180- day performance period in CY 2024. Small practices (practices with 15 or fewer providers) are automatically excused from the PI category. |
If your practice is participating in MIPS 2024, you will submit data following the performance year between January 2 - April 2, 2025. See the timeline below for steps once the performance year finishes:
![MIPS timeline: 2024 Performance Year (Jan–Dec), 2025 Data Submission (Jan 2–Mar 31), Summer 2025 Feedback, and 2026 Payment Adjustment (Jan–Dec), each with required clinician actions.]()
## Tracking and Improvement During 2024
The QPP has released a helpful [Small Practice Action Planning Tool](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2334/2023%20Small%20Practice%20Action%20Planning%20Tool.pdf). If you are in a small practice, or plan on reporting traditional MIPS, this guide provides a step by step tool kit to understand areas for improvement on previous MIPS scores to focus on in 2024.
\*This article is provided for instructional purposes only. Elation Health does not support or guarantee anything other than relay useful information from various organizations. Elation Health also does not provide support for third-party technologies. We recommend consulting[CMS guidelines](https://qpp.cms.gov/resources/resource-library)for the most up to date information.
Copyright U.S Centers for Medicare & Medicaid Services. All rights reserved.
## Resources
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [CMS Resource Library](https://qpp.cms.gov/resources/resource-library)
## Related Articles
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024)
* [MIPS Eligibility- Frequently Asked Questions (FAQ)](/articles/MIPS-Eligibility-FAQ)
* [Clinical Quality Measures supported in Elation](/admin-compliance)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Health Maintenance Documentation & Reminders Guide](/articles/health-maintenance)
# MIPS (2024)- Quick Start Guide
Source: https://help.elationhealth.com/articles/MIPS-2024-Quick-Start-Guide
This article is a quick reference guide for everything you need to know about the MIPS 2024 Reporting Period.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Quick Start Guide Overview
MIPS participation may seem overwhelming. To break down MIPS participation and actions to take during 2024, here is the guide to follow along all the resources Elation Health offers for MIPS eligible clinicians. This information is intended as support for your practice to participate in MIPS using Elation. For questions specific to MIPS and regulatory requirements, contact the QPP directly.
A helpful guide from the QPP is the [2024 MIPS Quick Start Guide for Small Practices](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2622/2024MIPSGuideforSmallPractices.pdf). This information has been tailored and is intended for informational purposes only.
## MIPS Eligibility
Use the [QPP participation look up tool](https://qpp.cms.gov/participation-lookup) to determine if you need to report MIPS.
You can also reference the [MIPS Eligibility- Frequently Asked Questions (FAQ)](/articles/MIPS-Eligibility-FAQ) Help Center Article or the [QPP MIPS Eligibility & Participation Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2623/2024MIPSEligibandParticGuide.pdf).
## MIPS Quality Category
Ensure MIPS eCQMs are turned on ([link to article](/articles/clinical-reminders-for-clinical-quality-measures)) and that you are tracking eCQMs as best possible. Follow workflows to close care gaps. Create a performance improvement plan to determine what needs to be tracked better over time.
Understand and determine your reporting type and collection type. Review the [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024) article to support this.
## MIPS Promoting Interoperability
Does your practice have greater than 15 providers in it? If not, do nothing, you do not need to report to this category.
If your practice has greater than 15 providers and plans to report the PI category, ensure you can participate by reviewing the [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024) article, checking all your integrations, and reviewing workflows for the associated measures.
**Important Note**: If you are reporting on the Promoting Interoperability Category, make sure you submit your intent to submit data to your local Public Health Agency and reach out to Elation Health so we can assist in understanding the integration.
## MIPS Improvement Activities
Look at the Improvement Activities list and determine which Improvement Activities are most relevant to your practice. Review the [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024) article to support this.
## All contents and material
![MIPS 2024 timeline showing four phases: Performance Year (Jan–Dec 2024, collect data), Data Submission (Jan 2–Mar 31, 2025, submit via QPP), Performance Feedback (Summer 2025, review scores), and Payment Adjustment (Jan–Dec 2026, adjustments applied), each with specific to-do actions.]()
1. Sign up and attend webinars that Elation hosts throughout the year. If you miss them, watch the recordings to help you better understand the material. Here are some of the webinars to look out for in 2024:
* MIPS Overview
* MIPS Quality
* MIPS PI and IA
* MIPS Mid Year check in
2. Review Help Center Articles about specific area listed in order of recommended reading:
* Overview Articles
* [MIPS Eligibility- Frequently Asked Questions (FAQ)](/articles/MIPS-Eligibility-FAQ)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [MIPS 2024 Guide- End of Year Reminders & Data Submission FAQs](/articles/MIPS-2024-Guide-End-of-Year-Reminders-Data-Submission-FAQs)
* Measure Specific Articles
* [\[CMS69v12\] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan](/articles/CMS69v12-Preventive-Care-and-Screening-Body-Mass-Index-BMI-Screening-and-Follow-Up-Plan)
* [\[CMS122v12\] Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%) (MIPS 2024)](/articles/CMS122v12-Diabetes-Hemoglobin-A1c-Poor-Control-MIPS-2024)
* [\[CMS124v12\] Cervical Cancer Screening (MIPS 2024)](/articles/CMS124v12-Cervical-Cancer-Screening-MIPS-2024)
* [\[CMS125v12\] Breast Cancer Screening](/articles/CMS125v12-Breast-Cancer-Screening)
* [\[CMS130v13\] Colorectal Cancer Screening](/articles/CMS130v13-Colorectal-Cancer-Screening)
* [\[CMS131v12\] Diabetes: Eye Exam (MIPS 2024)](/articles/CMS131v12-Diabetes-Eye-Exam-MIPS-2024)
* [\[CMS139v12\] Falls: Screening for Future Fall Risk (MIPS 2024)](/articles/CMS139v12-Falls-Screening-for-Future-Fall-Risk-MIPS-2024)
* [\[CMS149v12\] Dementia: Cognitive Assessment (MIPS 2024)](/articles/CMS149v12-Dementia-Cognitive-Assessment-MIPS-2024)
* [\[CMS155v12\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2024)](/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2024)
* [\[CMS165v12\] Controlling High Blood Pressure (MIPS 2024)](/articles/CMS165v12-Controlling-High-Blood-Pressure-MIPS-2024)
* [Promoting Interoperability (MIPS) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-TEFCA)
* [Promoting Interoperability (MIPS) - Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange)
* [Promoting Interoperability (MIPS) - Public Health and Clinical Data Exchange](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
* [Promoting Interoperability (MIPS) - SAFER Guides Assessment](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment)
* [Promoting Interoperability (MIPS) - Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)
* [Promoting Interoperability (MIPS) - e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
3. Review the following webinars (we will add links to additional webinars as they occur):
* [MIPS 2023 Data Submission](https://vimeo.com/elationhealth/2023-mips-submission?share=copy)
4. Reference QPP Resources as needed:
* [QPP 2024 Quality Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2661/2024QualityQuickStartGuide.pdf)
* [QPP 2024 MIPS Quality Measure List](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2661/2024QualityQuickStartGuide.pdf)
* [MIPS Quality Performance Category Fact Sheet](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2402/MIPS%20Quality%20Performance%20Category%20Fact%20Sheet.pdf)
* [2024 Part B Claims Reporting Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2649/2024PartBClaimsReportingGuide.pdf)
* [QPP 2024 MIPS Eligibility & Participation Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2623/2024MIPSEligibandParticGuide.pdf)
* [QPP 2024 Improvement Activities Inventory](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2644/2024ImprovementActivitiesInv.zip)
* [2024 MIPS Quick Start Guide for Small Practices](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2622/2024MIPSGuideforSmallPractices.pdf)
# MIPS 2025 Guide- End of Year Reminders & Data Submission FAQs
Source: https://help.elationhealth.com/articles/MIPS-2025-End-of-Year-Reminders-Data-Submission-FAQs
This article lists important actions and deadlines for the 2025 MIPS performance year.
**Patient name on MIPS printouts vs. QRDA submissions.** MIPS printouts generated from Elation show a patient's Full Name (preferred/actual name) when one is set in their demographics. QRDA-3 files submitted to CMS continue to use the patient's legal name, as required for compliance. See the [Patient Demographics Guide](/articles/Patient-Demographics-Guide) for more on the Legal Name vs. Full Name fields.
## Frequently Asked Questions
* [Am I required to submit anything for MIPS for the 2025 Performance Year?](#MIPS_eligibility)
* [I’ve confirmed I’m eligible for MIPS in 2025 - where do I submit my data?](#submission)
* [What kind of data do I need to submit to CMS?](#data)
* [When can I start submitting data? When is the deadline?](#deadline)
* [How do I submit my data?](#submit_data)
* [Prepare Your Data](#prepare_data)
* [Submit Data to QPP](#submit_to_QPP)
### Am I required to submit anything for MIPS for the 2025 Performance Year?
Your 2025 MIPS eligibility status determines whether you’re obligated to submit any data for the MIPS program. Only providers who have exceeded a certain threshold of Medicare patients and Medicare reimbursements are required to submit data.
Before proceeding with anything else, it’s critical that you check your latest eligible status. Please do so by [accessing this website](https://qpp.cms.gov/participation-lookup) and entering your NPI.
Instructions for interpreting your eligibility results can be found in [this help center article](/articles/MIPS-Eligibility-FAQ).
**I’ve confirmed I’m eligible for MIPS in 2025 - where do I submit my data?**
MIPS data submission can be completed by logging into the [Quality Payment Program (QPP) website](https://qpp.cms.gov/login). Each practice needs at least one person to be responsible for submitting the practice’s data.
If someone from your practice submitted MIPS data in the past, they can use the same user account to submit your 2025 data.
If nobody in your practice has submitted MIPS data before, [access this webpage to set up HARP credentials](https://harp.cms.gov/register/profile-info). Once you have these credentials, you can use them later to log into the QPP website.
### What kind of data do I need to submit to CMS?
Each of the four MIPS categories has different data submission requirements. At a high level, you’ll be taking the following actions:
* **Quality** Category: Download a QRDA-3 file from the Clinical Quality Dashboard in Elation. Upload this QRDA-3 file to the QPP portal.\*\*
* **Improvement Activities** Category: Fill out a form directly in the QPP portal.
* **Promoting Interoperability** Category (if applicable): Reference the Promoting Interoperability Dashboard in Elation to fill out a form directly in the QPP portal.
* \*\*Cost \*\* Category: No action needed.
Quality measures are tracked based on provider/practice workflows and documentation according to the requirements determined by CMS. As a reminder, quality measures should be selected **early** in the year and not an afterthought or there will be no opportunity for improvement. Review this [Help Center Article](/articles/MIPS-2025-Quality-Category) on the Quality category as a refresher of how to meet quality in Elation.
### When can I start submitting data? When is the deadline?
The MIPS submission window will open between January 2, 2026 through March 31, 2026. You will need to complete data submission by March 31, 2026, 8 pm Eastern.
#### Logistical Recommendations
1. [Double check your eligibility](https://qpp.cms.gov/participation-lookup) to verify if you need to participate in MIPS.
2. If you find that you’re eligible (required):
3. Make sure each provider has saved your practice’s TIN under their [Elation user profile details](/articles/managing-user-accounts#manage).
4. Ensure at least one person in your practice has [HARP credentials](https://harp.cms.gov/register/profile-info) so that they can log into the [Quality Payment (QPP) portal](https://qpp.cms.gov/login).
### How do I submit my data?
#### Prepare Your Data
##### Quality
Download your QRDA-3 file from Elation. This is a standardized file with measure data that you can upload to the QPP. The QRDA-3 file can be found under **Reports** → **Clinical Quality Measures**.
![Reports menu open in Elation with "Clinical Quality Measures" highlighted and circled, showing the path Reports → Clinical Quality Measures to access the QRDA-3 download.]()
On the left side of the dashboard, select the correct program, providers, and year and click **Generate Summary**. Lastly, click **Export** → **Download QRDA-3**.
![Clinical Quality Measures dashboard with Export menu open, showing "Download QRDA-3" option highlighted with an orange circle.]()
**About QRDA files:** The QRDA file will be downloaded to your personal computer. Save the file as you would normally save a file, and retain this file for data validation and potential auditing purposes. The file is in a .xml file format and is not intended to be human-readable if you open it. However, it is decipherable by CMS for their analysis after you upload it to the QPP portal. You can read more about how to export QRDA files in this [Help Center Article](/articles/QRDA-Export-Guide).
##### Improvement Activities
Decide which Improvement Activities you are planning to report to the QPP. [Review this article to learn more about Improvement Activities.](/articles/MIPS-2025-Improvement-Activities-Category)
##### Promoting Interoperability
This category is reweighted and **exempt** for any practice with fewer than 15 providers, in an Advanced APM, and other factors.
#### Submit Data to The QPP
Now that you have saved and understood what data you are submitting to the QPP, head over to the [QPP and login](https://qpp.cms.gov/login) with your credentials. Once you have logged in, be sure to submit your data for Quality (i.e. upload the QRDA-3 file that you downloaded from Elation) and attest to your selected Improvement Activities. For more information on how to navigate inside the QPP portal, and what actions to take, review the [QPP User Access Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3541/2025-Traditional-MIPS-Data-Submission-Guide.pdf) published by the QPP.
**Related Articles**
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# MIPS (2025) - Improvement Activities Category
Source: https://help.elationhealth.com/articles/MIPS-2025-Improvement-Activities-Category
This article describes the Improvement Activities Performance Category for MIPS 2025.
## Introduction
The following information is provided for small practices (15 or fewer providers in a TIN) that report Traditional MIPS. Improvement Activities are one category of MIPS and worth 30% of the overall MIPS score if in a small practice and not reporting on the Promoting Interoperability category, and reporting Traditional MIPS . Total points for the Improvement Activities category caps at 40 and is dependent on a combination of scoring factors. In Calendar Year (CY) 2025 the weighting previously established for improvement activities has been removed and all activities are worth the same weight.
**To earn full credit in this performance category as a small practice, you must generally submit 1 improvement activity to receive 40 points.**
Improvement activities have a minimum of a continuous 90-day performance period (during calendar year (CY 2025) unless otherwise stated in the activity description. To submit Improvement Activities as an Eligible Clinician you can sign in and attest.
## Improvement Activities
With over 100 Improvement Activities to choose from, it can be overwhelming to decide which one is best suited for your practice. If you are in a small practice you only need to select one high weighted activity and attest to the activity in the QPP portal during MIPS reporting. Many of the activities capture best practices that you or your practice may already be doing.
* [Improvement Activities Measures and Activities Tool Online](https://qpp.cms.gov/mips/explore-measures?tab=improvementActivities\&py=2025)
* [QPP Improvement Activities Inventory Zip File](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3131/2025-Improvement-Activities-Inventory.zip)
* [QPP Improvement Activities Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3113/2025-Improvement-Activities-Quick-Start-Guide.pdf)
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# MIPS (2025) Overview
Source: https://help.elationhealth.com/articles/MIPS-2025-Overview
This article describes the 2025 requirements for the Merit-based Incentive Payment System (MIPS) program.
## Introduction to the QPP and MIPS
The Quality Payment Program (QPP) is a federally mandated Medicare program by Centers for Medicare and Medicaid Services (CMS) that seeks to improve patient care and outcomes while managing the costs of services patients receive.
Clinicians may participate in the Quality Payment Program through one of three reporting options:
![Three-column comparison table showing Traditional MIPS, MIPS Value Pathways (MVPs), and APM Performance Pathway (APP) reporting options, comparing measure selection, quality reporting, Promoting Interoperability, and cost category requirements for each path.]()
Traditional Merit-based Incentive Payment System (MIPS) is the primary way to participate in the Quality Payment Program. Advanced Alternative Payment Models (APMs) are optional programs that offer different incentive structures for high quality, cost efficient care. An example of participating in the APP is if your practice has signed up to work with an ACO, ACO’s are considered APMs and submit data through the APP.
MIPS is the standard fee-for-service (FFS) payment track that applies to around 95% of physicians. Under MIPS, CMS evaluates performance across four categories: Quality, Cost, Improvement Activities, and Promoting Interoperability. Here is a brief description of each category from CMS:
![Four MIPS performance categories: Quality (measures care performance), Promoting Interoperability (patient engagement and CEHRT use), Improvement Activities (clinical practice improvement), and Cost (Medicare Part B claims).]()
## 2025 MIPS Eligibility
The following Clinician Types are eligible for MIPS:
* Physicians (MD, DO, DDS, DMD, DPM, OD)
* Osteopathic practitioners
* Chiropractors
* Physician assistants
* Nurse practitioners
* Clinical Nurse Specialists
* Certified nurse anesthetists
* Physical therapists
* Occupational therapists
* Clinical psychologists
* Qualified speech-language pathologists
* Qualified audiologists
* Registered dietitians or nutrition professionals
* Clinical social workers
* Certified nurse-midwives
If any of the following apply to the provider, they are not required to participate in MIPS:
1. Fewer than 200 Medicare fee-for-service patients
2. Less than \$90,000 in Medicare charges
3. Fewer than 200 Medicare fee schedule services
4. Participate in an Advanced APM
5. First-year Medicare provider
Use the [CMS’s Participation Lookup website](https://qpp.cms.gov/participation-lookup) to confirm eligibility.
### Interpreting Eligibility
Once you look up your NPI on the [CMS Participation Lookup website](https://qpp.cms.gov/participation-lookup), locate the **Associated Practice** that is using Elation.
You will see one of three possible outcomes. Only one of these outcomes (outline below in orange) requires you to participate in MIPS.
![Three eligibility outcomes from CMS Participation Lookup: both INDIVIDUAL and GROUP eligible (required, highlighted); only GROUP eligible (not required individually); neither eligible (not required, no payment adjustment).]()
**Eligibility Note:** if you or your practice are associated with and participating in an APM (ACO or other APM type) contact the APM administrator to determine best practices for MIPS participation and data submission. MIPS APM participation may differ from traditional MIPS participation. MIPS quality data are generally submitted via the APM - and important distinction to understand.
## MIPS Performance Categories
Each of the four performance evaluation categories has different requirements that need to be met and each practice’s goal is to maximize points earned. This year, CMS has weighted the categories as follows and is identical to the weights from the 2024 performance year:
![MIPS category weights when Promoting Interoperability data is submitted: Quality 30%, Cost 30%, Improvement Activities 15%, Promoting Interoperability 25%.]()
![MIPS standard weighting for small practices with Promoting Interoperability auto-reweighted: Quality 40%, Cost 30%, Improvement Activities 30%, Promoting Interoperability 0%.]()
### Quality (30%)
One of the highest weighted categories is Quality, which looks at Clinical Quality Measures.
Elation supports **12 electronic clinical quality measures** (eCQMs). You can learn more about the Clinical Quality Measures that Elation supports in our [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category) article.
* **9 of these eCQMs** can be reported by those who are participating in MIPS through the **Traditional MIPS** path. The 3 measures that are *not* reportable for Traditional MIPS include: Breast Cancer Screening, Colorectal Cancer Screening and Preventive Care and Screening: Body Mass Index (BMI) Screening.
* If you are participating in MIPS through a **MIPS Value Pathway (MVP)** or **APM Performance Pathway**, please refer to the MVP specifics or check with your APM entity to confirm which measures you are required to report.
Practices submitting via Traditional MIPS can submit as many measures as they want but are scored on their 6 top-performing quality measures. Data needs to be collected for these measures across at least 70% of their visits.
One (1) of the 6 measures must be an outcome measure. The outcome measures available in Elation are:
Each measure is scored out of 10 points. The provider's score depends on how many patients are meeting the requirements of the measure. For each measure, the provider earns a percentage first, which is then converted to a score out of 10 based on benchmarks (i.e. the better they perform against their peers, the higher their score per measure will be). The scores for the 6 measures are then put in a calculation to determine how many points the provider earns out of 30 for the Quality category.
Practices who have 15 or fewer providers under a Tax ID Number will automatically earn 6 extra points towards their Quality numerator.
### Cost (30%)
The Cost category measures Medicare spending per beneficiary and total per capita cost. The provider's score is automatically calculated from the billing codes that they submit via claims. Practices don’t need to complete any specific actions in Elation or submit anything in particular for this category. To optimize your scoring potential in this category, we recommend taking steps as a practice to minimize overall cost and hospitalizations for your patients.
### Improvement Activities (15%)
For this category, CMS publishes a [list of activities](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3131/2025-Improvement-Activities-Inventory.zip) that are intended to improve care and outcomes. This is typically an easy category for practices to earn points. You can also learn more about Improvement Activities in our [MIPS (2025)- Improvement Activities Category](/articles/MIPS-2025-Improvement-Activities-Category) article.
For the 2025 MIPS performance year, scoring for the improvement activities category has significantly changed. Activities are no longer classified as high or medium-weight. To earn full credit in this performance category, you must simply meet the numerical requirement below that applies to your circumstances:
* Clinicians, groups, and virtual groups with the small practice, rural, non-patient facing, or health professional shortage area special status must attest (submit a **yes**) to 1 activity.
* All other clinicians, groups, and virtual groups must attest (submit a **yes**) to 2 activities.
### Promoting Interoperability (25%)
This category requires 4 objectives, 2 registry integrations, a security audit, and a few attestations. Learn more about the Promoting Interoperability Performance Category in the [MIPS (2025)- Promoting Interoperability Category](/articles/MIPS-2025-Promoting-Interoperability-Category) article.
Promoting Interoperability includes an automatic exception for small practices (i.e. 15 providers or fewer). The 25% will automatically be allocated towards the Quality and Improvement Activities measures.
## MIPS Adjustments
A practice’s performance across the 4 MIPS categories (or fewer if reweighted) will result in a MIPS final score of 0 to 100 points.
This final score determines whether they will receive a **negative** (up to -9%), **neutral**, or **positive** (up to +9%) payment adjustment on their Medicare Part B Physician Fee Schedule payments in 2027.
To receive a neutral adjustment (i.e. avoid a penalty), practices who are required to participate in MIPS must earn at least **75 total points**.
## 'Traditional MIPS' Participation Summary
After determining your MIPS eligibility and participation level, your practice can begin selecting and performing your measures and activities. To start, here is a timeline for each category:
| Quality | Cost | Improvement Activities | Promoting Interoperability |
| --------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Clinicians must prioritize [6 measures](/admin-compliance) , collecting data for each measure for the 12-month performance period (Jan 1 - Dec 31, 2025). | No action needed to collect or submit any data for cost measures. CMS calculates your Cost performance through your claims. | Clinicians must select between 1 to 2 activities, performing each activity for a continuous 90-day period in Calendar Year (CY) 2025. | Small practices (practices with 15 or fewer providers) are automatically excused from the PI category. Clinicians who don't quality for this exclusion must collect data using CEHRT on the required measures for the same continuous 180- day performance period in CY 2025. |
\**This table is only applicable to Traditional MIPS reporting. Reporting with an APM, or MVP will have different reporting requirements.*
## Tracking and Improvement During 2025
The QPP has multiple resources offered on their [QPP resources site](https://qpp.cms.gov/resources/resource-library), through their help desk, and regularly updated on their newsletter.
\*This article is provided for instructional purposes only. Elation Health does not support or guarantee anything other than relay useful information from various organizations. Elation Health also does not provide support for third-party technologies. We recommend consulting[CMS guidelines](https://qpp.cms.gov/resources/resource-library)for the most up to date information.
Copyright U.S Centers for Medicare & Medicaid Services. All rights reserved.
## Resources
* [CMS Resource Library](https://qpp.cms.gov/resources/resource-library)
## Related Articles
* [MIPS (2025) - Quick Start Guide](/articles/MIPS-2025-Quick-Start-Guide)
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [MIPS (2025) - Promoting Interoperability Category](/articles/MIPS-2025-Promoting-Interoperability-Category)
* [MIPS (2025) - Improvement Activities Category](/articles/MIPS-2025-Improvement-Activities-Category)
* [](/articles/MIPS-2024-Quick-Start-Guide)[Clinical Quality Measures supported in Elation](/admin-compliance)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Health Maintenance Documentation & Reminders Guide](/articles/health-maintenance)
# MIPS (2025) - Promoting Interoperability Category
Source: https://help.elationhealth.com/articles/MIPS-2025-Promoting-Interoperability-Category
This article describes the Promoting Interoperability Performance Category for MIPS 2025.
## What is Promoting Interoperability (MIPS PI Category)?
In 2025, MIPS-Eligible Professionals (EPs), that do not have an existing exclusion for the PI category, must attest to their performance on objectives and measures, across 4 categories; Promoting Interoperability, is 1 of the 4 categories. Interoperability, or the use of technology to exchange and make use of information, makes communicating patient information less burdensome and improves outcomes. The Promoting Interoperability category historically was designed for inpatient facility reporting and is the newest iteration of what was previously known as Meaningful Use, and Advancing Care Information. It has since been targeted towards outpatient providers, and finally extended to any MIPS providers that trigger the requirements (not excluded for other reasons). The MIPS Promoting Interoperability performance category emphasizes the electronic exchange of health information using certified electronic health record technology (CEHRT) to improve:
* Patient access to their health information;
* The exchange of information between clinicians and pharmacies; and
* The systematic collection, analysis, and interpretation of healthcare data.
Promoting Interoperability accounts for 25% of an EP’s MIPS score unless you qualify for a [Hardship Exception](/articles/Promoting-Interoperability-MIPS-2024#hardship-exceptions) or have an existing automatic exclusion and reweighting of the category.
## Reporting Requirements
For Performance Year 2025, you must submit collected data for certain measures from each of the 4 objective measures (unless an exclusion is claimed) for the same 180 continuous days or more during 2025 (this is an increase from the previous 90 day minimum in CY2023). The 4 objectives and measures that Elation supports are:
1. [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
2. [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
3. [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
4. [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
In addition to submitting measures, you must enter Elation's CMS Identification code (0015C1H7GK8MY31) during reporting and submit a **yes** to:
* The Actions to Limit or Restrict Compatibility or Interoperability of CEHRT (previously named the Prevention of Information Blocking) Attestation,
* The ONC Direct Review Attestation,
* [The security risk analysis](/articles/Promoting-Interoperability-Security-Risk-Analysis), and;
* [The SAFER Guides measure](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment) (High Priority Practices Guide)
## Scoring
The scoring for the Promoting Interoperability objectives and measures are as follows.
* [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX) (10 points)
* [Query of PDMP](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program) (10 points)
* [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (30 points total)
* [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange) (30 points)
* [Enabling Exchange Under TEFCA](/articles/Promoting-Interoperability-MIPS-TEFCA) (30 points)
* [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange) (25 points)
* [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)(25 points total)
You must report all required measures (submit a **yes**/report at least 1 patient in the numerator, as applicable, or claim an exclusion) or you will earn a zero for the Promoting Interoperability performance category.
For the Public Health and Clinical Data Exchange objective, you will be awarded full points if a **yes** is submitted for the 2 required measures (Immunization Registry and Electronic Case Reporting) or one “yes” and one exclusion.
The Electronic Case Reporting registry integration is still under construction. If you have interest in the Electronic Case Reporting functionality to meet the Promoting Interoperability category requirements, please reach out to the Elation using the **Contact Elation Support** button and contact your local or regional Public Health Agency to register for the intent to submit data.
Reporting on this objective will require an exclusion for the Electronic Case Reporting measure to be claimed, unless your practice has set up a request with your local Public Health Agency to submit data.
If exclusions are claimed, the points for those measures will be reallocated to other measures.
### Bonus Points
Certain optional measures will allow you to receive bonus points:
* You can earn 5 bonus points for submitting a yes response for one of the optional Public Health and Clinical Data Exchange measures (Public Health Registry Reporting, Clinical Data Registry Reporting, or Syndromic Surveillance Reporting).
## Hardship Exceptions
Hardship Exceptions allow for the Promoting Interoperability performance category to receive a weight of 0% when calculating your final score and the 25% will be redistributed to another performance category (or categories) unless you choose to submit data for Promoting Interoperability.
Some clinicians will be **automatically** reweighted based on:
* Their special status (for example, hospital-based clinicians),
* **If they are a part of a small practice (less than 15 providers).**
These clinicians will not need to submit a Promoting Interoperability hardship exception application.
If you’re reporting as a group or virtual group all MIPS eligible clinicians in the group or virtual group must qualify for reweighting for the group to be reweighted, unless the group or virtual group has a special status that qualifies them for automatic reweighting.
You may submit a MIPS Promoting Interoperability Performance Category Hardship Exception Application, citing one of the following reasons for review and approval:
* MIPS eligible clinician using decertified EHR technology
* Insufficient Internet connectivity
* Extreme and uncontrollable circumstances
* Lack of control over the availability of CEHRT
If your hardship exception is approved, the Promoting Interoperability performance category will be reweighted.
## Achieving Objectives in Elation
Follow the instructions below for the measures that Elation supports:
1. [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
2. [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
3. [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange)
4. [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
5. [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
6. [Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)
## Additional Resources
* \[QPP Promoting Interoperability Performance Category Overview]\([https://qpp.cms.gov/mips/promoting-interoperability”](https://qpp.cms.gov/mips/promoting-interoperability”) with “[https://qpp.cms.gov/mips/promoting-interoperability?py=2024](https://qpp.cms.gov/mips/promoting-interoperability?py=2024))
* [2025 Promoting Interoperability Performance Category Quick Start Guide: Traditional MIPS](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3112/2025-Promoting-Interoperability-Quick-Start-Guide.pdf)
\*This article is provided for instructional purposes only. Elation Health does not support or guarantee anything other than relay useful information from various organizations. Elation Health also does not provide support for third-party technologies. We recommend consulting[CMS guidelines](https://qpp.cms.gov/resources/resource-library)for the most up to date information.
Copyright U.S Centers for Medicare & Medicaid Services. All rights reserved.
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [Promoting Interoperability (MIPS) - e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
* [Promoting Interoperability (MIPS) - Health Information Exchange (HIE) - Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
* [Promoting Interoperability (MIPS) - Public Health and Clinical Data Exchange](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
* [Promoting Interoperability (MIPS) - Security Risk Analysis](/articles/Promoting-Interoperability-Security-Risk-Analysis)
* [Promoting Interoperability (MIPS) - SAFER Guides Assessment](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment)
* [Promoting Interoperability (MIPS) - Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)[](/articles/Quality-Category-MIPS-2024)
# MIPS (2025) - Quality Category
Source: https://help.elationhealth.com/articles/MIPS-2025-Quality-Category
This article describes the Quality Performance Category for MIPS 2025.
**Contents**
* [Quality Category Overview](#overview)
* [Reporting Options](#reporting_options)
* [Traditional MIPS](#traditional_mips)
* [MIPS Value Pathways](#value_pathways)
* [APM Performance Pathways](#APM_performance_pathways)
* [Collection Types](#collection_types)
* [What does Elation support for Quality measures and collection types?](#Elation_reporting)
* [Additional Resources](#additional_resources)
## Quality Category Overview
The Quality category in MIPS provides a variety of reporting flexibilities. There are reporting options and collection types to consider. The Quality category is intended to measure Quality performance based on certain measures. Most providers are most familiar with Traditional MIPS and APP Reporting (reporting with an ACO).
MIPS Quality reporting generally covers a 12 month performance period (full calendar year January 1-December 31, 2025)
As a reminder and reflected in all CMS documentation; the first step for all MIPS eligible clinicians is to understand their reporting requirements. Understanding what a provider is required to report, planning on that reporting for the calendar year, and establishing improvement and documentation practices that align with requirements is the responsibility of each provider or practice.
## Reporting Options
### Traditional MIPS
[Traditional MIPS](https://qpp.cms.gov/mips/quality-requirements?py=2025), established in the first year of QPP, is the original reporting option for MIPS. You select the quality measures and improvement activities that you'll collect and report from all of the quality measures and improvement activities finalized for MIPS. You’ll also report the complete Promoting Interoperability measure set, if you are required to report the MIPS PI category and do not have an existing exclusion. The QPP collects and calculates data for the cost performance category for you.
General reporting requirements are as follows:
* You’ll need to submit collected data for at least **6 quality measures** (including one outcome measure or high priority measure in the absence of an applicable outcome measure), or a complete specialty measure set.
* For the 2025 performance period you’ll need to report performance data for at least 75% of the denominator eligible cases for each quality measure (data completeness).
* You can submit measures from different collection types to fulfill the requirement to report data for at least 6 quality measures.
You may supplement Claims Based measure collection.
You can review the [QPP list of quality measures here](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3125/2025-MIPS-Quality-Measures-List.xlsx) and identify which measures and collection type you plan to report on. To better assist in preparing you for this process, the QPP has a [Quick Start Quality Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3116/2025-Quality-Quick-Start-Guide.pdf). See the list of electronic Clinical Quality Measures and Collection Types further below in this Help Center Article.
### MIPS Value Pathways
MIPS Value Pathways (MVPs) are the newest reporting option that offer clinicians a subset of measures and activities relevant to a specialty or medical condition. MVPs offer more meaningful groupings of measures and activities, to provide a more connected assessment of the quality of care. You’ll select, collect, and report on a reduced number of quality measures and improvement activities (as compared to traditional MIPS). You’ll also report the complete Promoting Interoperability measure set (the same as reported in traditional MIPS), if you are required to report MIPS and the MIPS PI category and do not have an existing exclusion (only report if you are not a small practice). The MVP measure set includes a Value in Primary Care measure bundle that is the most relevant and currently the only MVP bundle supported by Elation. To report on an MVP measure set you must select 4 quality measures from the measure bundle offered. The **bolded measures** and collection types are the measures that are available for the Value in Primary Care MVP:
1. **Diabetes: Glycemic Status Assessment Greater Than 9%**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, MIPS CQMs Specifications
2. **Advance Care Plan**
* Collection Type: **Medicare Part B Claims Measure Specifications**, MIPS CQMs Specifications
3. **Preventive Care and Screening: Screening for Depression and Follow-Up Plan**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, eCQM Specifications, MIPS CQMs Specifications
4. **Controlling High Blood Pressure**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, MIPS CQMs Specifications
5. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
* Collection Type: eCQM Specifications
6. CAHPS for MIPS Clinician/Group Survey
* Collection Type: CAHPS Survey Vendor
7. Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
* Collection Type: eCQM Specifications, MIPS CQMs Specifications
8. HIV Screening
* Collection Type: eCQM Specifications
9. Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM)
* Collection Type: MIPS CQMs Specifications
10. Screening for Social Drivers of Health
* Collection Type: MIPS CQMs Specifications
11. Adult Immunization Status
* Collection Type: MIPS CQMs Specifications
12. Preventive Care and Wellness (composite)
* Collection Type: MIPS CQMs Specifications
13. Initiation, Review, And/Or Update To Suicide Safety Plan For Individuals With Suicidal Thoughts, Behavior, Or Suicide Risk
* Collection Type: MIPS CQMs Specifications
### APM Performance Pathways
The Alternative Payment Model (APM) Performance Pathway (APP) is a streamlined reporting option for clinicians who participate in a MIPS APM. The APP is designed to reduce reporting burden, create new scoring opportunities for participants in MIPS APMs, and encourage participation in APMs. You’ll report a predetermined measure set made up of quality measures in addition to the complete Promoting Interoperability measure set (the same as reported in traditional MIPS), if you are required to report the PI category and do not have an existing exclusion (example, you are not in a small practice). MIPS APM participants currently receive full credit in the improvement activities performance category.
*If you participate in an ACO/APM reach out to that APM administrator to understand how to report MIPS with the ACO or other APM. ACOs and other APMs get full credit for Improvement Activities and the only reporting requirement for APM participants is the Quality category which is reported as a whole (with the ACO/APM).*
## Collection Types
* **Electronic Clinical Quality Measures (eCQMs)**
* eCQMs are standardized measures that a Certified EHR Technology (CEHRT) meets to specification and is certified to. There are currently 47 eCQMs available to report to MIPS in 2025. Elation is certified to 12 eCQMs, and 7 eCQMs are eligible for Traditional MIPS reporting. eCQMs are measured as part of your regular workflows and can be found regularly in the Quality Dashboard of Elation. During reporting, eCQMs are extracted as a QRDA file and submitted to the QPP.
*
QRDA files and eCQMs are used and submitted to other CMS programs and are applicable for other program participants as such, eCQMs no longer applicable in traditional MIPS are applicable for MVPs and APMs and remain in production and functionality in Elation.
* These are the eCQMs that Elation supports in 2025 (9 bolded eCQMs that contribute to traditional MIPS and the total 12):
* * * [\[CMS124v13\] Cervical Cancer Screening (MIPS 2025)](/articles/CMS124v13-Cervical-Cancer-Screening-MIPS-2025)
* [\[CMS122v13\] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2025)](/articles/CMS122v13-Diabetes-Glycemic-Status-Greater-than-9percent)
* [\[CMS131v13\] Diabetes: Eye Exam (MIPS 2025)](/articles/CMS131v13-Diabetes-Eye-Exam-MIPS-2025)
* [\[CMS139v13\] Falls: Screening for Future Fall Risk (MIPS 2025)](/articles/CMS139v13-Falls-Screening-for-Future-Fall-Risk-MIPS-2025)
* [\[CMS149v13\] Dementia: Cognitive Assessment (MIPS 2025)](/articles/CMS149v13-Dementia-Cognitive-Assessment-MIPS-2025)
* [\[CMS155v13\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2025)](/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2025)
* [\[CMS165v13\] Controlling High Blood Pressure (MIPS 2025)](/articles/CMS165v13-Controlling-High-Blood-Pressure-MIPS-2025)
* **[\[CMS2v14\] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2025)](/articles/CMS2v14)**
* **[\[CMS159v13\] Depression Remission at Twelve Months (MIPS 2025)](/articles/CMS159v13)**
* [\[CMS69v13\] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan (not available for Traditional MIPS)](/articles/CMS69v13-Preventive-Care-and-Screening-Body-Mass-Index-BMI-Screening-and-Follow-Up-Plan)
* [\[CMS125v13\] Breast Cancer Screening (not available for Traditional MIPS)](/articles/CMS125v13-Breast-Cancer-Screening)
* [\[CMS130v13\] Colorectal Cancer Screening (not available for Traditional MIPS)](/articles/CMS130v13-Colorectal-Cancer-Screening)
* **MIPS Clinical Quality Measures (CQMs)**
* MIPS CQMs are often collected by third party intermediaries and submitted on behalf of MIPS eligible clinicians. You may choose to work with a Qualified Registry.
* **Medicare Part B Claims Measures**
* This collection type is only available to those designated with the small practice special status (15 or fewer clinicians). Medicare Part B claims measures are always reported with the clinician’s individual (rendering) NPI even when reporting as a group, subgroup (MVPs only) virtual group (traditional MIPS), or APM Entity. For more information about reporting quality measures through Medicare Part B claims, [download this guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2649/2024PartBClaimsReportingGuide.pdf) from the QPP.
### What does Elation support for Quality measures and collection types?
Elation supports 12 eCQMs, 9 of which count in Traditional MIPS, and 3 are used in the MVP Value in Primary Care group. Administrative Claims Based measures may be selected to support additional measure selections for MIPS to report for Traditional MIPS and MVPs. Elation supports APM reporting with the selected eCQMs, and other measures supported depending on collection type.
* **Traditional MIPS**: You may report using 6 eCQMs or a combination of eCQMs and claims based measures, or reporting through a registry. To report through a registry, we recommend connecting with MDInteractive.
* **MVPs**: You may report on the Value in Primary Care MVP the 4 bolded measures above which include 3 eCQMs and 1 Claim Based Measure.
* **APP**: If you have signed up with an APM to participate this year, such as an ACO, or REACH, ensure your quality reporting is aligned with the measures the ACO administrator selected and only one quality submission is required, the quality submission reported with your APM.
Elation Health provides the tools to support certain reporting requirements. All reporting requirements are the sole responsibility of the reporting provider. The changing nature of CMS programs and MIPS as part of those programs, require continuous changes to the program. If you have concerns with the measures required to report to MIPS or CMS programs please direct that feedback to CMS and the QPP. Elation Health provides a certain set of eCQMs that require significant development work to meet requirements for PCPs. If you have additional needs beyond the eCQMs that are supported in Elation, such as, support with reporting to MIPS or CMS programs, that should be directed to those relevant agencies. The QPP provides a not insignificant amount of support for reporting.
**Contact CMS**
Phone:1-866-288-8292 (TRS: 711)
Monday - Friday 8 a.m - 8 p.m ET
Email: [QPP@cms.hhs.gov](mailto:QPP@cms.hhs.gov)
## Additional Resources
* [QPP 2025 Quality Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3116/2025-Quality-Quick-Start-Guide.pdf)
* [QPP 2025 MIPS Quality Measure List](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3125/2025-MIPS-Quality-Measures-List.xlsx)
* [MIPS Quality Performance Category Fact Sheet](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2402/MIPS%20Quality%20Performance%20Category%20Fact%20Sheet.pdf)
* [2025 Part B Claims Reporting Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3118/2025-Part-B-Claims-Measure-Reporting-Quick-Start-Guide.pdf)
* [Quality Performance Category: Learning about Collection Types](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3076/Quality-Learning-About-Collection-Types.pdf)[](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2661/2024QualityQuickStartGuide.pdf)
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)[](/articles/Quality-Category-MIPS-2024)
* [Elation Support Clinical Quality Measures](/admin-compliance)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)[](/articles/Promoting-Interoperability-MIPS-2024)
# MIPS (2025) - Quick Start Guide
Source: https://help.elationhealth.com/articles/MIPS-2025-Quick-Start-Guide
This article is a quick reference guide for everything you need to know about the MIPS 2025 Reporting Period.
## Quick Start Guide Overview
MIPS participation may seem overwhelming. To break down MIPS participation and actions to take during 2025, here is the guide to follow along all the resources Elation Health offers for MIPS eligible clinicians. This information is intended as support for your practice to participate in MIPS using Elation. For questions specific to MIPS and regulatory requirements, contact the Quality Payment Program (QPP) directly.
A helpful guide from the QPP is the [2025 MIPS Quick Start Guide for Small Practices](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3115/2025-MIPS-Quick-Start-Guide-for-Small-Practices.pdf).
* Important Note: This information has been tailored and is intended for informational purposes only.
To begin understanding the Quality Payment Program (QPP) and MIPS program the QPP offers the following introductory videos for familiarizing yourself with MIPS:
* [Introduction to MIPS](https://youtu.be/6Ovw-QELq7E)
* [How to Check Eligibility Status](https://www.youtube.com/watch?v=rHoH4hJaetI)
## MIPS Eligibility
Use the [QPP participation look up tool](https://qpp.cms.gov/participation-lookup) to determine if you need to report MIPS.
## MIPS Quality Category
Ensure MIPS eCQMs are turned on as noted in [this Help Center Article](/articles/clinical-reminders-for-clinical-quality-measures) for turning on eCQMs and that you are tracking eCQMs as best possible. Follow workflows to close care gaps. Create a performance improvement plan to determine what needs to be tracked better over time.
Understand and determine your reporting type and collection type. Review the [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category) article to support this.
## MIPS Promoting Interoperability
Does your practice have greater than 15 providers in it? If not, do nothing, you do not need to report to this category.
If your practice has greater than 15 providers and plans to report the PI category, ensure you can participate by reviewing the [MIPS (2025) - Promoting Interoperability Category](/articles/MIPS-2025-Promoting-Interoperability-Category) article, checking all your integrations, and reviewing workflows for the associated measures.
**Important Note**: If you are reporting on the Promoting Interoperability Category, make sure you submit your intent to submit data to your local Public Health Agency and reach out to Elation Health so we can assist in understanding the integration.
## MIPS Improvement Activities
Look at the Improvement Activities list and determine which Improvement Activities are most relevant to your practice. Review the [MIPS (2025) - Improvement Activities Category](/articles/MIPS-2025-Improvement-Activities-Category) article to support this.
## Additional Resources
Review Help Center Articles about specific area listed in order of recommended reading:
1. Overview Articles
* [MIPS Eligibility - Frequently Asked Questions (FAQ)](/articles/MIPS-Eligibility-FAQ)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [MIPS (2025) - Promoting Interoperability Category](/articles/MIPS-2025-Promoting-Interoperability-Category)
* [MIPS (2025) - Improvement Activities Category](/articles/MIPS-2025-Improvement-Activities-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
2. Measure Specific Articles
* [\[CMS124v13\] Cervical Cancer Screening (MIPS 2025)](/articles/CMS124v13-Cervical-Cancer-Screening-MIPS-2025)
* [\[CMS122v13\] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2025)](/articles/CMS122v13-Diabetes-Glycemic-Status-Greater-than-9percent)
* [\[CMS131v13\] Diabetes: Eye Exam (MIPS 2025)](/articles/CMS131v13-Diabetes-Eye-Exam-MIPS-2025)
* [\[CMS139v13\] Falls: Screening for Future Fall Risk (MIPS 2025)](/articles/CMS139v13-Falls-Screening-for-Future-Fall-Risk-MIPS-2025)
* [\[CMS149v13\] Dementia: Cognitive Assessment (MIPS 2025)](/articles/CMS149v13-Dementia-Cognitive-Assessment-MIPS-2025)
* [\[CMS155v13\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2025)](/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2025)
* [\[CMS165v13\] Controlling High Blood Pressure (MIPS 2025)](/articles/CMS165v13-Controlling-High-Blood-Pressure-MIPS-2025)
* [\[CMS2v14\] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2025)](/articles/CMS2v14)
* [\[CMS159v13\] Depression Remission at Twelve Months (MIPS 2025)](/articles/CMS159v13)
* [Promoting Interoperability (MIPS 2025) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2025-TEFCA)
* [Promoting Interoperability (MIPS 2025) - Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2025-HIE-Bidirectional-Exchange)
* [Promoting Interoperability (MIPS 2025) - Public Health and Clinical Data Exchange](/articles/Promoting-Interoperability-MIPS-2025-Public-Health-and-Clinical-Data-Exchange)
* [Promoting Interoperability (MIPS) - SAFER Guides Assessment](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment)
* [Promoting Interoperability (MIPS) - Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)
* [Promoting Interoperability (MIPS) - e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
3. Review the following recorded webinars. We will add links to recorded webinars as they occur.
* (Coming Soon)
4. Reference QPP Resources as needed:
* [2025 MIPS Quick Start Guide for Small Practices](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3115/2025-MIPS-Quick-Start-Guide-for-Small-Practices.pdf)
* [QPP 2025 Quality Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3116/2025-Quality-Quick-Start-Guide.pdf)
* [QPP 2025 Promoting Interoperability Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3112/2025-Promoting-Interoperability-Quick-Start-Guide.pdf)
* [QPP 2025 Improvement Activities Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3113/2025-Improvement-Activities-Quick-Start-Guide.pdf)
* [MIPS Quality Performance Category Fact Sheet](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2402/MIPS%20Quality%20Performance%20Category%20Fact%20Sheet.pdf)
* [QPP 2025 Improvement Activities Inventory](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3131/2025-Improvement-Activities-Inventory.zip)
* [2025 Part B Claims Reporting Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3118/2025-Part-B-Claims-Measure-Reporting-Quick-Start-Guide.pdf)
# MIPS (2026) Eligibility - Frequently Asked Questions (FAQ)
Source: https://help.elationhealth.com/articles/MIPS-2026-Eligibility-FAQ
This article describes how you can verify whether or not you are required to report for the Merit-based Incentive Payment System (MIPS).
## How do I know if I have to report MIPS?
The first step for anyone with questions regarding MIPS is to check your eligibility, also known as, reporting requirements.
1. Step 1: Lookup Eligibility
* Use the [CMS’s Participation Lookup website](https://qpp.cms.gov/participation-lookup) and use a provider NPI to determine if the provider or practice has MIPS reporting requirements.
2. Step 2: Interpreting Eligibility
* Once practices find the **Associated Practice** that is using Elation, there are three possible outcomes, only one of which requires practices to participate in MIPS (see below).
![Three MIPS eligibility scenarios: Row 1 (highlighted): both INDIVIDUAL and GROUP eligible — required to participate, can submit either way. Row 2: individual not eligible, group optional. Row 3: neither eligible, no payment adjustment.]()
**ELIGIBILITY NOTE** If you or your practice are associated with and participating in an APM (ACO or other APM type) contact the APM administrator to determine best practices for MIPS participation and data submission. MIPS APM participation may vary from traditional MIPS participation. MIPS data and quality data are generally submitted via the APM and that is important to understand.
All of this information is based on regulatory statue with this eligibility determination.
## 2026 MIPS Eligibility Determination
### Which Clinician Types are eligible for MIPS?
The following Clinician Types are eligible for MIPS:
* Physicians (MD, DO, DDS, DMD, DPM, OD)
* Osteopathic practitioners
* Chiropractors
* Physician assistants
* Nurse practitioners
* Clinical Nurse Specialists
* Certified nurse anesthetists
* Physical therapists
* Occupational therapists
* Clinical psychologists
* Qualified speech-language pathologists
* Qualified audiologists
* Registered dietitians or nutrition professionals
* Clinical social workers
* Certified nurse-midwives
* Clinical nurse specialists
### Which exceptions exempt me from MIPS reporting?
If any of the following apply to the provider, they are not required to participate in MIPS:
* Fewer than 200 Medicare fee-for-service patients
* Less than \$90,000 in Medicare charges
* Fewer than 200 Medicare fee schedule services
* Participate in an Advanced APM
* First-year Medicare provider
### Who can I speak to about my MIPS Eligibility?
For questions regarding eligibility specifically, please contact the QPP helpdesk for further support. The QPP helpdesk is the support center for all things related to MIPS and provides the best support.
QPP helpdesk
* Hours: Monday - Friday 8 a.m - 8 p.m Eastern Time
* Phone: 1-866-288-8292 (TRS: 711)
* Email: [QPP@cms.hhs.gov](mailto:QPP@cms.hhs.gov)
### What are the additional resources I can reference?
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [MIPS (2026) - Quick Start Guide](/articles/MIPS-2026-Quick-Start-Guide)
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [MIPS (2026) - Promoting Interoperability Category](/articles/MIPS-2026-Promoting-Interoperability-Category)
* [MIPS (2026) - Improvement Activities Category](/articles/MIPS-2026-Improvement-Activities-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [QPP 2026 MIPS Eligibility & Participation Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3605/2026-Small-Practice-Eligibility-FAQ.pdf)
# MIPS (2026) - Improvement Activities Category
Source: https://help.elationhealth.com/articles/MIPS-2026-Improvement-Activities-Category
This article describes the Improvement Activities Performance Category for MIPS 2026.
## Introduction
The following information is provided for small practices (15 or fewer providers in a TIN) that report Traditional MIPS. Improvement Activities are one category of MIPS and worth 30% of the overall MIPS score if in a small practice and not reporting on the Promoting Interoperability category, and reporting Traditional MIPS . Total points for the Improvement Activities category caps at 40 and is dependent on a combination of scoring factors. In Calendar Year (CY) 2026 the weighting previously established for improvement activities has been removed and all activities are worth the same weight.
**To earn full credit in this performance category as a small practice, you must submit 1 improvement activity to receive 40 points.**
Improvement activities have a minimum of a continuous 90-day performance period (during calendar year (CY 2026) unless otherwise stated in the activity description. To submit Improvement Activities as an Eligible Clinician you can sign in and attest.
## Improvement Activities
With over 100 Improvement Activities to choose from, it can be overwhelming to decide which one is best suited for your practice. If you are in a small practice you only need to select one activity and attest to the activity in the QPP portal during MIPS reporting. Many of the activities capture best practices that you or your practice may already be doing.
* [Improvement Activities Measures and Activities](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3607/Links-to-2026-MIPS-Measure-Specs-Activity-Inventory-and-Supporting-Documentation.pdf)
* [QPP Improvement Activities Inventory Zip File](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3567/2026-Improvement-Activities-Inventory.zip)
* [QPP Improvement Activities Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3600/2026-Improvement-Activities-Quick-Start-Guide.pdf)
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [MIPS (2026) - Quick Start Guide](/articles/MIPS-2026-Quick-Start-Guide)
# MIPS (2026) Overview
Source: https://help.elationhealth.com/articles/MIPS-2026-Overview
## Overview
### Introduction to the QPP and MIPS
The Quality Payment Program (QPP) is a federally mandated Medicare program by Centers for Medicare and Medicaid Services (CMS) that seeks to improve patient care and outcomes while managing the costs of services patients receive.
Clinicians may participate in the Quality Payment Program through one of three reporting options:
![Three-column comparison table of QPP participation options: Traditional MIPS, MIPS Value Pathways (MVPs), and APM Performance Pathway (APP), outlining key differences in measure selection, quality reporting, and cost evaluation for each.]()
Traditional Merit-based Incentive Payment System (MIPS) is the primary way to participate in the Quality Payment Program. Advanced Alternative Payment Models (APMs) are optional programs that offer different incentive structures for high quality, cost efficient care. An example of participating in the APP is if your practice has signed up to work with an ACO, ACO’s are considered APMs and submit data through the APP.
MIPS is the standard fee-for-service (FFS) payment track that applies to around 95% of physicians. Under MIPS, CMS evaluates performance across four categories: Quality, Cost, Improvement Activities, and Promoting Interoperability. Here is a brief description of each category from CMS:
![Four MIPS performance categories: Quality (measures care performance), Promoting Interoperability (patient engagement via CEHRT), Improvement Activities (clinical practice improvement), and Cost (Medicare Part B claims).]()
### 2026 MIPS Eligibility
The following Clinician Types are eligible for MIPS:
* Physicians (MD, DO, DDS, DMD, DPM, OD)
* Osteopathic practitioners
* Chiropractors
* Physician assistants
* Nurse practitioners
* Clinical Nurse Specialists
* Certified nurse anesthetists
* Physical therapists
* Occupational therapists
* Clinical psychologists
* Qualified speech-language pathologists
* Qualified audiologists
* Registered dietitians or nutrition professionals
* Clinical social workers
* Certified nurse-midwives
If any of the following apply to the provider, they are not required to participate in MIPS:
1. Fewer than 200 Medicare fee-for-service patients
2. Less than \$90,000 in Medicare charges
3. Fewer than 200 Medicare fee schedule services
4. Participate in an Advanced APM
5. First-year Medicare provider
Use the [CMS’s Participation Lookup website](https://qpp.cms.gov/participation-lookup) to confirm eligibility.
#### Interpreting Eligibility
Once you look up your NPI on the CMS Participation Lookup website, locate the **Associated Practice** that is using Elation. You will see one of three possible outcomes. Only one of these outcomes (outline below in orange) requires you to participate in MIPS.
![Three possible MIPS eligibility outcomes: both Individual and Group required (must participate); Individual not required but Group optional; neither Individual nor Group required (no payment adjustment).]()
**ELIGIBILITY NOTE** If you or your practice are associated with and participating in an APM (ACO or other APM type) contact the APM administrator to determine best practices for MIPS participation and data submission. MIPS APM participation may differ from traditional MIPS participation. MIPS quality data are generally submitted via the APM - an important distinction to understand.
## MIPS Performance Categories
Each of the four performance evaluation categories has different requirements that need to be met and each practice’s goal is to maximize points earned. This year, CMS has weighted the categories as follows and is identical to the weights from the 2025 performance year:
![MIPS category weights when no categories are reweighted (Promoting Interoperability submitted): Quality 30%, Cost 30%, Improvement Activities 15%, Promoting Interoperability 25%.]()
![MIPS category weights for small practices with Promoting Interoperability reweighted to 0%: Quality 40%, Cost 30%, Improvement Activities 30%, Promoting Interoperability 0%.]()
### Quality (30%)
One of the highest weighted categories is Quality, which looks at Clinical Quality Measures.
Practices submitting via Traditional MIPS can submit as many measures as they want but are scored on their 6 top-performing quality measures. Data needs to be collected for these measures across at least 75% of their visits. Elation has 12 electronic clinical quality measures (eCQMs)that are used in MIPS that we can report on and with a set of videos that cover workflows. You can also learn more about all the electronic Clinical Quality Measures that Elation supports in the [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards).
One (1) of the 6 measures must be an outcome measure. The outcome measures available in Elation are: [Controlling High Blood Pressure](/articles/CMS165v14-Controlling-High-Blood-Pressure)
[Diabetes: Glycemic Status Assessment Greater Than 9%](/articles/CMS122v14-Diabetes-Glycemic-Status-Assessment-Greater-Than-9)
Each measure is scored out of 10 points. The provider's score depends on how many patients are meeting the requirements of the measure. For each measure, the provider earns a percentage first, which is then converted to a score out of 10 based on benchmarks (i.e. the better they perform against their peers, the higher their score per measure will be). The scores for the 6 measures are then put in a calculation to determine how many points the provider earns out of 30 for the Quality category.
Practices who have 15 or fewer providers under a Tax ID Number will automatically earn 6 extra points towards their Quality numerator.
### Cost (30%)
The Cost category measures Medicare spending per beneficiary and total per capita cost. The provider's score is automatically calculated from the billing codes that they submit via claims. Practices don’t need to complete any specific actions in Elation or submit anything in particular for this category. To optimize your scoring potential in this category, we recommend taking steps as a practice to minimize overall cost and hospitalizations for your patients.
### Improvement Activities (15%)
For this category, CMS publishes a [list of activities](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3567/2026-Improvement-Activities-Inventory.zip) that are intended to improve care and outcomes. This is typically an easy category for practices to earn points. You can also learn more about Improvement Activities in our [MIPS (2026) - Improvement Activities Category](/articles/MIPS-2026-Improvement-Activities-Category) article.
For the 2026 MIPS performance year, scoring for the improvement activities categoryry has maintained some consistency to 2025 (when the category changed). Activities are not classified as high or medium-weight. To earn full credit in this performance category, you must simply meet the numerical requirement below that applies to your circumstances:
* Clinicians, groups, and virtual groups with the small practice, rural, non-patient facing, or health professional shortage area special status must attest (submit a **yes**) to 1 activity.
* All other clinicians, groups, and virtual groups must attest (submit a **yes**) to 2 activities.
### Promoting Interoperability (25%)
This category requires 4 objectives, 2 registry integrations, a security audit, and a few attestations. Learn more about the Promoting Interoperability Performance Category in the [MIPS (2026) - Promoting Interoperability Category](/articles/MIPS-2026-Promoting-Interoperability-Category) article.
Promoting Interoperability includes an automatic exception for small practices (i.e. 15 providers or fewer). The 25% will automatically be allocated towards the Quality and Improvement Activities measures.
## MIPS Adjustments
A practice’s performance across the 4 MIPS categories (or fewer if reweighted) will result in a MIPS final score of 0 to 100 points.
This final score determines whether they will receive a **negative** (up to -9%), **neutral**, or **positive** (up to +9%) payment adjustment on their Medicare Part B Physician Fee Schedule payments in 2028.
To receive a neutral adjustment (i.e. avoid a penalty), practices who are required to participate in MIPS must earn at least **75 total points**.
## 'Traditional MIPS' Participation Summary
After determining your MIPS eligibility and participation level, your practice can begin selecting and performing your measures and activities. To start, here is a timeline for each category:
| Quality | Cost | Improvement Activities | Promoting Interoperability |
| --------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Clinicians must prioritize [6 measures](/admin-compliance) , collecting data for each measure for the 12-month performance period (Jan 1 - Dec 31, 2026). | No action needed to collect or submit any data for cost measures. CMS calculates your Cost performance through your claims. | Clinicians must select between 1 to 2 activities, performing each activity for a continuous 90-day period in Calendar Year (CY) 2026. | Small practices (practices with 15 or fewer providers) are automatically excused from the PI category. Clinicians who don't quality for this exclusion must collect data using CEHRT on the required measures for the same continuous 180- day performance period in CY 2026. |
\**This table is only applicable to Traditional MIPS reporting. Reporting with an APM, or MVP will have different reporting requirements.*
## Tracking and Improvement During 2026
The QPP has multiple resources offered on their [QPP resources site](https://qpp.cms.gov/resources/resource-library), through their help desk, and regularly updated on their newsletter.
\*This article is provided for instructional purposes only. Elation Health does not support or guarantee anything other than relay useful information from various organizations. Elation Health also does not provide support for third-party technologies. We recommend consulting[CMS guidelines](https://qpp.cms.gov/resources/resource-library)for the most up to date information.
Copyright U.S Centers for Medicare & Medicaid Services. All rights reserved.
## Resources
* [CMS Resource Library](https://qpp.cms.gov/resources/resource-library)
## Related Articles
* [MIPS (2026) - Quick Start Guide](/articles/MIPS-2026-Quick-Start-Guide)
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [MIPS (2026) - Promoting Interoperability Category](/articles/MIPS-2026-Promoting-Interoperability-Category)
* [MIPS (2026) - Improvement Activities Category](/articles/MIPS-2026-Improvement-Activities-Category)
* [Clinical Quality Measures supported in Elation](/admin-compliance)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Health Maintenance Documentation & Reminders Guide](/articles/health-maintenance)
# MIPS (2026) - Promoting Interoperability Category
Source: https://help.elationhealth.com/articles/MIPS-2026-Promoting-Interoperability-Category
This article describes the Promoting Interoperability Performance Category for MIPS 2026.
## Overview
### What is Promoting Interoperability (MIPS PI Category)?
In 2026, MIPS-Eligible Professionals (EPs), that do not have an existing exclusion for the PI category, must attest to their performance on objectives and measures, across 4 categories; Promoting Interoperability, is 1 of the 4 categories. Interoperability, or the use of technology to exchange and make use of information, makes communicating patient information less burdensome and improves outcomes. The Promoting Interoperability category historically was designed for inpatient facility reporting and is the newest iteration of what was previously known as Meaningful Use, and Advancing Care Information. It has since been targeted towards outpatient providers, and finally extended to any MIPS providers that trigger the requirements (not excluded for other reasons). The MIPS Promoting Interoperability performance category emphasizes the electronic exchange of health information using certified electronic health record technology (CEHRT) to improve:
* Patient access to their health information;
* The exchange of information between clinicians and pharmacies; and
* The systematic collection, analysis, and interpretation of healthcare data.
Promoting Interoperability accounts for 25% of an EP’s MIPS score unless you qualify for a [Hardship Exception](#hardship_exceptions) or have an existing automatic exclusion and reweighting of the category.
### Reporting Requirements
For Performance Year 2026, you must submit collected data for certain measures from each of the 4 objective measures (unless an exclusion is claimed) for the same 180 continuous days or more during 2026 (this is an increase from the previous 90 day minimum in CY2023). The 4 objectives and measures that Elation supports are:
1. [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
2. [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
3. [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
4. [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
In addition to submitting measures, you must enter Elation's CMS Identification code (2025C43YZH8S00G) during reporting and submit a **yes** to:
* The Actions to Limit or Restrict Compatibility or Interoperability of CEHRT (previously named the Prevention of Information Blocking) Attestation,
* The ONC Direct Review Attestation,
* [The security risk analysis](/articles/Promoting-Interoperability-Security-Risk-Analysis), and;
* [The SAFER Guides measure](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment) (High Priority Practices Guide)
### Scoring
The scoring for the Promoting Interoperability objectives and measures are as follows.
* [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX) (10 points)
* [Query of PDMP](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program) (10 points)
* [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (30 points total)
* [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange) (30 points)
* [Enabling Exchange Under TEFCA](/articles/Promoting-Interoperability-MIPS-2026-TEFCA) (30 points)
* [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange) (25 points)
* [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange) (25 points total)
You must report all required measures (submit a **yes**/report at least 1 patient in the numerator, as applicable, or claim an exclusion) or you will earn a zero for the Promoting Interoperability performance category.
For the Public Health and Clinical Data Exchange objective, you will be awarded full points if a **yes** is submitted for 1 of the 2 required measures (Immunization Registry and Electronic Case Reporting) or one “yes” and one exclusion.
**Electronic Case Reporting (eCR) Suppression**: Due to ongoing technical onboarding pauses, CMS has finalized a policy to suppress the Electronic Case Reporting measure for 2026. You must still report a response (Yes, No, or Exclusion), but you will receive full credit regardless of the performance as long as you provide an answer.
If exclusions are claimed, the points for those measures will be reallocated to other measures.
#### Bonus Points
Certain optional measures will allow you to receive bonus points:
* You can earn 5 bonus points for submitting a yes response for one of the optional Public Health and Clinical Data Exchange measures (Public Health Registry Reporting, Clinical Data Registry Reporting, or Syndromic Surveillance Reporting).
### Hardship Exceptions
Hardship Exceptions allow for the Promoting Interoperability performance category to receive a weight of 0% when calculating your final score and the 25% will be redistributed to another performance category (or categories) unless you choose to submit data for Promoting Interoperability.
Some clinicians will be **automatically** reweighted based on:
* Their special status (for example, hospital-based clinicians),
* **If they are a part of a small practice (less than 15 providers).**
These clinicians will not need to submit a Promoting Interoperability hardship exception application.
If you’re reporting as a group or virtual group all MIPS eligible clinicians in the group or virtual group must qualify for reweighting for the group to be reweighted, unless the group or virtual group has a special status that qualifies them for automatic reweighting.
You may submit a MIPS Promoting Interoperability Performance Category Hardship Exception Application, citing one of the following reasons for review and approval:
* MIPS eligible clinician using decertified EHR technology
* Insufficient Internet connectivity
* Extreme and uncontrollable circumstances
* Lack of control over the availability of CEHRT
If your hardship exception is approved, the Promoting Interoperability performance category will be reweighted.
## Achieving Objectives in Elation
Follow the instructions below for the measures that Elation supports:
1. [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
2. [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
3. [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange)
4. [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
5. [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
6. [Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)
## Additional Resources
* [QPP Promoting Interoperability Performance Category Overview](https://qpp.cms.gov/reporting-requirements/ways-to-report/traditional-mips/promoting-interoperability?py=2026)
* [2026 Promoting Interoperability Performance Category Quick Start Guide: Traditional MIPS](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3599/2026-Promoting-Interoperability-Quick-Start-Guide.pdf)
\*This article is provided for instructional purposes only. Elation Health does not support or guarantee anything other than relay useful information from various organizations. Elation Health also does not provide support for third-party technologies. We recommend consulting[CMS guidelines](https://qpp.cms.gov/resources/resource-library)for the most up to date information.
Copyright U.S Centers for Medicare & Medicaid Services. All rights reserved.
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Promoting Interoperability (MIPS) - e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
* [Promoting Interoperability (MIPS) - Health Information Exchange (HIE) - Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
* [Promoting Interoperability (MIPS) - Public Health and Clinical Data Exchange](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
* [Promoting Interoperability (MIPS) - Security Risk Analysis](/articles/Promoting-Interoperability-Security-Risk-Analysis)
* [Promoting Interoperability (MIPS) - SAFER Guides Assessment](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment)
* [Promoting Interoperability (MIPS) - Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)[](/articles/Quality-Category-MIPS-2024)
# MIPS (2026) - Quality Category
Source: https://help.elationhealth.com/articles/MIPS-2026-Quality-Category
This article describes the Quality Performance Category for MIPS 2026.
## Quality Category Overview
The Quality category in MIPS provides a variety of reporting flexibilities. There are reporting options and collection types to consider. The Quality category is intended to measure Quality performance based on certain measures. Most providers are most familiar with Traditional MIPS and APP Reporting (reporting with an ACO).
MIPS Quality reporting generally covers a 12 month performance period (full calendar year January 1-December 31, 2026)
As a reminder and reflected in all CMS documentation; the first step for all MIPS eligible clinicians is to understand their reporting requirements. Understanding what a provider is required to report, planning on that reporting for the calendar year, and establishing improvement and documentation practices that align with requirements is the responsibility of each provider or practice.
## Reporting Options
### Traditional MIPS
[Traditional MIPS](https://qpp.cms.gov/reporting-requirements/ways-to-report/traditional-mips/quality?py=2026), established in the first year of QPP, is the original reporting option for MIPS. You select the quality measures and improvement activities that you'll collect and report from all of the quality measures and improvement activities finalized for MIPS. You’ll also report the complete Promoting Interoperability measure set, if you are required to report the MIPS PI category and do not have an existing exclusion. The QPP collects and calculates data for the cost performance category for you.
General reporting requirements are as follows:
* You’ll need to submit collected data for at least **6 quality measures** (including one outcome measure or high priority measure in the absence of an applicable outcome measure), or a complete specialty measure set.
* For the 2026 performance period you’ll need to report performance data for at least 75% of the denominator eligible cases for each quality measure (data completeness).
* You can submit measures from different collection types to fulfill the requirement to report data for at least 6 quality measures.
You may supplement Claims Based measure collection.
You can review the [QPP list of quality measures here](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3570/2026-MIPS-Quality-Measures-List.xlsx) and identify which measures and collection type you plan to report on. To better assist in preparing you for this process, the QPP has a [Quick Start Quality Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3596/2026-Quality-Quick-Start-Guide.pdf). See the list of electronic Clinical Quality Measures and Collection Types further below in this Help Center Article.
### MIPS Value Pathways
[MIPS Value Pathways (MVPs)](https://qpp.cms.gov/mips/mips-value-pathways) are the newest reporting option that offer clinicians a subset of measures and activities relevant to a specialty or medical condition. MVPs offer more meaningful groupings of measures and activities, to provide a more connected assessment of the quality of care. You’ll select, collect, and report on a reduced number of quality measures and improvement activities (as compared to traditional MIPS). You’ll also report the complete Promoting Interoperability measure set (the same as reported in traditional MIPS), if you are required to report MIPS and the MIPS PI category and do not have an existing exclusion (only report PI if you are not a small practice). The MVP measure set includes a Value in Primary Care measure bundle that is the most relevant and currently the only MVP bundle supported by Elation. To report on an MVP measure set you must select 4 quality measures from the measure bundle offered. The **bolded measures** and collection types are the measures that are available for the Value in Primary Care MVP:
1. **Diabetes: Glycemic Status Assessment Greater Than 9%**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, MIPS CQMs Specifications
2. **Advance Care Plan**
* Collection Type: **Medicare Part B Claims Measure Specifications**, MIPS CQMs Specifications
3. **Preventive Care and Screening: Screening for Depression and Follow-Up Plan**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, eCQM Specifications, MIPS CQMs Specifications
4. **Controlling High Blood Pressure**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, MIPS CQMs Specifications
5. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
* Collection Type: eCQM Specifications
6. CAHPS for MIPS Clinician/Group Survey
* Collection Type: CAHPS Survey Vendor
7. Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
* Collection Type: eCQM Specifications, MIPS CQMs Specifications
8. HIV Screening
* Collection Type: eCQM Specifications
9. Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM)
* Collection Type: MIPS CQMs Specifications
10. Adult Immunization Status
* Collection Type: MIPS CQMs Specifications
11. Preventive Care and Wellness (composite)
* Collection Type: MIPS CQMs Specifications
12. Initiation, Review, And/Or Update To Suicide Safety Plan For Individuals With Suicidal Thoughts, Behavior, Or Suicide Risk
* Collection Type: MIPS CQMs Specifications
### APM Performance Pathways
The Alternative Payment Model (APM) Performance Pathway (APP) is a streamlined reporting option for clinicians who participate in a MIPS APM. The APP is designed to reduce reporting burden, create new scoring opportunities for participants in MIPS APMs, and encourage participation in APMs. You’ll report a predetermined measure set made up of quality measures in addition to the complete Promoting Interoperability measure set (the same as reported in traditional MIPS), if you are required to report the PI category and do not have an existing exclusion (example, you are not in a small practice). MIPS APM participants currently receive full credit in the improvement activities performance category.
*If you participate in an ACO/APM reach out to that APM administrator to understand how to report MIPS with the ACO or other APM. ACOs and other APMs get full credit for Improvement Activities and the only reporting requirement for MIPS APM participants is the Quality category which is reported as a whole (with the ACO/APM).*
## Collection Types
### Electronic Clinical Quality Measures (eCQMs)
eCQMs are standardized measures that a Certified EHR Technology (CEHRT) meets to specification and is certified to. There are currently 47 eCQMs available to report to MIPS in 2026. Elation is certified to 12 eCQMs, and 7 eCQMs are eligible for Traditional MIPS reporting. eCQMs are measured as part of your regular workflows and can be found regularly in the Quality Dashboard of Elation. During reporting, eCQMs are extracted as a QRDA file and submitted to the QPP.
QRDA files and eCQMs are used and submitted to other CMS programs and are applicable for other program participants as such, eCQMs no longer applicable in traditional MIPS are applicable for MVPs and APMs and remain in production and functionality in Elation.
These are the eCQMs that Elation supports in 2026 (9 bolded eCQMs that contribute to traditional MIPS and the total 12):
* **[\[CMS2v15\] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2026)](/articles/CMS2v15-Preventive-Care-and-Screening-Screening-for-Depression-and-Follow-Up-Plan)**
* **[\[CMS122v14\] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2026)](/articles/CMS122v14-Diabetes-Glycemic-Status-Assessment-Greater-Than-9)**
*
* **[\[CMS131v14\] Diabetes: Eye Exam (MIPS 2026)](/articles/CMS131v14-Diabetes-Eye-Exam)**
* **[\[CMS139v14\] Falls: Screening for Future Fall Risk (MIPS 2026)](/articles/CMS139v14-Falls-Screening-for-Future-Fall-Risk)**
* **[\[CMS149v14\] Dementia: Cognitive Assessment (MIPS 2026)](/articles/CMS149v14-Dementia-Cognitive-Assessment)**
* **[\[CMS155v14\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2026)](/articles/CMS155v14-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents)**
* **[\[CMS159v14\] Depression Remission at Twelve Months (MIPS 2026)](/articles/CMS159v14-Depression-Remission-at-Twelve-Months)**
* \*\*[\[CMS165v14\] Controlling High Blood Pressure (MIPS 2026)](/articles/CMS165v14-Controlling-High-Blood-Pressure)
* [\[CMS69v14\] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan (not available for Traditional MIPS)](/articles/CMS69v14-Preventive-Care-and-Screening-BMI-Screening-and-Follow-Up-Plan)
* [\[CMS125v14\] Breast Cancer Screening (not available for Traditional MIPS)](/articles/CMS125v14-Breast-Cancer-Screening)
* [\[CMS130v14\] Colorectal Cancer Screening (not available for Traditional MIPS)](/articles/CMS130v14-Colorectal-Cancer-Screening)
### MIPS Clinical Quality Measures (CQMs)
MIPS CQMs are often collected by third party intermediaries and submitted on behalf of MIPS eligible clinicians. You may choose to work with a Qualified Registry.
### Medicare Part B Claims Measures
This collection type is only available to those designated with the small practice special status (15 or fewer clinicians). Medicare Part B claims measures are always reported with the clinician’s individual (rendering) NPI even when reporting as a group, subgroup (MVPs only) virtual group (traditional MIPS), or APM Entity. For more information about reporting quality measures through Medicare Part B claims, [download this guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3593/2026-Part-B-Claims-Quality-Reporting-Quick-Start-Guide.pdf) from the QPP.
### What does Elation support for Quality measures and collection types?
Elation supports 12 eCQMs, 9 of which count in Traditional MIPS, and 3 are used in the MVP Value in Primary Care group. Administrative Claims Based measures may be selected to support additional measure selections for MIPS to report for Traditional MIPS and MVPs. Elation supports APM reporting with the selected eCQMs, and other measures supported depending on collection type.
* **Traditional MIPS**: You may report using 6 eCQMs or a combination of eCQMs and claims based measures, or reporting through a registry. To report through a registry, we recommend connecting with MDInteractive.
* **MVPs**: You may report on the Value in Primary Care MVP the 4 bolded measures above which include 3 eCQMs and 1 Claim Based Measure.
* **APP**: If you have signed up with an APM to participate this year, such as an ACO, or REACH, ensure your quality reporting is aligned with the measures the ACO administrator selected and only one quality submission is required, the quality submission reported with your APM.
Elation Health provides the tools to support certain reporting requirements. All reporting requirements are the sole responsibility of the reporting provider. The changing nature of CMS programs and MIPS as part of those programs, require continuous changes to the program. If you have concerns with the measures required to report to MIPS or CMS programs please direct that feedback to CMS and the QPP. Elation Health provides a certain set of eCQMs that require significant development work to meet requirements for PCPs. If you have additional needs beyond the eCQMs that are supported in Elation, such as, support with reporting to MIPS or CMS programs, that should be directed to those relevant agencies. The QPP provides a not insignificant amount of support for reporting.
**Contact CMS**
Phone:1-866-288-8292 (TRS: 711)
Monday - Friday 8 a.m - 8 p.m ET
Email: [QPP@cms.hhs.gov](mailto:QPP@cms.hhs.gov)
## Additional Resources
* [QPP 2026 Quality Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3596/2026-Quality-Quick-Start-Guide.pdf)
* [QPP 2026 MIPS Quality Measure List](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3570/2026-MIPS-Quality-Measures-List.xlsx)
* [MIPS Quality Performance Category Fact Sheet](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2402/MIPS%20Quality%20Performance%20Category%20Fact%20Sheet.pdf)
* [2026 Part B Claims Reporting Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3593/2026-Part-B-Claims-Quality-Reporting-Quick-Start-Guide.pdf)
* [Quality Performance Category: Learning about Collection Types](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3076/Quality-Learning-About-Collection-Types.pdf)
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Elation Support Clinical Quality Measures](/admin-compliance)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)[](/articles/Promoting-Interoperability-MIPS-2024)
# MIPS (2026) - Quick Start Guide
Source: https://help.elationhealth.com/articles/MIPS-2026-Quick-Start-Guide
This article is a quick reference guide for everything you need to know about the MIPS 2026 Reporting Period.
## Quick Start Guide Overview
MIPS participation may seem overwhelming. To break down MIPS participation and actions to take during 2026, here is the guide to follow along all the resources Elation Health offers for MIPS eligible clinicians. This information is intended as support for your practice to participate in MIPS using Elation. For questions specific to MIPS and regulatory requirements, contact the Quality Payment Program (QPP) directly.
A helpful guide from the QPP is the [2026 MIPS Quick Start Guide for Small Practices](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3594/2026-Small-Practices-Quick-Start-Guide.pdf).
* Important Note: This information has been tailored and is intended for informational purposes only.
To begin understanding the Quality Payment Program (QPP) and MIPS program the QPP offers the following introductory videos for familiarizing yourself with MIPS:
* [Introduction to MIPS](https://youtu.be/6Ovw-QELq7E)
* [How to Check Eligibility Status](https://www.youtube.com/watch?v=rHoH4hJaetI)
## MIPS Eligibility
Use the [QPP participation look up tool](https://qpp.cms.gov/participation-lookup) to determine if you need to report MIPS.
**MIPS Quality Category**
Ensure MIPS eCQMs are turned on as noted in [this Help Center Article](/articles/clinical-reminders-for-clinical-quality-measures) for turning on eCQMs and that you are tracking eCQMs as best possible. Follow workflows to close care gaps. Create a performance improvement plan to determine what needs to be tracked better over time.
Understand and determine your reporting type and collection type. Review the [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category) article to support this.
## MIPS Promoting Interoperability
Does your practice have greater than 15 providers in it? If not, do nothing, you do not need to report to this category.
If your practice has greater than 15 providers and plans to report the PI category, ensure you can participate by reviewing the [MIPS (2026) - Promoting Interoperability Category](/articles/MIPS-2026-Promoting-Interoperability-Category) article, checking all your integrations, and reviewing workflows for the associated measures.
## MIPS Improvement Activities
Look at the Improvement Activities list and determine which Improvement Activities are most relevant to your practice. Review the [MIPS (2026) - Improvement Activities Category](/articles/MIPS-2026-Improvement-Activities-Category) article to support this.
## Additional Resources
Review Help Center Articles about specific area listed in order of recommended reading:
1. Overview Articles
* [MIPS (2026) Eligibility - Frequently Asked Questions (FAQ)](/articles/MIPS-2026-Eligibility-FAQ)
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
* [MIPS (2026) - Promoting Interoperability Category](/articles/MIPS-2026-Promoting-Interoperability-Category)
* [MIPS (2026) - Improvement Activities Category](/articles/MIPS-2026-Improvement-Activities-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
2. Measure Specific Articles
* [\[CMS2v15\] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2026)](/articles/CMS2v15-Preventive-Care-and-Screening-Screening-for-Depression-and-Follow-Up-Plan)
* [\[CMS122v14\] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2026)](/articles/CMS122v14-Diabetes-Glycemic-Status-Assessment-Greater-Than-9)
* [\[CMS124v14\] Cervical Cancer Screening (MIPS 2026)](/articles/CMS124v14-Cervical-Cancer-Screening)
* [\[CMS131v14\] Diabetes: Eye Exam (MIPS 2026)](/articles/CMS131v14-Diabetes-Eye-Exam)
* [\[CMS139v14\] Falls: Screening for Future Fall Risk (MIPS 2026)](/articles/CMS139v14-Falls-Screening-for-Future-Fall-Risk)
* [\[CMS149v14\] Dementia: Cognitive Assessment (MIPS 2026)](/articles/CMS149v14-Dementia-Cognitive-Assessment)
* [\[CMS155v14\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2026)](/articles/CMS155v14-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents)
* [\[CMS159v14\] Depression Remission at Twelve Months (MIPS 2026)](/articles/CMS159v14-Depression-Remission-at-Twelve-Months)
* [\[CMS165v14\] Controlling High Blood Pressure (MIPS 2026)](/articles/CMS165v14-Controlling-High-Blood-Pressure)
* [Promoting Interoperability (MIPS 2026) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2026-TEFCA)
* [Promoting Interoperability (MIPS 2026) - Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange)
* [Promoting Interoperability (MIPS 2026) - Public Health and Clinical Data Exchange](/articles/Promoting-Interoperability-MIPS-2026-Public-Health-and-Clinical-Data-Exchange)
* [Promoting Interoperability (MIPS) - SAFER Guides Assessment](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment)
* [Promoting Interoperability (MIPS) - Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)
* [Promoting Interoperability (MIPS) - e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
3. Reference QPP Resources as needed:
* [QPP Resource Library](https://qpp.cms.gov/resources/resource-library)
* [2026 MIPS Quick Start Guide for Small Practices](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3594/2026-Small-Practices-Quick-Start-Guide.pdf)
* [QPP 2026 Quality Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3596/2026-Quality-Quick-Start-Guide.pdf)
* [QPP 2026 MIPS Quality Measure List](https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ec-ecqms\&global_measure_group=eCQMs\&globalyearfilter=2026)
* [QPP 2026 Promoting Interoperability Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3599/2026-Promoting-Interoperability-Quick-Start-Guide.pdf)
* [QPP 2026 Improvement Activities Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3600/2026-Improvement-Activities-Quick-Start-Guide.pdf)
* [MIPS Quality Performance Category Fact Sheet](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2293/MIPS%20Improvement%20Activities%20Performance%20Category%20Fact%20Sheet.pdf)
* [QPP 2026 Improvement Activities Inventory](http://qpp.cms.gov/reporting-requirements/measures-activities/explore?tab=improvementActivities\&py=2026)
* [2026 Part B Claims Reporting Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3564/2026-Part-B-Claims-Measure-Specifications-and-Supporting-Documents.zip)
* [QPP 2026 MIPS Eligibility & Participation Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2623/2024MIPSEligibandParticGuide.pdf)
# [MIPS CQM 47] Advance Care Plan
Source: https://help.elationhealth.com/articles/MIPS-Advance-Care-Plan
This articles provides information on how the Advance Care Plan Quality measure is calculated along with step-by-step instructions on how to meet the measure requirements using Elation.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
1. [Measure Details](https://elation.lightning.force.com/lightning/r/Knowledge__kav/ka01G000000TVOyQAO/view#details)
2. [Measure Parameters](https://elation.lightning.force.com/lightning/r/Knowledge__kav/ka01G000000TVOyQAO/view#parameters)
3. [Elation Workflows](https://elation.lightning.force.com/lightning/r/Knowledge__kav/ka01G000000TVOyQAO/view#workflows)
4. [Measure Information](https://elation.lightning.force.com/lightning/r/Knowledge__kav/ka01G000000TVOyQAO/view#info)
## 1. Measure Details
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record OR documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan.
This measure is to be submitted a minimum of **once per performance period** for patients seen during the performance period. There is no diagnosis associated with this measure. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.
**Important Notes**:
* This measure can only be reported through a [Registry](/articles/registry-reporting-alternative-for-cqms) or through claims. Elation recommends reporting through a registry for immediate feedback on performance.
* This measure is appropriate for use in all healthcare settings (e.g., inpatient, nursing home, ambulatory) except the emergency department. For each of these settings, there should be documentation in the medical record(s) that advance care planning was discussed or documented.
* Patient encounters for this measure conducted via telehealth (e.g., encounters coded with GQ, GT, 95, or POS 02 modifiers) are allowable.
## 2. Measure Parameters
**Numerator**: Patients who have an advance care plan or surrogate decision maker documented in the medical record OR documentation in the medical record that an advance care plan was discussed but patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan. You must use one of the following CPT Category II codes to document the numerator:
* Advance Care Planning discussed and documented; advance care plan or surrogate decision maker documented in the medical record (1123F)
* Advance Care Planning discussed and documented in the medical record; patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan (1124F)
* Advance Care Planning not documented, reason not otherwise specified (1123F with modifier 8P)
**Important Notes**:
* The CPT Category II codes used for this measure indicate Advance Care Planning was discussed and documented. The act of using the Category II codes on a claim indicates the provider confirmed that the Advance Care Plan was in the medical record (that is, at the point in time the code was assigned, the Advance Care Plan in the medical record was valid) or that advance care planning was discussed. The codes are required annually to ensure that the provider either confirms annually that the plan in the medical record is still appropriate or starts a new discussion.
* The provider does not need to review the Advance Care Plan annually with the patient to meet the numerator criteria; documentation of a previously developed advanced care plan that is still valid in the medical record meets numerator criteria.
* Services typically provided under CPT codes 99497 and 99498 satisfy the requirement of Advance Care Planning discussed and documented, minutes. If a patient received these types of services, submit CPT II 1123F or 1124F.
**Denominator**: All patients aged 65 years and older with the following patient encounter during the performance period (CPT or HCPCS) where Place of Service (POS) is not 23 (Emergency Room-Hospital)
* 90791, 90832, 90834, 90837, 90845, 90846, 90847, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99232, 99233, 99234, 99235, 99236, 99291, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0402, G0438, G0439
## 3. Elation Workflows
1. **During an encounter**: In a visit note dated during the performance period, record that one of the following actions where taken with the patient using one of the CPT II Codes:
* Advance Care Planning discussed and documented; advance care plan or surrogate decision maker documented in the medical record (1123F)
* Advance Care Planning discussed and documented in the medical record; patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan (1124F)
* Advance Care Planning not documented, reason not otherwise specified (1123F with modifier 8P).
2. **Using Document Tags**: If an Advance Care Plan was discussed and documented, add one of the following Document Tags to a report or visit note based on the corresponding action taken:
* Care Plan w/ Surrogate Documented (1123F)
* Care Plan w/o Surrogate Documented (1124F)
## 4. Measure Information
Learn more about how to meet this measure's requirements in the following CMS documentation:
* [Measure information from CMS (Registry reporting)](https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-Measures/2022_Measure_112_MIPSCQM.pdf)
* [Measure information from CMS (Claims reporting)](https://qpp.cms.gov/docs/QPP_quality_measure_specifications/Claims-Registry-Measures/2022_Measure_047_MedicarePartBClaims.pdf)
## Related Articles
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Elation Clinical Quality Measures](/admin-compliance)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
# MIPS Eligibility- Frequently Asked Questions (FAQ)
Source: https://help.elationhealth.com/articles/MIPS-Eligibility-FAQ
This article describes how you can verify whether or not you are required to report for the Merit-based Incentive Payment System (MIPS).
## How do I know if I have to report MIPS?
The first step for anyone with questions regarding MIPS is to check your eligibility, also known as, reporting requirements.
1. Step 1: Lookup Eligibility
* Use the [CMS’s Participation Lookup website](https://qpp.cms.gov/participation-lookup) and use a provider NPI to determine if the provider or practice has MIPS reporting requirements.
2. Step 2: Interpreting Eligibility
* Once practices find the **Associated Practice** that is using Elation, there are three possible outcomes, only one of which requires practices to participate in MIPS (see below).
![Three MIPS eligibility scenarios: 1) Both INDIVIDUAL and GROUP eligible (highlighted): required to participate, submit as either for higher score. 2) INDIVIDUAL ineligible, GROUP eligible: individual not required, group optional. 3) Both ineligible: not required, no payment adjustment.]()
**Eligibility Note** : if you or your practice are associated with and participating in an APM (ACO or other APM type) contact the APM administrator to determine best practices for MIPS participation and data submission. MIPS APM participation may vary from traditional MIPS participation. MIPS data and quality data are generally submitted via the APM and that is important to understand.
This is a logic determination visual shared by CMS:
![2025 MIPS Eligibility Decision Tree flowchart from CMS showing sequential yes/no questions: MIPS-eligible clinician type → enrolled in Medicare after 1/1/25 → meets low-volume threshold → Qualifying APM Participant → Partial QP. Outcomes include: not eligible, excluded from MIPS, may choose whether to participate, or required to participate and subject to MIPS Final Score payment adjustment. Sidebar lists eligible clinician types and 2025 low-volume threshold criteria (over $90,000 Part B charges, over 200 Medicare Part B patients, over 200 covered professional services).]()
All of this information is based on regulatory statue with this eligibility determination.
## Which Clinician Types are eligible for MIPS?
The following Clinician Types are eligible for MIPS:
* Physicians (MD, DO, DDS, DMD, DPM, OD)
* Osteopathic practitioners
* Chiropractors
* Physician assistants
* Nurse practitioners
* Clinical Nurse Specialists
* Certified nurse anesthetists
* Physical therapists
* Occupational therapists
* Clinical psychologists
* Qualified speech-language pathologists
* Qualified audiologists
* Registered dietitians or nutrition professionals
* Clinical social workers
* Certified nurse-midwives
* Clinical nurse specialists
## Which exceptions exempt me from MIPS reporting?
If any of the following apply to the provider, they are not required to participate in MIPS:
* Fewer than 200 Medicare fee-for-service patients
* Less than \$90,000 in Medicare charges
* Fewer than 200 Medicare fee schedule services
* Participate in an Advanced APM
* First-year Medicare provider
## Who can I speak to about my MIPS Eligibility?
For questions regarding eligibility specifically, please contact the QPP helpdesk for further support. The QPP helpdesk is the support center for all things related to MIPS and provides the best support.
QPP helpdesk
* Hours: Monday - Friday 8 a.m - 8 p.m Eastern Time
* Phone: 1-866-288-8292 (TRS: 711)
* Email: [QPP@cms.hhs.gov](mailto:QPP@cms.hhs.gov)
## What are the additional resources I can reference?
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [MIPS (2025) - Quick Start Guide](/articles/MIPS-2025-Quick-Start-Guide)
* [MIPS (2025) - Quality Category](/articles/MIPS-2025-Quality-Category)
* [MIPS (2025) - Promoting Interoperability Category](/articles/MIPS-2025-Promoting-Interoperability-Category)
* [MIPS (2025) - Improvement Activities Category](/articles/MIPS-2025-Improvement-Activities-Category)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
# Maine State- ImmPact- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Maine-State-Immpact-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Maine State Immunization Registry [ImmPact] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Maine State Immunization Information System (ImmPact).
## What is the ImmPact Immunization Registry Interface?
The ImmPact Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to ImmPact, the Maine State Immunization Information System. Practices can also query ImmPact for vaccination history or forecast.
## Why is the ImmPact Immunization Registry Interface valuable?
With the ImmPact Immunization Registry Interface, practices no longer need to separately log in to ImmPact to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to ImmPact. You can also pull vaccination history for specific patients from ImmPact to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & ImmPact
The Elation Team will assist you with initiating interface with ImmPact. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. Are you currently manually documenting vaccinations in ImmPact?
2. Do you participate in Vaccines for Children (VFC)? If so, what is your VFC PIN?
3. What is the name and email of the best contact at your practice?
4. Have you reviewed the [Maine Immunization Information System (IIS) rules](https://www.maine.gov/dhhs/mecdc/infectious-disease/immunization/documents/maine-iis-rules.pdf)? If not, please do so.
5. Have you reviewed the [Maine Security and Confidentiality Policy](https://www.maine.gov/dhhs/mecdc/infectious-disease/immunization/providers/immpact/Confidentiality-and-Security-Policy-2019-Feb-19.pdf)? If not, please do so.
## How to submit vaccination data to ImmPact using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to ImmPact. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ImmPact
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Billing Guide- Managing Carriers & Plans in Elation
Source: https://help.elationhealth.com/articles/Managing-Carriers-and-Plans
This article guides you through using your Elation Insurance Settings page to manage your practice's database of Insurance Carriers and Plans.
**Elation Billing customers:** Your practice's insurance carriers come from a canonical list maintained by Elation. You cannot rename or edit carriers in this list — contact Elation Support to request changes. You can delete carriers directly from this list. The workflows below for adding and editing carriers apply to **EHR-only** customers.
## Content
* [What is structured insurance information?](#description)
* [Why is structured insurance information important?](#value)
* [How to manage Carriers & Plans in Settings](#settings)
* [Setting edit privileges](#edit_privileges)
* [Adding a new insurance Carrier or Plan](#add_carrier_or_plan)
* [Editing an existing Carrier or Plan](#edit_carrier_or_plan)
* [Deleting an existing Carrier or Plan](#delete_carrier_or_plan)
* [Storing patient insurance details](#store_patient_insurance)
* [Frequently Asked Questions](#faq)
## What is structured insurance information?
Structured insurance information allows you to create your own database of Carriers (Payers) and corresponding Carrier Plans in Elation. You can then select Carriers and Plans from your database when adding primary and secondary insurance coverage information in the patient's demographics to use for insurance billing and claims management.
## Why is structured insurance information important?
By setting up and managing the insurance Carriers and Plans list for your practice, you are setting up your practice for success. Having accurate insurance information in each patient's chart is critical to your practice’s ability to store accurate patient records, submit claims and receive payment from Payers and run reports based on patient insurance.
## How to manage Carriers & Plans in Settings
You can view, search for and manage your practice’s list of insurance Carriers and Plans in the Insurance section of your Elation Settings page.
### Setting edit privileges
By default, only users in your practice who are set as ***Admin*** will have the ability to add, edit, and delete insurance Carriers or Plans for your practice. This is designated by the green **Admin Only** toggle on the Insurance Settings page. This Setting is intended to prevent duplicates.
### Adding a new insurance Carrier or Plan
**Elation Billing customers:** Your practice's insurance carriers come from a canonical list maintained by Elation. You cannot rename, edit, or delete carriers in this list — contact Elation Support to request changes. The workflows below for adding carriers apply to **EHR-only** customers.
1. Click on the **+ Add new insurance** button at the top right of the Insurance Settings page
2. Enter the **Insurance Carrier Name**(required)
3. Enter the address and phone (if available)
4. Select an **Insurance Type**, if applicable. Available options are:
* Capitated
* Commercial
* Managed Medicaid
* Medicaid
* Medicare
* Medicare Advantage
* Medicare Supplement
* Self Pay
* Workers Compensation/Third Party Liability
5. Store the Payer ID in the **Payer ID** field
6. Enter alternative search names for the Carrier if needed.
* Use commas to separate multiple names. The search is not case sensitive but is sensitive to differences in spaces and spelling.
7. Store the **Electronic Claims** status for the Payer if needed.
* Available options are:
* Set up for electronic claims
* When selected, an **E-claims** label will appear the Carrier Details table of the Insurance Settings page
* Not set up for electronic claims
* The **Electronic Claims** status section is generally used to designate whether you are approved to send claims electronically to the Carrier.
8. Click **+ Add a plan** to add a Carrier Plan to the Carrier.
9. Enter the Plan name
10. Click **Save** when done
![Insurance Settings page showing the Add New Insurance modal open for "Aetna Medicare Advantage" with carrier address, Insurance Type set to "Medicare Advantage," Payer ID 60054, alternate name "Aetna MA," electronic claims set to "Set up for electronic claims," and a red arrow pointing to the "+ Add New Insurance" button.]()
### Editing an existing insurance Carrier or Plan
1. Find the insurance Carrier or Plan you want to edit
2. Click the **pencil** icon to edit
3. Make changes as needed within the window that appears
4. Click **Save**
To prevent the duplication of insurance carriers, each Carrier must have a unique mailing address. Ex. One Cigna has the address P.O. Box 1122, New York, NY 10002. If you add a second Cigna with the same address you will receive an alert telling you it is a duplicate and you will be blocked from adding this second Cigna. If you add a Cigna with a different address or if you leave the address blank, you will be allowed to add this second Cigna.
### Deleting an existing insurance Carrier or Plan
Deleting an insurance Carrier and/or Plan from the Settings page will remove it from your practice’s list of insurances AND will also delete this insurance information from any patient charts with this insurance carrier/plan. Please use this feature with discretion.
**Elation Billing customers:** Your practice's insurance carriers come from a canonical list maintained by Elation. You cannot rename, edit, or delete carriers in this list — contact Elation Support to request changes. The workflows below for deleting carriers apply to **EHR-only** customers.
You can delete an entire insurance Carrier and its associated Plan(s), or you can delete individual plans within each Carrier.
* To delete an entire Carrier and all Plans associated to that Carrier
1. Click the **trashcan** icon next to the Carrier name from the Insurance table
2. Click the **Delete Insurance** button at the bottom of the Carrier Details
* To delete individual Plan(s) within a specific Carrier, click the **Edit** button next to the Carrier name, find the Plan you want to delete, and then click the **Delete** button next to the Plan name
![Insurance Settings page showing the delete workflow for Aetna carrier: trashcan icon highlighted on the carrier row, and the Insurance modal open showing Aetna PPO (9 patients) and Aetna HMO (2 patients) with Delete buttons highlighted, and the Delete Insurance button highlighted at the bottom.]()
## Storing patient insurance details
When entering insurance information into a patient’s chart, you will be prompted to select from your pre-populated list of the insurance Carriers and Plans. Reference the [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance) to learn more about storing patient insurance details.
## Frequently Asked Questions (FAQ)
### Who within my practice can add/edit/delete insurance carriers and plans?
By default, only practice **Admin** Level Users will have the ability to add, edit, and delete insurance Carriers and Plans for your practice. To change this default, an Admin User can click the **Admin Only** toggle on the Insurance Settings page to switch it to gray to turn off the **Admin Only** restriction. Once the **Admin Only** toggle is off, any user within the practice will be able to add, edit, and delete insurance Carriers and Plans.
### I'm on Elation Billing — why can't I edit a carrier name?
If your practice uses Elation Billing, your insurance carriers come from a canonical list that Elation maintains to ensure accurate claim routing and payer identification. Carrier names, addresses, Payer IDs, and Electronic Claims status are not editable by practice users. To request a correction or addition, contact Elation Support with the carrier details and the change you need.
### What happens if I import a patient chart that contains an insurance carrier/plan that does not currently exist within my practice?
If a patient chart is imported into your practice with an insurance Carrier that does not currently exist, then Elation will automatically create that insurance Carrier for your practice and add it to the list of insurance Carriers and Plans in your Insurance Settings page.
**Next Step**
**Review your list of Carriers and Plans and begin storing patient insurance details!**
## Related Articles
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Insurance Card Image Upload Guide](https://elation.lightning.force.com/articles/Knowledge/Insurance-Card-Image-Upload-Guide)
* [Patient Demographics Guide](https://elation.lightning.force.com/articles/Knowledge/Patient-Demographics-Guide)
* [Billing Guide- Creating a Super Bill and coding for your visit](https://elation.lightning.force.com/articles/Knowledge/billing)
* [Billing Guide- Setting up CPT Codes and Place of Service](https://elation.lightning.force.com/articles/Knowledge/billing-settings---service-locations--procedure-codes)
# Elation Patient Passport Guide - Managing Passport invitations
Source: https://help.elationhealth.com/articles/Managing-Passport-invitations
**For practice staff** · 5 min read
You'll need staff-level access to patient charts in Elation EHR. Use the scenario cards below to jump directly to the workflow that matches your situation.
## Overview
### Invitation Methods
For flexibility, there are several ways to invite patients to the patient portal. Options include:
* Sending a stand-alone invitation.
* Sending an invitation while sharing records or communications.
* Sending an invitation automatically after the patient books an appointment on the Booking Site.
* Sending invitations to multiple patients at a time.
It is important to know if the patient's email address is already linked to an active patient portal account as their invitation will differ:
* If the patient's email is not linked to an active patient portal account, your invitation will prompt the patient to register for a new account.
* If the patient's email address is linked to an active patient portal account (e.g., they have an account with another Elation doctor or for a family member), your invitation will prompt them to link the new account to their existing one.
Send a first-time invitation to a patient without an existing account
Link a new chart to a patient portal account that is already active
[Grant or change access for a parent, guardian, or caregiver](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access)
Send invitations to multiple patients at once
### Patient's Invite Experience
Patients need an invitation from your practice to register for a patient portal account. The invitation is sent to the patient's email. When the patient clicks the link, they enter their name, create a password, and agree to the Terms of Service. After registering, they complete a short verification step to confirm their relationship to the chart and set their notification preferences.
A phone number is not required to send an invitation. Patients can optionally add a phone number after registration from their **Account Settings**.
### The invitation email
When you send a patient portal invitation, the patient receives an email from Elation. Here is what they will see:\
\
**From**: ElationEMR Support
**Subject line:** Passport Account Registration
**Email body:** Hi \[Patient or proxy name] Elation South invites you to join Passport - a secure way to stay connected with your care team:
![Passport invitation email showing "Create Your Account" button, sent from ElationEMR Support, with bullet points listing portal features and a 60-day link expiration notice.]()
## General Workflow Instructions
### Inviting patients one by one to the patient portal for the first time
#### Sending a stand-alone invitation
In the patient's chart, click on the **Passport** icon (the globe) at the corner of the patient's profile picture.
Select who you are granting access to:
* **Patient access** — Enter the patient's email address, or click **Use patient email on file...** if one is already stored in their demographics.
* **Family and friends access** — Click **+ Add access**, then enter the person's **First name**, **Last name**, and **Email**. See the [Granting Family and Friends Access guide](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access) for additional details.
Review **Sharing Options** to adjust how much of the Clinical Profile the person can see. By default, it uses the settings configured under **Patient Sharing Defaults**.
Click **Save & send invitation**.
**Sharing Options** only control visibility of the patient's Clinical Profile. They do not grant access to uploaded chart documents, lab reports, or imaging results — those are only shared with the patient if manually attached to a Patient Letter.
![Passport Access dialog open from the globe icon on a patient chart, showing Patient access with "Use patient email on file" link and a Family and friends access section with an Add access button.]()
![Passport Access modal showing patient email entered and "Entire Clinical Profile, Expanded Summary, excluding Confidential" selected as the sharing option, with "Save and send invitation" button visible.]()
#### Inviting patients through a Patient Letter
When you send a Patient Letter to a patient who doesn't have a patient portal account yet, you'll be prompted to invite them to register. This will allow them to access the letter and other information you've sent.
### Managing invitations
#### Checking the status of invitations
Here are the possible statuses for a patient portal invitation:
* Green = Registered/active
* Yellow = Invited but not registered
* Gray = Not invited
![Three patient chart headers showing Passport status icons: gray globe labeled "Passport Inactive," yellow globe labeled "Passport Invitation Sent," and green globe labeled "Passport Active."]()
#### Re-sending invitations
In the patient's chart, click on the Passport icon (the globe) at the corner of the patient's profile picture.
Click **Resend** next to the patient's name.
Click **Save**.
![Passport Access dialog showing "Invitation sent" status for Test Patient, with Resend and Revoke invitation buttons visible under Patient access.]()
#### Revoking invitations
To cancel or revoke a patient portal invitation:
In the patient's chart, click on the Passport icon (the globe) at the corner of the patient's profile picture.
Click **Revoke invitation** next to the patient's name.
Click **Save**.
![Passport Access dialog showing "Revoke invitation" confirmation popup warning that removing the invitation is permanent and the patient must be re-invited to regain access.]()
### Disabling a patient portal account
In the patient's chart, click on the Passport icon (the globe) at the corner of the patient's profile picture.
Click **Disable access** next to the patient's name.
Click **Save**.
![Passport Access modal showing "Disable access" clicked for Test Patient (Self), with a confirmation dialog asking "Are you sure you want to disable this access?" and Confirm/Cancel buttons.]()
The patient can no longer access their patient portal account until you invite them again.
Currently, Elation does not support disabling Patient Passport accounts in bulk. Each account must be disabled individually using the steps above. If you're closing your practice or transitioning to a different EHR, see the [Offboarding Guide – Data Export & Patient Communication Checklist](/articles/offboarding-data-export-patient-communication) for guidance on communicating with patients before their accounts are disabled.
### Re-enabling a patient portal account
To re-enable an account, simply send the patient a new invitation, and they can register again.
### Switching a patient's access to family and friends access
If a patient's account was originally set up as individual patient access and needs to be changed to family and friends access — for example, a parent who should be managing a child's chart — update the access type from the Passport Access window by clicking **Move to family & friend access**. See the [Granting Family and Friends Access guide](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access-staff) for additional details about family and friend access.
![Passport Access dialog showing an active patient account with the "Move to family and friends access" button highlighted in yellow]()
### Switching a family or friend’s access to patient access
If an account was originally set up as family and friends access and needs to be changed to individual patient access — for example, a patient who was initially invited through a caregiver’s account but now needs their own direct access — update the access type from the Passport Access window by clicking **Move to patient access**.
## Advanced Invitation Workflows
### Inviting patients in bulk
[Click here for instructions on how to invite patients in bulk](/articles/introduction-to-bulk-letters).
### Inviting patients through booking an appointment through the Booking Site
If you use the Booking Site and enable the **Automatically send patients an email invitation to join Elation Patient Passport after they book online** setting, any patient who books an appointment and doesn't have a patient portal account will automatically receive an invitation.
![Calendar & Booking settings, Booking site tab, with the "Automatically send patients an email invitation to join Elation Patient Passport after they book online" toggle highlighted and enabled.]()
If many of your patients plan to use one patient portal account to access multiple charts—such as parents managing children's records or caregivers managing relatives' charts—we recommend leaving this setting off so that your staff can confirm the use case for the account with the patients before sending an invitation.
### Inviting patients to link their patient passport accounts
If the patient's email is already linked to a patient portal account (e.g., they have an account with another Elation doctor or for a family member), your invitation will prompt them to link the new account to their existing one.
Even if the patient now sees you as their current provider, they may still see records from their previous practice when logging in to their patient portal account. Ask the patient to switch account views from the portal as needed. [Click here for patient-facing instructions about switching between charts](/articles/what-patient-passport-messaging-looks-like-to-a-patient#switching-between-linked-accounts).
Consider mentioning this behavior during onboarding for patients who previously used the portal with another practice. This helps set expectations and reduces confusion when they first log in.
## Invitation Scenarios
Use this table to identify the correct workflow for common situations you may encounter when inviting patients.
| **Scenario** | **Staff Actions** | **Patient Actions** | **Additional Considerations** |
| ------------------------------------------------------------------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| The **patient's** email is not tied to any active Patient Passport account. | Collect the patient's email address and store it in their chart. Send a stand-alone invitation. | Find the invitation email from elationpassport.com, click **Create Your Account**, create a password, confirm their date of birth, and agree to the Terms of Service. | If the patient's email is shared with others, advise them to use a private email address to protect their health information. |
| The **patient's** email is already linked to an active Patient Passport account and they want to reuse it. | Collect the patient's email address (must be the same one linked to their existing account) and store it in their chart. Send a stand-alone invitation. | Find the invitation email, click **Login**, sign in to their existing account, and verify the date of birth to accept access to the new chart. | If the patient's email is used for a family member's account and they do not want to link their personal account to it, they should either update the family member's account to a different email or provide you with a different email address. |
| A **legal representative's** (family's or friend's) email is not tied to any active Patient Passport account. | Collect the legal representative's email address and store it in the patient's chart. Send a stand-alone invitation. See the [Granting Family and Friends Access guide](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access) for additional details. | See the [Family & Friend Access Guide](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access-staff) from the patient's perspective. | |
| A **legal representative's** (family's or friend's) email is already linked to an active Patient Passport account. | Collect the legal representative's email address (must be the same one linked to their existing account) and store it in the patient's chart. Send a stand-alone invitation. See the [Granting Family and Friends Access guide](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access) for additional details. | See the [Family & Friend Access Guide](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access-staff) from the patient's perspective. | |
### Does Elation prevent a minor from registering as the patient?
Elation does not enforce an age-based restriction on Patient Passport enrollment. If an invitation is sent to a minor's own email address and they select that they are the patient during registration, the system will not block the account from being created. Enforcing your own policy for minor access — in accordance with applicable state law — is up to your practice. Consider using [Family and Friends Access](/articles/patient-passport-family-and-friends-access) for younger patients, then switching to direct patient access once appropriate.
## Related Articles
* [Elation Patient Passport Introduction](/articles/elation-patient-passport-an-introduction)
* [Elation Patient Passport Guide - Setting up Patient Passport](/articles/Setting-up-Patient-Passport)
* [Elation Patient Passport Guide - Communicating with patients & sharing records](/articles/Passport--Communicating-with-patients)
* [Elation Patient Passport Guide - Helping patients troubleshoot Passport issues](/articles/troubleshooting-passport-with-patients)
* [Elation Patient Passport - Patient's Point of View](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
# Coding Guide- Managing deprecated, non-billable ICD-10 codes
Source: https://help.elationhealth.com/articles/Managing-deprecated-ICD10-codes
This article will discuss best practices for managing deprecated ICD-10 codes in Elation.
## What are deprecated ICD-10 codes?
Deprecated ICD-10 codes are ICD-10 codes that are no longer billable according to the Centers for Medicare & Medicaid Services (CMS) guidelines. ICD-10 codes are updated by CMS every year and include ICD-10 code deletions, as well as additions and revisions.
In Elation, deprecated ICD-10 codes are indicated by an orange dot in the Problem List of the patient’s Clinical Profile and are labeled as **non-billable codes**. The total number of deprecated ICD-10 codes is listed in a banner at the top of the Problem List.
![Problem List section showing a red-outlined banner reading "2 Problems contain non-billable ICD code(s)" with a Fix button, and orange dots next to Acidosis and Cough indicating deprecated codes.]()
## Why is it important to recognize deprecated codes?
It is important to recognize which codes have been deprecated by CMS because submitting a claim with any deprecated codes will lead to claim rejections. Using Elation’s deprecated ICD-10 codes feature to identify and update ICD-10 codes will help ensure that only valid ICD-10 codes are referenced in your encounter and billing documentation.
If you do not submit any ICD-10 codes for billing, you can ask Elation to turn on a feature to hide the deprecated ICD-10 code indicators from your Problem List. Contact the Support Team using the **I need help** -> **Contact Support Button** button at the top of your Elation account if you want Elation to turn this feature on.
## How to update deprecated ICD-10 codes
There are two ways to update deprecated ICD-10 codes in a patient’s chart:
1. Fix all deprecated codes in the Problem List using the **Fix** button
2. Look for a banner at the top of the Problem List that tells you, if any exist, how many non-billable (deprecated) ICD-10 codes are in the Problem List.
3. Click **Fix** to start updating deprecated ICD-10 codes.
4. Find a replacement ICD-10 code in the diagnosis search & select it from the ICD-10 database.
5. Click the **x** to the right of the deprecated code to delete to disassociate the deprecated code from the problem.
6. Click **Save** to save your changes.
7. Repeat steps 2 to 5 until the banner is gone.
![Patient chart Problem List showing a banner "2 Problems contain non-billable ICD code(s)" with the Fix button highlighted by a red arrow, prompting the user to click Fix to begin updating deprecated codes.]()
1. Edit individual problems
* To edit a specific Problem with a deprecated code:
1. Click **Actions** >> **Edit** next to the problem.
2. Find a replacement ICD-10 code in the diagnosis search & select it from the ICD-10 database.
3. Click the **x** to the right of the deprecated code to delete to disassociate the deprecated code from the problem.
4. Click **Save** to save your changes.
![Edit Patient Problem dialog for Cough showing: step 1 select replacement code R05.9, step 2 delete deprecated R05 code marked "Non-billable code", step 3 click Save.]()
## How can I locate all patient charts with deprecated ICD-10 codes?
Search for patient charts with deprecated ICD-10 codes using the
[Patient List Report](/articles/find-patients-with-elations-patient-list)
so that you can proactively update the deprecated codes to active, billable codes.
Follow the steps below to locate patient charts with deprecated ICD-10 codes:
1. Click the **Reports** button in the blue navigation bar.
2. Click **Patient List**.
3. Enter one of the deleted ICD-10 codes in the Active Problems in Clinical Profile box to filter for only patients who have that code in their Problem List. Once you are ready to generate your report, click **Generate List**
4. Once you are ready to generate your report, click **Generate List**
*
If you would like to apply additional filtering, reference our [Patient List Report Guide](/articles/find-patients-with-elations-patient-list) for additional guidance.
5. The list of patients with the corresponding deprecated ICD-10 code will appear on the right of the screen. Click on each patient's name to open their chart and find the ICD-10 code you searched for in their Problem List.
6. Click **Actions** >> **Edit** next to the problem.
7. Find a replacement ICD-10 code in the diagnosis search & select it from the ICD-10 database.
8. Click the **x** to the right of the deprecated code to delete to disassociate the deprecated code from the problem.
9. Click **Save** to save your changes.
10. Repeat steps 5 to 9 for each affected patient.
11. Repeat steps 1 to 10 for each deprecated ICD-10 code.
## Frequently Asked Questions
### What happens if I send a claim with a deprecated code?
Your claim will be rejected if you send a claim with a deprecated code.
### What will happen if I try to export a deprecated ICD-10 code to different areas of the visit note?
You can export deprecated ICD-10 codes to the Assessment section of the visit note but you will not be able to export deprecated ICD-10 codes to the billing section of the visit note. Please
[update the deprecated ICD-10 code](#updated_deprecated_ICD10)
to an active, billable ICD-10 code before exporting ICD-10 codes to the billing section of the visit note.
### Can I add a deprecated ICD-10 code to the billing section of a visit note?
No, deprecated ICD-10 codes cannot be added to the billing section of a visit note once they are deemed non-billable as they are no longer valid for use. The codes will be grayed-out with a yellow banner detailing that they are non-billable codes.
![Billing Information coding panel showing Acidosis (E87.2) and Cough (R05) highlighted in red as "Non-billable code," grayed out and unavailable for selection.]()
## Related Articles
* [Problem List Guide](/articles/managing-your-problem-list)
* [Billing Guide- Creating a Super Bill & coding for your visit](/articles/billing)
* [Billing Guide- Frequently Asked Questions](/articles/Billing-Guide-Frequently-Asked-Questions)
# Prescriptions Guide - Managing electronic prior authorizations
Source: https://help.elationhealth.com/articles/Managing-electronic-prior-authorizations
## Overview
### What is electronic prior authorization (ePA) for prescriptions?
The electronic prior authorization (ePA) feature lets prescribers and their Prescription Delegates initiate prior authorization requests with the patient’s Pharmacy Benefits Manager (PBM) right from the [Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds), then manage and track these requests in the **ePA Worklist**.
### What are the benefits of electronic prior authorization for prescriptions?
Electronic prior authorization (ePA) significantly reduces the traditional dependence on pharmacy-initiated prior authorization processes and third-party ePA portals like CoverMyMeds.
ePA lets you:
* Initiate a prior authorization request before sending the ePrescription to the pharmacy.
* Avoid delays caused by waiting for pharmacy-initiated requests.
* Track and complete prior authorization tasks via a new **ePA Worklist** report.
### Which patients qualify for electronic prior authorizations for prescriptions?
ePAs are supported for patients with active prescription benefits coverage with a PBM that supports ePA through Surescripts, Elation’s ePrescribing partner.
## Workflow Instructions
### Initiating an electronic prior authorization request
Electronic prior authorization (ePA) requests are initiated directly from Elation’s Prescription Form.
A patient’s prescription coverage status is determined by their Pharmacy Benefits Manager (PBM), and the coverage information displayed reflects what the PBM provides. If you believe the patient has active coverage but it’s not showing, review their **Legal First Name**, **Legal Last Name**, **Date of birth**, **Sex at birth**, full **Address**, and **Primary Phone Number** to ensure the details in Elation match what the PBM uses to identify the patient.
If the patient’s PBM doesn’t support electronic prior authorizations, hovering over the Electronic Prior Authorization field will show the message: *“Electronic prior authorization is not supported by the patient’s insurance provider.”*
![Prescription Form for Adderall XR 10mg showing the "Initiate ePA" option highlighted in the Electronic Prior Authorization dropdown field at the bottom of the form, with coverage panel on the right showing Non-Formulary status and PA required.]()
| **1** | Open a [Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Check the right-hand side of the Prescription Form to verify if the patient has active [prescription coverage](/articles/Prescription-Form-Guide-patient-prescription-benefits), which is required to submit an ePA request. If the patient is covered by multiple PBMs, select which coverage you want to use for the ePA. If you need to send ePA requests to more than one PBM, then you will need to create separate prescription drafts for each ePA request. |
| **3** | Enter the following details for the ePA: **Medication name** • **Sig** • **Qty** • **Pharmacy** |
| **4** | Specify if an electronic prior authorization should be initiated in the **Electronic Prior Authorization** field. The options are: **Do not initiate ePA** • **Initiate ePA / Initiate ePA for selected coverage** • **Initiate urgent ePA / Initiate urgent ePA for selected coverage** |
| **5** | Click one of the following to initiate the ePA request: To wait for ePA approval before sending the prescription, click **Save as Draft & Close**. • To send the prescription to the pharmacy without waiting for ePA approval, click **Prescribe**. |
After the ePA is initiated, the **Electronic Prior Authorization** field becomes locked and displays **ePA initiated**. This status is also recorded in the **Chronological Record**, but it will not update as the ePA request progresses.
If an ePrescription has already been sent, create a new prescription draft for the same medication to initiate the ePA request, and then delete the draft once the request has been submitted.
### Managing electronic prior authorization requests
#### Viewing the ePA Worklist Report
Third-party cookies must be enabled on your web browser to view the **ePA Worklist** . [Click here for step-by-step instructions](/articles/Managing-third-party-cookies) .
To view all ePA requests, go to **Reports** -> **ePA Worklist**. The report will automatically time out after 15 minutes of inactivity. If this happens, click the **Refresh** in your browser to load the report again.
![Reports menu open in Elation navigation bar, with an arrow pointing to the ePA Worklist option.]()
##### Viewing the worklist
The **Worklist** section shows all requests that need your attention. You can view and sort requests by the following criteria:
* * [Task required](#tasks)
* Patient’s name
* Patient’s date of birth
* PA due date
* PA created dates
* Medication description details
In addition, you can
* Use the **Filter** to narrow results by any of the worklist criteria.
* Click **Clear All** to remove any filters.
* Sort any column by clicking the **sort** icon.
* Refresh the worklist to see the updates using the **refresh** icon.
##### Viewing task history
The **Task History** section shows all in progress requests as well as completed or closed requests that you’ve acknowledged.
* View requests based on any of the following criteria:
* Status
* Provider
* Patient’s name
* Patient’s date of birth
* PA created date
* Medication description details
* Sort any column by clicking the sort icon.
* Refresh the worklist to see the updates using the **refresh** icon.
* Use the **Filter** to narrow results by any of the worklist criteria.
* Click **Clear All** to remove any filters.
#### Managing prior authorization tasks
| **Task Status** | **Reason** | **Next Steps** |
| ---------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Complete Prior Auth Criteria | The PBM requires additional information or supporting documentation before processing the prior authorization request. | Fill out the remainder of the prior authorization. [Click here for instructions](#complete_ePA). |
| Prior Auth Denied | The PBM denied the prior authorization or appeal. | To acknowledge and dismiss a denied request, open the task & click **Acknowledge Denied PA**. • To acknowledge and dismiss a denied appeal, open the task & click **Acknowledge Denied Appeal**. • To submit an appeal for a PBM that supports electronic appeals, click **Appeal**. Otherwise, reach out to the PBM directly to appeal a decision. [Click here for step by step instructions on how to submit an electronic appeal](#appeal_denial). |
| Prior Auth Partially Denied | The PBM denied a portion of the prescribed quantity due to quantity or duration limits for the medication. | To acknowledge and dismiss a partially denied request, open the task & click **Acknowledge Partially Denied PA**. • To submit an appeal for a PBM that supports electronic appeals, click **Appeal**. Otherwise, reach out to the PBM directly to appeal a decision. [Click here for step by step instructions on how to submit an electronic appeal](#appeal_denial). |
| Prior Auth Approved | The PBM approved the prior authorization or appeal. | To accept and download the response attachment (if any), click **Accept and Download**. • To acknowledge and dismiss the approved request, click **Acknowledge Approved PA**. |
| Prior Auth Cancelled | The PBM accepted your request to cancel the PA. | To acknowledge and dismiss the approved cancellation, click **Acknowledge Approved Cancel**. |
| Prior Auth Closed | The PBM closed the PA request. A PA request may be closed if • A PA may also be temporarily closed and then reopened if the PA request needs to be routed to a different vendor. | To acknowledge and dismiss the closed request, click **Acknowledge Closed PA**. |
#### Completing prior authorization criteria
![Prior authorization worklist task for Trebbiano, Glenora showing Neupogen PA Form – Subsequent with a 06/17/2025 reply deadline, displaying patient and medication details, with the START button highlighted.]()
After an ePA request is initiated, seeing **Complete Prior Auth Criteria** in the worklist means you need to take further action or provide more information for the request to move forward.
**1**
Click on the ePA request that says **Complete Prior Auth Criteria** .
**2**
Click **Start** .
**3**
The PBM may not approve your request if you do not answer all related questions.
Fill in any questions that appear for the request.
1. Click **Next** to proceed to the next question.
2. Click **Back** to return to a previous question.
3. Click **Skip to Submit** to go straight to the summary screen.
The PBM may not approve your request if you do not answer all related questions.
4. Click **Options** -> **Start Questionnaire Over** to clear your progress and return to the first question.
5. Click **Options** -> **Go to Worklist** to return to the worklist without submitting your answers.
6. Click **Options** -> **Go to Task History** to go to the **Task History** section without submitting your answers.
7. Click **Options** -> **Cancel Prior Authorization** to cancel your request.
**4**
Review the summary page at the end of the questionnaire to confirm all your answers are accurate.
**5**
Click **Upload File** under **Attachments** to include any supporting documentation as needed.
* [Click here for instructions on how to attach patient records to a prior authorization request](#attach_records).
**6**
Additional comments and/or attachments may result in a manual request review which may result in slower response times.
Add additional information in the **Additional comments** box as needed. Up to 2,000 characters are supported.
**7**
Click **Submit** to submit your request.
**8**
Use the **Task History** section to monitor the request's progress as needed. Once a decision is made, it will appear in the worklist.
#### Canceling an ePA request
| **1** | Open the task in the worklist. Only tasks with the **Complete Prior Auth Criteria** status can be canceled. |
| ----- | ----------------------------------------------------------------------------------------------------------- |
| **2** | Click **Options** -> **Cancel Prior Authorization** . |
This marks the task as canceled and moves it to the **Task History** section.
#### Appealing a denied request
Not all PBMs support electronic appeals. If the instructions below aren’t available for a denied request, it means the PBM doesn’t support electronic appeals, and you’ll need to contact them directly to appeal the decision.
To appeal a denied request:
| **1** | Open the denial in the worklist. |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Appeal** . |
| **3** | Click **Upload File** under **Attachments** to include any supporting documentation as needed. |
| **4** | Add additional information in the **Comments** box as needed. Up to 2,000 characters are supported. |
| **5** | Click **Appeal** . |
| **6** | Use the **Task History** section to monitor the request's progress as needed. Once a decision is made, it will appear in the worklist. |
#### Attaching patient chart records to prior authorization requests/appeals
To attach patient chart records to a prior authorization requests/appeals:
| **1** | Use Chrome or Firefox to print the record. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Use the browser’s [Print to PDF](https://pdf.wondershare.com/pdf-knowledge/print-to-pdf-firefox-chrome-ie-safari.html) feature to save the document as PDF on your computer. |
| **3** | Upload the PDFs to the request as needed. |
## Frequently Asked Questions
### When I click ePrescribe or Save as Draft & Close I receive a **Prescription failed** message. How should I proceed?
If you see a **Prescription failed** message, discard the prescription draft, refresh the patient’s chart and then create the prescription again. If you continue to see this message, notify Elation using **I need help** -> **Contact Elation Support** and we will investigate this issue.
### When I open the ePA Worklist, I receive a 'Something went wrong. Internal Server Error' message. How should I proceed?
The “Something went wrong. Internal Server Error” error message appears when the **Prior Auth Worklist** can’t load because third-party cookies are disabled by your web browser. Third-party cookies must be enabled on your browser to view the **Prior Auth Worklist**. [Click here for step-by-step instructions](/articles/Managing-third-party-cookies).
### Can electronic prior authorization initiation be restricted to a specific group of users, or made available to all users?
No, not currently. Only Prescribers and their Prescription Delegates can initiate an electronic prior authorization.
### I forgot to initiate the electronic prior authorization before submitting the prescription to the pharmacy. What steps should I take now?
If an ePrescription has already been sent:
| **1** | Create a new prescription draft for the same medication. |
| ----- | --------------------------------------------------------------------------------------------------------------- |
| **2** | Specify how electronic prior authorization should be initiated in the **Electronic Prior Authorization** field. |
| **3** | Click **Save as Draft & Close** to initiate the request. |
| **4** | **Discard** the prescription draft. |
### Is it possible to attach documents from the patient chart—like visit notes and lab results—to the electronic prior authorization without first converting them to PDF?
No. Currently, only PDFs saved to your computer can be uploaded to a prior authorization request.
### Can Elation automatically request a prior authorization if the formulary requires one?
No, not currently. You must manually initiate an electronic prior authorization.
### What happens if I accidentally delete a prescription connected to an electronic prior authorization?
Deleting the associated prescription does not affect the electronic prior authorization request.
### Are ePA requests canceled automatically when the related prescription draft or ePrescribed prescription is deleted from the patient chart?
No, ePAs must be canceled manually or will automatically close if the PBM does not receive a response.
### What happens if the pharmacy also starts a prior authorization for the same medication I already requested?
You should continue managing the prior authorization you initiated in Elation and, if needed, communicate with the pharmacy about your in progress prior authorization.
### Does electronic prior authorization support referrals or hospital-based testing/procedures?
No, electronic prior authorization in Elation is only supported for prescriptions. For referrals or hospital-based testing/procedures (for example, imaging), prior authorizations must still be submitted directly to the insurance company using their usual process (payer portal, fax, etc.).
### If a prior authorization request is initiated in CoverMyMeds, does it appear in Elation's ePA Worklist?
No, a prior authorization request initiated in CoverMyMeds does not flow into Elation. To track a request in the **ePA Worklist**, you must initiate the electronic prior authorization from the [Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) within Elation.
## Related Articles
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [User Accounts Guide - Managing third party cookies while using Elation](/articles/Managing-third-party-cookies)
# Patient Forms Guide - Managing forms responses
Source: https://help.elationhealth.com/articles/Managing-forms-responses
## Overview
### What happens after forms are completed?
Completed forms will automatically appear in the Outstanding Items section of the patient’s chart. Each form will show up as an individual ‘Report’ that can be reviewed and signed off, along with the date and time it was completed.
By default, only Provider Level Users can sign off on forms responses. For each Patient Form, Admin Level Users can enable the **Allow staff sign-off for this form** setting to let Staff Level Users sign off on that form's responses. This is ideal for forms that generally do not require provider oversight, such as forms for demographics or insurance collection. [Click here for information about this setting](/articles/Patient-Forms-Guide#specifying-who-can-sign-off-on-completed-forms).
## Workflow Instructions
### Reviewing and exporting responses to the chart
**1**
Open the patient’s chart. Each completed form will appear as its own report under **Outstanding Items**.
* By default, completed Patient Forms are filed under the **Patient Forms** [report category](/articles/report-types).
1. To file the forms under a different report category, click **Actions** -> **Edit Details** for each form.
2. To view all completed Patient Forms at once, click on **Reports** -> **Patient Forms** at the top of the chart.
**2**
Click on the form’s name to open and review the patient’s responses.
* Both providers and staff will have visibility of all the question texts and answers.
* Look out for any unanswered questions. Questions cannot be set as required which means patients can skip questions and submit a partially completed form.
**What appears on a completed form:** the section title, each question's text, and the patient's answers. Section **Intro Text** is not included — it is only shown to the patient while they complete the form. For signature sections, click **View Full Text** above the signature to expand the agreement language the patient consented to; it is collapsed by default. The printed version shows the agreement text inline.
**3**
If you’d like to export any responses to the chart, check the checkbox to the left of the response.
**4**
**Exception:** Some forms responses can only be exported to specific areas of the chart, even if you select **Clinical Profile** or **Visit Note**. (E.g. **Demographics: Personal Pronouns** or **Insurance Card Images - Primary**.)
Choose whether you are exporting to the **Clinical Profile**,**Visit Note** or **Clinical Profile and Visit Note**.
1. After exporting, you can modify the wording of the responses in the chart.
**5**
Click **Export selected** .
**6**
Sign off on the completed form(s) to add them to the patient's Chronological Record.
* By default, only Provider Level Users can sign off on forms responses. For each form, Admin Level Users can enable the **Allow staff sign-off for this form** setting to let Staff Level Users sign off on its form responses. [Click here for information about this setting](/articles/Patient-Forms-Guide#specifying-who-can-sign-off-on-completed-forms).
### Handling responses for special questions
#### Processing patient-reported medications in forms
To export a medication:
| **1** | Click **Match to med** . |
| ----- | ----------------------------------------------------------------------------------------- |
| **2** | Search for the medication in the database and select the appropriate match from the list. |
| **3** | Click **Save** . |
| **4** | Repeat steps 1 to 3 for each patient-reported medication you want to export. |
#### Processing insurance card images in forms
| **1** | AI-powered algorithms will extract the **Group ID** and **Member ID** from the insurance card images and pre-populate those fields for you. Compare the information in the images to what you see in the **Group ID** and **Member ID** fields and then compare the data to what you already have stored for the patient to see if updates are needed. ![Insurance card form panel showing AI-extracted Member ID (R99999999) and Group ID (65006500) in the New Info column, highlighted for comparison against existing on-file values.]()
|
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Edit** to update the insurance information in your patient's chart with the information on the new card(s). |
| **3** | Check off the box for insurance card images and click **Export selected** to export the images to your patient's demographics. Insurance card images can only be exported to the Demographics section even if you choose **Clinical Profile** or **Visit Note**. |
You must update the **Insurance Carrier Name**, **Plan Name**, **Group ID** and **Member ID** information on file before you can export the images to the patient's demographics. This is to make sure your patients always have the correct insurance data stored in their chart.
Historical insurance card images will be moved to the **Historical Insurance Records** section of the patient’s demographics.
## Frequently Asked Questions
### Reviewing Completed Patient Forms
#### Can we change where the patient's response exports to in the Clinical Profile?
Yes! For the **Other** question topic, you can customize where in the Clinical Profile you'd like to export the patient's response. First add the **Other** question topic to your form. Then click the **Export to** dropdown and select the section.
#### Can the answers submitted for one patient be shared across multiple patient charts?
Currently, answers will only be exported to the chart of the patient who filled it out. For example, the family history from one form that may apply to multiple children cannot be exported across multiple charts.
#### Why does my completed consent form only show the patient's signature, and not the consent language?
Section-level **Intro Text** is only shown to the patient while they are filling out the form — it is not included in the completed form in the chart or on the printout. If your consent language is in Intro Text, move it into the **agreement question** of the Patient Signature section instead; question text does appear on the completed form and on the printout. In the chart, the agreement text sits behind the **View Full Text** control above the signature, which is collapsed by default — click it to expand.
#### Why does the printed form show more than the chart view?
On the printed or faxed copy, the agreement text appears inline. In the chart it is collapsed behind **View Full Text** above the signature. The underlying content is the same.
#### Can a staff user sign off on forms in the patient's chart?
Yes, if an Admin enables it on that specific form. For each Patient Form, Admin Level Users can check the **Allow staff sign-off for this form** box to let Staff Level Users sign off on that form's responses. The setting is per form and is off by default on newly created forms. [Click here for information about this setting](/articles/Patient-Forms-Guide#specifying-who-can-sign-off-on-completed-forms).
#### I can't select the insurance card images from the completed forms to export, why?
You must update the Insurance **Carrier Name**, **Plan Name**, **Group ID** or **Member ID** information on file by clicking **Edit** before you can export the images to the patient's demographics. This is to make sure your patients always have the correct insurance data stored in their chart.
#### Is there a report that lists forms (e.g. PHQ-9, GAD-7) that patients have returned but not yet filed, across multiple patients?
Not as a dedicated aggregate report. Completed forms appear in each patient's **Outstanding Items** queue at the top of their chart until they're reviewed and filed. For a practice-wide, cross-patient to-do list, use the **Requiring Action** section on the **Practice Home** page, which you can filter by queue (e.g. Reports, Office Messages) and switch between users with the **View queue for** dropdown.
#### Can I configure a form to export responses to the Vaccinations section of the Clinical Profile?
Not currently. Patient Forms responses cannot be exported to the Vaccinations section at this time. As a workaround, copy the information from the completed form and manually enter it into the Vaccinations section.
## Related Articles
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Patient Forms Guide - Creating and managing Patient Forms](/articles/Patient-Forms-Guide)
* [Patient Forms Guide - Sending forms to patients](/articles/Sending-forms-to-patients)
* [Patient Forms Guide - Receiving and filling out forms as a patient](/articles/Receiving-and-filling-out-forms-as-a-patient)
# Lab Orders & Results - Managing lab order sets
Source: https://help.elationhealth.com/articles/Managing-lab-order-sets
## Overview
### What are Lab Order Sets?
Lab Order Sets are templates of tests that are frequently ordered together and optionally their corresponding diagnoses. Lab Order Sets are saved at the practice level so they can be used by any user for any patient.
### What are the benefits of Lab Order Sets?
Lab Order Sets speed up the lab ordering process by reducing the number clicks needed to input tests and diagnoses into an order form. Lab Order Sets can also help standardize ordering protocols across your practice.
### Viewing Lab Order Sets on the Settings page
The Lab Orders Settings page organizes your order sets **by vendor and compendium**. Each vendor's compendium has its own paginated, searchable list, so rather than loading all order sets at once, you can browse and search within each vendor's section independently.
Order sets within each vendor/compendium grouping are displayed in **alphabetical order**.
## Workflow Instructions
### Searching for a Lab Order Set
To search for an existing Lab Order Set:
| **1** | Go to **Settings** -> **Lab Orders** . |
| ----- | -------------------------------------------------------------------------------------------------------------------------- |
| **2** | Locate the section for the relevant vendor and compendium. |
| **3** | Use the **search bar** within that vendor's compendium section to filter order sets by name. |
| **4** | If the vendor has many order sets, use the **pagination controls** within that section to browse through additional pages. |
### Creating Lab Order Sets
The type of interface that you have with a lab vendor will determine how you must approach managing its order sets.
| | Vendors with whom you have **no** interface or a **unidirectional** interface | Vendors with whom you have a **bidirectional** interface |
| ------------------ | ------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------- |
| **Set-up** | A **generic** set of lab order sets can be used across all of these vendors. | **Separate** order sets must be created for each vendor. |
| **Test Selection** | You can add tests from Elation’s generic compendium and your practice’s user-created tests. | You can only add tests from each vendor’s own compendium. User-created tests are not allowed. |
Each time you go-live with a new bidirectional interface, make sure you review and recreate any order sets that you need to use for that vendor.
Lab order sets can be created from a patient’s chart or from the Lab Orders Settings page.
#### Creating Lab Order Sets from the Lab Order Form
To create Lab Order Sets from the Lab Order Form:
| **1** | Go to a patient's chart. |
| ----- | ---------------------------------------------------------------------------------- |
| **2** | At the top of the patient's chart, click **Orders** -> **Lab Order** . |
| **3** | Select the **Lab** you wish to create an order set for. |
| **4** | Search for and select the appropriate lab **Tests.** |
| **5** | Optionally add any test-level diagnoses or **Dx for All** (order-level diagnoses). |
| **6** | Click **Save as Order Set** . |
| **7** | Enter the **Order set name** . The order set name must be unique. |
| **8** | Click **Save** . |
#### Creating Lab Order Sets from the Lab Orders Settings page
To create Lab Order Sets from the Lab Orders Settings page:
| **1** | Click your email address in the upper righthand corner of Elation. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Lab Orders** . |
| **3** | Locate the section for the relevant vendor and compendium. Use the **search bar** within each vendor's compendium section to find existing order sets or confirm the name you want to use is unique, then click the **+Add Order Set** button within that section. • If you're creating an order set for a vendor with a bidirectional interface, locate the vendor name and compendium, then click **+Add Order Set**. • If you're creating an order set for a vendor with no interface or a unidirectional interface, scroll to the **Other Lab Order Sets** section and click **+Add Order Set**. |
| **4** | Enter a **Name** for the order set. The order set name must be unique. |
| **5** | Search for and select the appropriate lab **Tests** . |
| **6** | Optionally add any test-level diagnoses or **Dx for All** (order-level diagnoses). |
| **7** | Click **Save** . |
#### Special instructions for Scarlet Health Lab Order Sets
Electronic lab orders for Scarlet Health are routed through the Bioreference lab interface which means there are some special requirements when you create order sets for Scarlet Health:
* Create the order set under the Bioreference lab
Add a prefix such as ‘SH’ to the Lab Order Set name so you can tell these apart from your Bioreference order sets
* When adding tests, select ones that are marked as Scarlet Health.
* Add "TH31-8" as one of the tests in the order set. This test is used by the interface to identify Scarlet Health orders so **it must be included**.
### Editing Lab Order Sets
To edit a Lab Order Set:
| **1** | Click your email address in the upper righthand corner of Elation. |
| ----- | --------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Lab Orders** . |
| **3** | Find the Lab Order Set you want to edit. |
| **4** | Click the **pencil** button (edit button) next to the Lab Order Set to enter edit mode. |
| **5** | Make edits as needed. |
| **6** | Click **Save** to save your changes. |
### Deleting Lab Order Sets
To delete a Lab Order Set:
| **1** | Click your email address in the upper righthand corner of Elation. |
| ----- | ----------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Lab Orders** . |
| **3** | Find the Lab Order Set you want to delete. |
| **4** | Click the **trash can** button (delete button) next to the Lab Order Set. |
| **5** | Choose **Yes** in the delete confirmation box to proceed with deleting the Lab Order Set. |
Take caution when deleting Lab Order Sets as deleted Lab Order Sets cannot be restored. Deleting a Lab Order Set deletes it for all users in your practice.
### Applying Lab Order Sets to lab orders
To apply a Lab Order Set to a lab order:
| **1** | Open a lab order draft |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Apply a Lab Order Set using one of these methods: Click **View Order Sets** at the top of the Lab Order Form to browse all available Lab Order Sets and then click on the Lab Order Set to add it to the lab order. • Click into the **Tests** field and search for any Lab Order Set by its name and then click on the name of the Lab Order Set to add it to the lab order. |
#### Show Lab Order Sets first in test search results
To show Lab Order Sets first in test search results:
| **1** | Go to **Settings** -> **Lab Orders** . |
| ----- | ---------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to the **Lab Order Settings** section. |
| **3** | Change the **Sort Lab Test Suggestions By** dropdown to **Order sets first.** This change will be automatically saved. |
## Frequently Asked Questions
### Why can't I find a lab test that I have ordered before?
The directory of tests available (compendium), may be different depending on which Lab Vendor is selected for the Lab Order. Lab Vendors with a bidirectional lab interface utilize their own compendiums which means you must search for the test the exact way it is spelled out in their compendium. Try searching for the test using different terms (e.g. the Complete Metabolic Panel is known as **CMP** for LabCorp) to improve your search results.
If you have a question about a specific test or test code, please contact your lab representative for assistance.
### I cannot see some of the Lab Order Sets I created in the Lab Order Form. Why is this happening?
Some of your Lab Order Sets may not be visible because they are linked to a different Lab Vendor than the one selected for the Lab Order. To resolve this, check the [Lab Orders Settings](https://app.elationemr.com/settings/laborders/) page to ensure your order set was created under the correct vendor. If needed, create a new Lab Order Set.
### When I tried to save a new Lab Order Set I saw an error message that says the name is non-unique and the Lab Order Set won’t save. Why is this happening?
You are seeing this error message because each Lab Order Set must have a unique name regardless of the lab vendor. Choose a different unique name for the Lab Order Set you are trying to create and then click **Save**.
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Using the regular Lab Order Form](/articles/Regular-Lab-Order-Form)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Orders Guide - Creating tests for Order Forms](/articles/Creating-tests-for-Order-Forms)
* [Lab Orders & Results - Managing lab vendors](/articles/Managing-lab-vendors)
# Lab Orders & Results - Managing lab vendors
Source: https://help.elationhealth.com/articles/Managing-lab-vendors
1. [Request a lab interface](#request_interface)
* [Special instructions for Quest Diagnostics](#Quest)
* [Special instructions for Genova Diagnostics](#Genova_Diagnostics)
2. [Manage lab vendors in Elation](#manage_lab_vendors)
* [Add lab vendors](#add_lab_vendors)
* [Customize lab vendor details](#customize_vendor_details)
* [Track the status of a lab interface set-up](#track_status)
* [Troubleshooting a lab interface that stopped working](#troubleshooting_interface)
* [Delete lab vendors](#delete_vendors)
* [Specify a default lab vendor for your practice](#default_lab_vendor)
3. [Complete training](#complete_training)
* [Frequently Asked Questions (FAQ)](#FAQ)
## Overview
### What are the different types of lab vendor interfaces that Elation supports?
The three types of lab vendor interfaces are listed in the table below. Click on corresponding links for specific workflows as needed.
| **Lab Vendor Interface Type** | **No interface** | **Unidirectional interface** | **Bidirectional Interface** |
| --------------------------------- | ---------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Methods for ordering labs** | [eFax](/articles/efaxing-lab-and-radiology-orders) • [Print](/articles/Regular-Lab-Order-Form#print_order) | [eFax](/articles/efaxing-lab-and-radiology-orders) • [Print](/articles/Regular-Lab-Order-Form#print_order) | Electronic |
| **Methods for receiving results** | [eFax](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox) • [Scan & upload](/articles/filing-documents-to-a-patient-chart) | Electronic | Electronic |
| **Vendor List** | —----------------------- | [Click here for a list of lab vendors that offer a unidirectional lab interface with Elation](https://www.elationhealth.com/integrations/?ucterms=partner_service:laboratories). | [Click here for a list of lab vendors that offer a bidirectional lab interface with Elation](https://www.elationhealth.com/integrations/?ucterms=partner_service:laboratories-bidirectional). |
## Workflow Guides
### 1. Request a lab interface
To request a lab interface, click **I need help** -> **Contact Elation Support** and send Elation the following information (with the exception of [Genova Diagnostics](#Genova_Diagnostics)):
* The name of the lab vendor you want to interface with
* Your lab account number for that lab vendor
* The full name of your lab representative for that lab vendor
* The email address of your lab representative for that lab vendor
#### Special instructions for Quest Diagnostics
Also include the **Zip Code associated with your Quest account** when requesting a lab interface with Elation.
#### Special instructions for Genova Diagnostics
Follow these instructions to submit an interface request with Genova Diagnostics:
1. Login to your myGDX (Genova Diagnostics) account via this link: [https://www.gdx.net/mygdx/login](https://www.gdx.net/mygdx/login)
2. Click **Account Settings**.
3. Click **Update EHR Preferences**.
4. Find ‘Elation Health’ under **EHR Provider**.
5. Check off the **Ordering Interface** and **Results Interface** boxes
6. Click **Add**.
Afterwards Genova Diagnostics will work with us to activate your interface and you will be notified once it is live.
### 2. Manage lab vendors in Elation
#### Add lab vendors
To add a lab vendor to your Lab Order Form:
| **1** | Click on your email address in the upper righthand corner of Elation. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Labs** . |
| **3** | Click **+Add Lab Vendor** . |
| **4** | Type the name of the Lab Vendor you want to add. If Elation has an interface with the lab vendor, their name will appear as an option for you to select from. • If Elation does not have an interface with the lab vendor, type their name as you would like it to appear on your Lab Order Form. |
| **5** | Click **Add** . |
#### Customize lab vendor details
To customize the details of lab vendors in your lab vendor list:
| **1** | Click on your email address in the upper righthand corner of Elation. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Go to **Settings** -> **Labs** . |
| **3** | Click the **Details** button to the right of the lab vendor’s name. |
| **4** | Adjust any of the following details as needed: **Printed Orders** - Show this lab vendor on the Lab Order Form. This is by default **On**. • **Electronic Ordering** - [Monitor the status of your interface set up](#track_status). • **Electronic Results** - [Monitor the status of your interface set up](#track_status). • **Compendium** - Understand the compendium options for the lab vendor. • If the lab vendor does not have a compendium available, you’ll have access to a generic Elation compendium and can [create and utilize custom tests](/articles/Creating-tests-for-Order-Forms) when creating orders via the [regular Lab Order Form](/articles/Regular-Lab-Order-Form). • If the lab vendor has their own test compendium, only tests that are part of the compendium can be selected when creating orders via the [electronic Lab Order Form](/articles/Electronic-Lab-Order-Form). • **Locations** - Provide the name, address, phone, or fax details of vendor patient service centers to be displayed on the printed lab order. These **Locations** will appear in the **Site** selection of the Lab Order form; if no locations are added here, you’ll still be able to select **Any site** within the form. |
| **5** | Click **Close** to close the lab vendor details window. |
#### Track the status of a lab interface set-up
To track the status of a lab interface set-up:
| **1** | Click on your email address in the upper righthand corner of Elation. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Labs** . |
| **3** | For the vendor in question, check the **Electronic Orders?** or **Electronic Results?** columns to see the status of the lab interface. The statuses can be as follows: **Not Available**- Interface is not offered. • **Set Up** - Interface request not initiated. • **Waiting on lab** - Interface request sent to the lab, awaiting their response. • **Pending testing** - Interface is pending testing. • **Completed testing** - **pending go-live** - Interface testing completed and waiting to enable interface. • **Blocked** - **lab needs paperwork** - Interface enablement request is on hold pending additional paperwork from your practice. • **Live** - Interface is live and data can be transmitted. |
#### Troubleshooting a lab interface that stopped working
If a lab interface that was previously working has stopped functioning, follow these steps to diagnose and resolve the issue. Common issues include:
* A lab vendor you previously ordered from no longer appears as an electronic destination.
* Electronic results from a vendor have stopped arriving.
##### Step 1 – Check your lab vendor settings
| **1** | Click on your email address in the upper righthand corner of Elation. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Labs**. |
| **3** | Verify the vendor is still listed in your lab vendor list. |
| **4** | Check the **Electronic Ordering** and **Electronic Results** fields to confirm the interface type (unidirectional or bidirectional) and current status. ![]()
The status should show **Live** if the interface is active and data can be transmitted. Other statuses—such as **Blocked - lab needs paperwork**, **Pending testing**, or **Set Up**—indicate the interface is not currently operational. |
##### Step 2 – Validate your account with the lab
Contact your lab vendor directly to confirm:
* Your account is still active.
* Your account is correctly associated with Elation for electronic ordering or results delivery.
##### Step 3 – Contact Elation Support
If the vendor is missing from your list, the interface status looks incorrect, or you have confirmed your lab-side account is active but the issue persists, contact Elation Support.
Click **I need help** -> **Contact Elation Support** and include the following information:
* Practice name
* Vendor name
* Lab account number
* Lab representative contact information (if applicable)
* One or two examples of recent orders or reports that failed or did not transmit as expected (include order IDs, Patient IDs and dates)
#### Delete lab vendors
To delete a lab vendor from your lab vendor list:
| **1** | Click on your email address in the upper righthand corner of Elation. |
| ----- | --------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Labs** . |
| **3** | Click the **Details** button to the right of the lab vendor’s name. |
| **4** | Click **Delete this lab vendor** at the bottom of the window. |
Deleted lab vendors will no longer appear in your Lab Order Form.
#### Specify a default lab vendor for your practice
To set a default lab vendor that will automatically populate when any member of your practice creates a new lab order:
| **1** | Go to **Settings** -> **Lab Orders** . |
| ----- | --------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to the **Lab Order Settings** section. |
| **3** | Use the **Default Lab Vendor** dropdown to select the default lab vendor. Your selection will be automatically saved. |
### 3. Complete training
Some vendors, such as Labcorp, require everyone in the practice to complete training prior to enabling a lab interface. [Click here to watch the Labcorp training video](https://vimeo.com/418182520/abc5baa2bc).
## Frequently Asked Questions
### I do not see an interface for the lab I work with. Can Elation build a new lab interface with that lab?
To request a lab interface build with Elation, click **I need help**-> **Contact Elation Support** and send us the following information:
1. The name of the vendor.
2. The name and email address of your contact at the vendor.
Elation will review the request and reach out to the vendor to determine if an interface is possible and keep you updated on the progress of the request.
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Using the regular Lab Order Form](/articles/Regular-Lab-Order-Form)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Lab Orders & Results - Managing electronic lab results](/articles/Viewing-results-from-lab-interfaces)
# Coding Guide - Managing periodic CPT code updates
Source: https://help.elationhealth.com/articles/Managing-periodic-CPT-code-updates
This article describes the actions you should take in Elation when periodic CPT Code Updates occur.
## Overview
### What are CPT code updates?
Every year, the American Medical Association (AMA)© updates the list of CPT codes permitted for coding medical procedures and services.
[Click here to review the latest CPT code information from the AMA](https://www.ama-assn.org/practice-management/cpt)
.
### How does Elation maintain the latest ICD-10 changes?
Elation allows you to curate and store a list of your practice’s most commonly used CPT codes under Billing Settings for convenience. Anyone in your practice can search for and utilize these CPT codes when coding for encounters.
[Click here to learn more about storing Popular CPT Codes](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?)
.
## Workflow Instructions
### Managing yearly CPT code updates
#### Reviewing Popular CPT Codes
Using deprecated CPT codes when billing for encounters will result in claim rejections. To avoid this issue, we recommend reviewing your
[Popular CPT Codes](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?)
at the beginning of each calendar year to ensure you have saved the most up to date CPT Codes. To review your Popular CPT Code settings:
| **1** | Click **Settings** to open your Elation Settings. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Click **Billing Settings** . |
| 3 | Scroll to the **Popular CPT Codes** section of your Billing Settings. |
| 4 | Review each CPT code to make sure they are all still valid and have the most up to date descriptor. Delete any obsolete CPT Codes to prevent them from appearing in your CPT search when you are searching for billing codes. • Update the description of CPT Codes with revised descriptions to ensure your searches return accurate results. |
#### Reviewing Visit Note Templates with CPT Codes
If you have any visit note templates that include CPT codes, we also recommend reviewing your
[Visit Note Templates](/articles/elation-visit-note-templates)
at the beginning of each calendar year to ensure the codes are still valid. To review your Visit Note Templates:
| **1** | Open any patient’s chart. |
| ----- | -------------------------------------------------------------------- |
| 2 | Click on the **Templates** button at the top of the patient’s chart. |
| 3 | Click **Visit Note Templates** . |
| 4 | Click on the name of each Visit Note Template to view its contents. |
| 5 | Edit any outdated CPT Codes as needed. |
| 6 | Click **Save Template** to save your changes. |
## Related Articles
* [Billing Guide- Navigating Billing Settings](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
# User Accounts Guide - Managing third party cookies while using Elation
Source: https://help.elationhealth.com/articles/Managing-third-party-cookies
## Overview
Certain Elation features (e.g. [electronic prior authorizations for prescriptions](/articles/Managing-electronic-prior-authorizations)) require you to allow third-party cookies in your web browser. Follow the instructions below to enable third-party cookies for your browser of choice.
## Workflow Instructions
### Google Chrome
#### Allowing only Elation to use third-party cookies
To only allow Elation to use third-party cookies:
| **1** | Click the button that looks like **three vertical dots** in the top right-hand corner of Google Chrome. |
| ----- | ------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Settings** . |
| **3** | Click **Privacy and Security** -> **Third-party cookies** . |
| **4** | Under **Sites allowed to use third-party cookies** click **Add** . |
| **5** | Enter [http://app.elationemr.com/](http://app.elationemr.com/) into the **Site** box and then click **Add** . |
![Chrome Settings showing "Privacy and security" selected, Third-party cookies page open, and "Add a site" dialog with http://app.elationemr.com/ entered. Arrows highlight the Add button.]()
#### Allowing third-party cookies from all sites
To allow cookies from all third-party sites:
| **1** | Click the button that looks like **three vertical dots** in the top right-hand corner of Google Chrome. |
| ----- | ------------------------------------------------------------------------------------------------------- |
| **2** | Click **Settings** . |
| **3** | Click **Privacy and Security** -> **Third-party cookies** . |
| **4** | Select **All third-party cookies** . |
![Chrome Settings showing Third-party cookies page with "Allow third-party cookies" selected, and an arrow pointing from the three-dot menu to Settings, then to the Add button under "Sites allowed to use third-party cookies."]()
#### Enabling third-party cookies only when accessing specific pages in Elation
To only allow third-party cookies while you’re on specific pages in Elation:
| **1** | Click the **View site information** button next to Elation’s URL. ![Chrome's View site information panel open, showing "Pop-ups and redirects" toggled on and an arrow pointing to "Cookies and site data" option to click.]()
|
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Cookie and site data** . |
| **3** | Toggle on **Third-party cookies**. ![Chrome's "Cookies and site data" panel showing the Third-party cookies toggle enabled (Allowed), highlighted with an orange outline, on app.elationemr.com.]()
|
### Microsoft Edge
| **1** | Click the button that looks like **three horizontal dots** in the top right-hand corner of Edge. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Settings** . |
| **3** | Click **Cookies and site permissions**. If your browser is too small, expand your browser to see the Settings Menu or click on the button that looks like three horizontal lines at the top left corner. |
| **4** | Click **Cookies and site data** . |
| **5** | Turn off **Block third-party cookies**. ![Microsoft Edge Cookies and site data settings with "Block third-party cookies" toggle highlighted, showing it is currently turned off (disabled).]()
|
### Mozilla Firefox
| **1** | Click the button that looks like **three horizontal lines** at the top right corner of Firefox. |
| ----- | --------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Settings** . |
| **3** | Click **Privacy & Security** . |
| **4** | Click **Custom** . |
| **5** | Check off the **Cookies** box and then select **Cross-site tracking cookies, and isolate other cross-site cookies** . |
![Firefox Privacy & Security settings with Custom selected, Cookies checkbox checked, and "Cross-site tracking cookies, and isolate other cross-site cookies" chosen from the dropdown, highlighted with an orange border.]()
### Safari
| **1** | Click **Safari** at the top of your Mac device. |
| ----- | ----------------------------------------------- |
| **2** | Click **Settings…** . |
| **3** | Click **Advanced** . |
| **4** | Uncheck **Block all cookies** . |
![Safari Advanced settings panel with the Advanced tab selected, arrow pointing from Safari menu Settings option to the unchecked "Block all cookies" checkbox, highlighted in orange.]()
## Related Articles
* [Prescriptions Guide - Managing electronic prior authorizations](/articles/Managing-electronic-prior-authorizations)
# Maryland State- ImmuNet- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Maryland-State-ImmuNet-User-Guide
This article will describe how you can submit vaccination data to the Maryland State Immunization Registry [ImmuNet] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Maryland State Immunization Registry known as ImmuNet.
## What is the ImmuNet Immunization Registry Interface?
The ImmuNet Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to ImmuNet, the Maryland Immunization Registry. Practices can also query ImmuNet for vaccination history or forecast.
## Why is the ImmuNet Immunization Registry Interface valuable?
With the ImmuNet Immunization Registry Interface, practices no longer need to separately log in to ImmuNet to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to ImmuNet. You can also pull vaccination history for specific patients from ImmuNet to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & ImmuNet
The Elation Team will assist you with initiating interface with ImmuNet. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**.
## How to submit vaccination data to ImmuNet using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to ImmuNet. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ASIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
\*'Managing querying errors' \*
[section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Massachusetts State- MIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Massachusetts-State-MIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Massachusetts Immunization Information System [MIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Massachusetts State Immunization Registry known as MIIS.
## What is the MIIS Immunization Registry Interface?
The MIIS Immunization Registry Interface allows connected practices to
**send**
vaccination information from their Elation EHR directly to MIIS; the Massachusetts Immunization Information System. Practices can also query MIIS for vaccination history or forecast.
## Why is the MIIS Immunization Registry Interface valuable?
With the MIIS Immunization Registry Interface, practices no longer need to separately log in to HIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to MIIS. You can also pull vaccination history for specific patients from MIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & MIIS
The Elation Team will assist you with initiating interface with MIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**.
## How to submit vaccination data to MIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to MIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using MIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
### Can I use MIIS inventory management with Elation?
Yes! If you are using MIIS for inventory management, any vaccine reported to MIIS should deduct automatically from your inventory in the MIIS portal if the vaccine was reported via Elation with all the correct matching fields filled out (especially lot number and funding type).
These are the circumstances in which you will still need to log in to MIIS to manually track inventory:
1. If the administered vaccine is reported with an incorrect field, such as an incorrect lot number or lot type (funding type), the administered doses will not decrement appropriately, and the record will be listed in the MIIS website’s inventory decrementing tool for you to manually correct: [Inventory Decrementing Tool Mini Guide](https://resources.miisresourcecenter.com/trainingcenter/Inventory%20Decrementing%20Tool_2019_Mini%20Guide.pdf).
2. If you transfer state-supplied doses to another location, the inventory must be transferred within the MIIS portal manually as well: [Vaccines Transfer Mini Guide](https://resources.miisresourcecenter.com/trainingcenter/Vaccine%20Transfers_2018_Mini%20Guide.pdf).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Membership Management- Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Membership-Management-Frequently-Asked-Questions
See frequently asked questions about Membership plans and enrollments
## Recommended Reading
See the [Membership Management Introduction](/articles/Introduction-to-Membership-Management-with-Elation) article to learn more about the Membership Management feature.
## Creating and Managing Membership Plans
### What happens to patients currently enrolled in a plan if I delete that plan?
If a membership plan is deleted, all patients that were enrolled in that plan will become unenrolled immediately. No notification is sent to patients when they are unenrolled.
### What information about a plan is patient-facing?
Patient communications may include the membership plan display name, as well as the billing amount, start date, and billing frequency. The membership plan description is not currently patient facing but it may be in the future.
### What happens to patients currently enrolled in a plan if I change the billing amount?
If changes are made to the billing amount, all patients enrolled in that plan that do not have an override amount set to their subscription will automatically be charged the updated amount on their renewal date. A membership update message will be sent to the patient showing the new information associated with the plan.
### What happens to patients currently enrolled in a plan if I change the billing frequency?
Patients already enrolled keep the next renewal date they were originally scheduled for. Changing the billing frequency does **not** move existing patients to the new frequency — only patients who enroll after the change bill on the new frequency.
This is deliberate: automatically moving an existing patient's renewal date could charge them earlier than the date they were told to expect. It also means that if a plan was created with the wrong frequency — for example, **annually** when you meant **monthly** — correcting the frequency does not fix existing enrollments. Those patients keep their annual renewal date and won't be charged again until it arrives, up to a year later, with no error or warning.
If you want existing patients to move to the new frequency, review each patient's next renewal date in the Membership Report and adjust their subscription. To move a renewal, edit the subscription from the patient's **Demographics** → **Insurance, Payment & Membership** section, click **Override** next to **Next renewal date**, and enter the new date — see [Editing a patient's membership plan](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans#editing-a-patients-membership-plan).
### Is there a limit on the number of plans that can be created?
There is no limit to the number of plans that can be created.
### How can I create employer plans?
A unique plan can be created for each employer. As an example, you could create an **Acme Co. Plan** for the Acme Company. A chart could be created for the employer, which you could then used as the primary member when enrolling patients on the plan. As patients are added and removed from the plan, you can either modify the override amount for the primary member, or update the billing amount at the plan level. For example, if there are 9 members currently on a plan and you charge \$50 per member per month, when a 10th member is added you can either…
* change the primary members override amount from $450 to $500, or
* update the billing amount at the plan level from $450 to $500
### How can I create group/family plans?
Unique plans can be created for various combinations of patients. For example, you could create plans like:
* Individual
* 2 adults
* 2 adults 1 child
* 1 adult 1 child
When enrolling patients, you can add them into the appropriate group/family plan. If the dynamics of the group/family change, such as a new child being born, you can then unenroll the group/family from their current plan, and enroll them into an appropriate plan. Alternatively, you can keep the group on the same plan, but override the billing amount to reflect the new number of people on the plan.
### How can I create memberships based on age?
Unique plans can be created for specific age ranges, such as:
* Under 18
* 18-29
* Over 65
At the time of enrollment, you can add patients into the appropriate age-based plan. As patients age, you can unenroll the patient in their current plan, and enroll them into the appropriate plan.
To ensure patients are on the right age-based plan, you can use the Memberships Report. By clicking the **Edit Columns** button, you can choose to add a **Patient Age** column to the report. You can then filter for a given age-based plan, and then review the values in the **Patient Age** column to make sure all the patients are in the right plan. If any patients are nearing the upper bound of the age limitations for the plan, you can click the name of the patient in the Membership Report to open their chart in a new tab, and then create a post-dated message that prompts you to contact the patient about moving into the appropriate age-based plan at the right time.
### How can I create a fixed-duration membership (ex: 6-month plan or set number of visits)?
A unique membership plan can be created that corresponds to the type of membership being offered. During enrollment, you can create a post-dated message to trigger the appropriate follow-up action. For example, if you are enrolling a patient on a 6-month plan on 01/01/2023, you can create a message post-dated for the end of June that prompts you to reach out to the patient to see if they want to re-enroll or let their membership expire. You can then take the appropriate action.
## Enrollment
### What does a patient see when an enrollment occurs?
When a patient is enrolled in a membership plan, they will receive a message providing the details of the enrollment. This will include the plan name, start date, billing amount, billing frequency, and automatic payment information (if applicable).
### How do I enroll a group of patients in a group/family membership?
To enroll patients in a group/family membership, follow the steps to [enroll a patient from Practice Home](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#four) or [from Patient Demographics](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#five) , and use the **Patient Name** field to search for and add the additional members.
### Can we provide a way for patients to self-enroll in a membership?
Yes, please follow the instructions on this [help center article](/articles/Membership-Management-Patient-Self-Enrollment).
### Does Elation offer a free pre-enroll period where patients can sign up for our practice before we are live?
Patients can be enrolled into memberships with start dates that are set for some point in the future. This will enable you to provide services to patients without charging them until a specific date.
### How do I move a patient from one plan to another?
To move a patient from one plan to another, you can unenroll the patient from their current plan and then enroll them into the new plan. You can unenroll the patient from Patient Demographics, or by using the **Unenroll** option in the actions menu in the Memberships Report
**To unenroll using Patient Demographics:** [See instructions](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#nine)
**To unenroll using the Memberships Report:**
### How do I handle group plans that are based on number of members? Ex: if a group of 4 needs to be moved to a plan for 5, what needs to happen?
To move a group of patients from one plan to another, you can unenroll any of the patient from their current plan and then enroll them into the new plan (unenrolling one member will unenroll the entire group). You can unenroll the patient from Patient Demographics, or by using the **Unenroll** option in the actions menu in the Memberships Report.
**To unenroll using Patient Demographics:** [See instructions](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#nine)
**To unenroll using the Memberships Report:**
**To enroll patients in a group/family membership:** Follow the steps to [enroll a patient from Practice Home](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#four) or from [Patient Demographics](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#five), and use the **Patient Name** field to search for and add the additional members.
### Can a patient be enrolled in multiple memberships?
Yes, a patient can be enrolled in an unlimited number of memberships simultaneously.
### Can I pause a patient’s subscription?
Yes, a patient’s subscription can be paused at any time from either Patient Demographics or the Memberships Report
**To pause using Patient Demographics:** [See instructions](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#seven)
**To pause using the Memberships Report:**
### How do I enroll a patient who plans to pay using cash or check?
You can enroll your patient in a membership without planning to charge a card on file. The patient will continue to receive payment reminders on the billing date associated with their plan.
Each time the patient has a new charge for their membership fee (this charge will coincide with their billing date), there will be a new item listed in the Patient Payments Report. You can then access this information and mark that line item as paid.
### How do I remove one patient from a group?
If you attempt to unenroll a member, you will be notified that you will be unenrolling the group. To remove a single member, you can ‘Edit’ the group. Groups can be edited from Patient Demographics or from the Memberships Report.
**To remove a member from a group using Patient Demographics:**
**To remove a member from a group using the Memberships Report:**
## Payments, Fees, and Refunds
### What are the options for billing frequency?
You can select from monthly, quarterly, semi-annually or annually.
### What methods can I use for collecting payments (credit card, cash, check, etc.)?
Patients can pay by credit/debit card, ACH, cash, or check. Credit/debit card and ACH payments can be made automatically if a patient has details on file and the enrollment is configured to automatically charge the method on file. Payments made via cash or check will need to be done directly with your practice, and you can then update the payment record in Elation to show the charge was paid using the Patient Payments Report.
Cash and check payments are recorded through a single **Mark as paid by cash/check** action and are not stored as separate methods — the emailed receipt shows the method as **Cash** even for check payments. To record that a payment came in as a check, enter the check number in the **Reference / Check #** field when marking the payment; it saves with the transaction and appears in the Patient Payments Report and in Elation Billing.
If a patient pays in person by credit card outside of Elation's automatic charge (for example, through your practice's own card terminal), use the same **Mark as paid by cash/check** action to record it. That action covers any payment your practice collects manually, not only literal cash or check.
### When will I receive my payments?
Your practice is paid out weekly, every Monday on a two-day rolling basis. This means that your financial week runs from Friday to Thursday. The cut-off for weekly Monday payout is Thursday. If you process a payment on Friday, for example, that payment will be deposited on the following Monday (9 days later).
### Can I generate a claim or superbill for membership charges?
No. Membership charges and payments are tracked in the Membership Report and Patient Payment Report — they aren't applied to a claim or superbill, since memberships are a separate revenue stream. If your practice wants to track a membership charge as a line item in A/R, the workaround is to create a self-pay procedure code (for example, "Membership Fee"), then manually create a self-pay superbill and post the payment to it.
### What does a "Pending" status mean in the Membership Report?
A "Pending" status means the payment hasn't been successfully collected yet. If the membership is set to auto-charge the card on file, Elation attempts the charge on the plan's start or renewal date, and the status updates to "Active" once it succeeds. If the patient doesn't have a payment method on file, or the charge fails, the status stays "Pending" until it's resolved. Use **See payments** from the Membership Report to view the Patient Payment Report for that patient and check whether a charge has actually gone through.
### How do I manage enrollment fees?
You can charge enrollment fees by creating a payment request.
* From Practice Home, click **Payment**
* Search for the appropriate patient
* Enter the enrollment fee amount
* Select a Payment Reason (ex: **Membership fee- medical services**)
* Select a Payment Method and Payment Option
* Complete the request
### How do I give a refund?
Refunds can be issued through the Patient Payment Report.
* Click the **Patient Payments Report** option in the **Reports** dropdown at the top of the Elation window
* Browse the report or use the filters to find the appropriate patient
* Click the **…** action menu and select **Refund**
Individual line items in the Patient Payment Report can be refunded, but there is no option to issue a partial / pro-rated refund.
### How can I find a list of patients who are past due?
The Memberships Report can be filtered to show all patients who are past due.
* Click the **Memberships Report** option in the **Reports** dropdown at the top of the Elation window
* Use the **Status** filter and select **Past Due**
### How can discounts be given to specific patients or groups of patients?
Discounts can be provided through a few different means:
* **Create a membership plan with a built-in discount** — Follow the process for [adding a new plan](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#one), but modify the billing amount so it reflects a discount, then enroll patients in this discounted plan.
* **Override the billing amount for a specific patient** — Follow the steps to [enroll a patient from Practice Home](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#four) or from [Patient Demographics](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#five), and use the **Override** feature to enter a discounted billing amount.
* **Provide a ‘free’ period during enrollment** — Follow the steps to [enroll a patient from Practice Home](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#four) or from [Patient Demographics](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#five), and set the Start date for a point in the future. The patient will receive notice of enrollment immediately, but they will not be charged until the Start date.
### How do I offer promotions for joining a practice?
Promotional rates can be offered by enrolling a patient into a discounted plan, and then later enrolling them in another plan at the standard rate. After enrollment, you can create a post-dated message to trigger the appropriate follow-up action. For example, if you are offering a 3-month discount, you can create a message post-dated for the end of the 3-month period that prompts you to unenroll the patient from the discounted membership and enroll them in the standard membership.
### How do I handle associating payments to a family’s head of household?
When enrolling multiple patients in a group/family plan, you will designate a primary member for that enrollment. The primary member will receive all membership notifications and charges for the group. Note: other charges manually sent to the patient using a Patient Payment Request will go directly to the selected patient, even if they are the secondary members on a plan.
### Am I alerted if a patient does not pay their membership?
If a patient is past due, this information is visible in the Status column of the Memberships Report and in the Membership Information section of Patient Demographics.
### What happens if a patient does not have a card on file?
If the patient does not have a card on file at the time of enrollment and you choose to automatically charge a card, Elation will send a payment request to the patient. Patients can choose to store a card-on-file for future payments through completing a payment request. They will need to keep the checkbox “Keep this card on file” checked when completing the payment.
### How quickly do refunds appear on a patient’s credit card statement?
The patient will see the refund in \~5-10 business days. The refund request will be submitted to the appropriate card issuer immediately, but the time required to process the refund can vary based on the card issuer and underlying bank.
### How quickly will refunds be visible to me?
When you issue a refund, the refund amount should be deducted from your Stripe account balance immediately, which means that the next transfer or two to your bank account would be smaller to reflect this.
### How are membership fees labeled on the payment request sent to the patient?
The payment request will include a **Reason** field, which will show ‘Membership fee- medical services.’
## Communication
### What actions trigger automated communications to patients?
* Enrollment Confirmation
* Upon enrollment, the patient will receive confirmation of plan name, frequency, billing amount, first payment date, card on file (if applicable), other members (if applicable)
* Payment Request
* Payment request is sent automatically based on the frequency of the plan. The email is sent on the due date
* **Credit/debit card**: They’ll be charged 24 hours after the notice is sent. The patient will be considered past due if card payment hasn’t been processed 24 hours after the due date.
* **ACH payments**: The subscription will show **ACH Processing** during the settlement window (1–10 business days) and will not be marked past due until that window closes.
* Modifying a Plan
* If changes are made to the billing amount or billing frequency, patients will be updated about the change. Changes to plan name, display name or description will not automatically notify patients.
No communication goes to patients who are secondary members on group/family plans
### Does Elation offer pre-drafted documents to send to patients when their card expires?
Elation sends a notification if a card is declined, and will request that a new card be put on file. You can check the status of the payment on the Patient Payment Report, where you will see a declined charge. If the patient enters a new card and the payment succeeds, you will see a successful charge in addition to the previous declined charge (note: these will appear as two separate charges in the Patient Payment Report).
### Does Elation offer pre-drafted documents to send to patients when they are due to renew?
Yes, a message is sent automatically on the payment due date based on the enrollment start date and corresponding billing frequency. These messages are not configurable.
### When are payment reminders / notifications sent to patients? What if the patient continues to not pay their bill?
Patients will receive a payment request based on the billing date associated with their plan. If the patient does not take action on the request, you can send a reminder from the Patient Payment Report using the **Resend payment request** option in the **…** Actions menu.
### Will patients be notified if I change the details of a plan?
If changes are made to the plan name, display name, or description, no message will be sent to the patients enrolled on the plan. However, if the billing amount or billing frequency is changed, a membership update message will be sent to the patient showing the new information associated with the plan.
### Does Elation have the option to send a "Welcome Letter" once a patient enrolls to our practice?
An enrollment confirmation will be sent to the patient immediately after enrollment is completed, but there currently is not an option to customize this content or to automatically send additional material. You can use the **Letter** functionality in the patient’s chart to send a template letter to the patient at any time.
### Will a patient get a payment request even if they paid cash/check already?
Yes, a payment request will be sent out even if the patient has prepaid their balance using a cash or check.
## Related Articles
* [Membership Management Introduction](/articles/Introduction-to-Membership-Management-with-Elation)
* [Membership Management- How to Manage Plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments)
* [Membership Management- How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans)
* [Membership Management - Patient Self-Enrollment](/articles/Membership-Management-Patient-Self-Enrollment)
* [Membership Management- How Patients Receive Communications](/articles/Membership-Management-How-Patients-Receive-Communications)
* [Membership Management- How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
# Membership Management- How Patients Receive Communications
Source: https://help.elationhealth.com/articles/Membership-Management-How-Patients-Receive-Communications
Learn the types of notifications patients receive when you use Elation's Membership Management feature.
## Recommended Reading
We recommend reading the [How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans) article alongside learning about how patient receive communications.
## Plan/Enrollment Confirmations
When a patient is enrolled in a membership, they will receive an SMS or email (based on their communication preference) confirmation showing the plan, start date, billing amount, billing frequency, and payment method. In the case of a group membership, only the primary member will be contacted.
## Plan/Enrollment Modifications
When a patient's enrollment is modified, they will receive an SMS or email (based on their communication preference) confirmation showing the plan, start date, billing amount, billing frequency, and payment method. In the case of a group membership, only the primary member will be contacted.
## Charge for Membership
Renewal dates are set when a patient enrolls and don't automatically change if you edit the plan's billing frequency later. See [What happens to patients currently enrolled in a plan if I change the billing frequency?](/articles/Membership-Management-Frequently-Asked-Questions#what-happens-to-patients-currently-enrolled-in-a-plan-if-i-change-the-billing-frequency) for details on how to review and adjust existing renewal dates after a frequency change.
Patients will receive a payment request for the billing amount associated with their plan (or the override amount specified for the patient) on the plan start date and all subsequent renewal dates. Payment requests will be sent via the patient’s preferred communication method (email or SMS) on the payment due date. In the case of a group membership, only the primary member will be contacted.
If the patient has a card or bank account on file at the time of enrollment and you choose to automatically charge it, the card or bank account on file will be charged on the start date and subsequent renewal dates. the patient will receive a message indicating that that card or bank account will be charged, and they will also receive a link where they can access additional details and see that the charge is the result of a membership fee. The SMS content would read: \*“A message from \[Practice Name]: A \$\[Billing Amount] payment will be charged to \[Payment Method]. To update your card or see details click: \[Link]“\*Patients who prefer email communication will receive a similar message, but the detail about the charge being the result of a membership fee will be visible directly in the email. The charge will automatically be collected within 24hrs. This gives the patient time to update their payment-details-on-file or contact your office with any questions. Once the charge is completed, the patient will receive a receipt via text or email.
If the patient does not have a card or bank account on file, or if you choose to not automatically charge the method on file, Elation will send a payment request to the patient on the start date and subsequent renewal dates. If there is no information on file, a payment request (i.e. invoice) will be created and the payer will receive the following message: \*“\[Practice Name] has requested a payment of \$\[Billing Amount]. Click the link to pay. \[Link]“\*Patients can choose to store payment details on-file for future payments through completing a payment request. They will need to keep the checkbox “Keep this card on file” checked when completing the payment. Additionally, patients can pay you directly with a check or cash, but the payment requests will still be sent.
To identify any gaps in payment, you can use the Membership Reporting functionality to identify and follow up with any patients who are past due.
## Next Article to Read
[Membership Management- How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
## Related Articles
* [Introduction to Membership Management with Elation](/articles/Introduction-to-Membership-Management-with-Elation)
* [Membership Management- How to Manage Plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments)
* [Membership Management- How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans)
* [Membership Management- Patient Self-Enrollment](/articles/Membership-Management-Patient-Self-Enrollment)
* [Membership Management- How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
* [Membership Management - Frequently Asked Questions](/articles/Membership-Management-Frequently-Asked-Questions)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
# Membership Management - How to manage membership payments
Source: https://help.elationhealth.com/articles/Membership-Management-How-To-Receive-Payments
Learn how to manage payments and reporting using Elation's Membership Management feature.
📖 **RECOMMENDED READING**
Patients must first be enrolled in a membership plan in order for you to request/receive payments. Read the [How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans) article to learn about to enroll patients in plans.
## Overview
### What reporting is available for membership subscriptions?
Utilize the [Membership Report](#access_report) to view all of your patients enrolled in a membership. The report contains useful information about the patient, plan, enrollment and billing statuses, and more.
The Patient Payment Report tracks the actual [payments](#payments) made against membership subscriptions.
## Workflow Instructions
### Accessing the memberships report
To access the memberships report, go to **Reports** → **Membership Report**.
### Filtering the Membership Report
By default, all patients enrolled in membership plans will be shown, regardless of the status of their membership. Filters can be used individually or in combination to find specific patients based on the plan they are enrolled in, the status of their membership, and/or the patient’s name.
* The membership plan dropdown lets you filter for specific plans.
* The status dropdown filter lets you filter by a specific plan status. Available statuses include **Active**, **Past Due**, **Paused**, **ACH Processing**, and **ACH Verification Pending**.
* **ACH Processing**: Payment was initiated via ACH and is settling (typically takes 1–10 business days). This is not an indication that the payment failed.
* **ACH Verification Pending**: Patient used manual bank entry and has not yet confirmed microdeposits.
* The patient name filter lets you narrow down the report to a specific patient.
### Editing the columns of the Membership Report
By default, a subset of the full list of available data columns will be shown on the report. Click **Edit Columns** to specify which data columns you want to see in the report.
### Actioning on membership enrollments
Click the **…** button in the Actions column next to any enrollment to perform any of the following actions:
* Edit the plan.
* Pause/resume the membership subscription.
* Unenroll patient/group from a membership plan.
* See payments tied to a given patient.
* This will open the Patient Payment report filtered for the selected patient.
### Downloading membership enrollment data
Click **Download CSV** to obtain a file with membership enrollment data. The filters applied to the report at the time the download button was clicked will be reflected in the CSV file.
**Note:** Column selections made via **Edit Columns** are not reflected in the CSV export — the downloaded file uses a default set of columns regardless of which columns are visible in the report.
### Updating a patient's payment method for membership renewals
When a patient needs to update their payment method (e.g. connect a new bank account (ACH)) before or at their next membership renewal, you have two options.
#### Option 1: Send a payment info request to the patient before the renewal date
Open the patient's demographics and click **Request payment info** → **Send Request**. The patient receives an email prompting them to add payment details.
The patient clicks **Add Payment Details** in the email to open their payment details in a browser.
The patient clicks **+ New payment method**, fills in their billing information, and enters information about their new payment card or selects **US bank account** to connect their bank account for ACH payments.
* If the patient chooses **US bank account**, they can search for their bank and follow the prompts to log in and authenticate through their bank's secure connection flow.
* Patients can also enter their bank account details manually, then wait to receive a microdeposit from Stripe and verify it via a confirmation email. This method takes longer than logging in directly through their bank account and is generally not recommended.
The patient clicks **Save** to save their new payment method on file. Afterwards, if they want to specify their new payment method as the primary payment method on file, they can click **Edit** next to the newly added payment method, check **Make this my primary payment method**, and click **Save**.
The 'primary' payment method is only a designation if the patient already has a different payment method tied to their membership subscription. The patient (or your practice) would need to separately update the payment method associated with the membership subscription to the new 'primary' payment method.
1. Go to the patient's demographics and navigate to the **Membership Information** section.
2. Click **Edit**, confirm **Charge a payment method on file** is selected, choose the new primary payment method, and click **Update Enrollment**.
3. Elation will charge the new payment method on the next renewal date.
#### Option 2: Wait for the renewal date
On the renewal date, Elation automatically sends the patient an email or text with the charge amount and a link to their payment details.
If the patient receives an email, the subject line will read **\[Practice Name]: Payment summary for pending charge** or **You have an outstanding payment at \[Practice Name]**.
The patient clicks the link in the message — which may read **Update payment method**, **Manage payment methods**, or **Pay Now** — to open their payment details in a browser.
The patient clicks **+ New payment method**, fills in their billing information, and enters information about their new payment card or selects **US bank account** to connect their bank account for ACH payments.
* If the patient chooses **US bank account**, they can search for their bank and follow the prompts to log in and authenticate through their bank's secure connection flow.
* Patients can also enter their bank account details manually, then wait to receive a microdeposit from Stripe and verify it via a confirmation email. This method takes longer than logging in directly through their bank account and is generally not recommended.
The patient clicks **Save**, then selects the newly added payment method and clicks **Use selected payment method** to apply it to the pending subscription charge.
The patient clicks **Edit** next to the newly added payment method, checks **Make this my primary payment method**, and clicks **Save**. Elation will charge the bank account on the renewal date.
### Viewing payments
[Click here to see how to view membership subscription payments in the Patient Payment Report.](https://help.elationhealth.com/articles/using-elation-to-securely-collect-patient-payments#viewing-&-managing-payment-transactions)
## Related Articles
* [Introduction to Membership Management with Elation](/articles/Introduction-to-Membership-Management-with-Elation)
* [Membership Management- How to Manage Plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments)
* [Membership Management- How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans)
* [Membership Management - Patient Self-Enrollment](/articles/Membership-Management-Patient-Self-Enrollment)
* [Membership Management- How Patients Receive Communications](/articles/Membership-Management-How-Patients-Receive-Communications)
* [Membership Management - Frequently Asked Questions](/articles/Membership-Management-Frequently-Asked-Questions)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
# Membership Management - How to enroll patients in membership plans
Source: https://help.elationhealth.com/articles/Membership-Management-How-to-Enroll-Patients-in-Plans
Learn how to use Elation's Membership Management feature to manage membership enrollments.
📖 **RECOMMENDED READING**
Before enrolling any patients, you must first create your various membership plans. We recommend reading the [How to Manage Plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments) article before learning about how to enroll patients in plans.
## Overview
### How do I enroll a patient in a membership plan?
You can enroll patients in one or multiple membership plans simultaneously. When enrolling a patient, you can:
* Specify the plan(s).
* Set a primary member (for group enrollments).
* Override the pre-determined billing amount (if needed).
* Set a start date.
* Automatically charge payment information on file (if available).
You can also allow patients to [submit an enrollment request](/articles/Membership-Management-Patient-Self-Enrollment).
### What happens after patients are enrolled in a membership plan?
Once enrolled
* The patient will receive an email notification about the enrollment.
* If the patient has payment information on file:
* they will be charged within 24 hours of the start/renewal date.
* they can choose to split the total charge across multiple payment methods on file.
* If the patient does not have payment information on file, they will be sent a payment request on the start/renewal date.
* The patient remains on the membership plan until you manually un-enroll them.
To view or edit a specific patient's membership plan(s):
* Go to the patient's **Demographics** → **Insurance, Payment & Membership** section OR
* Go to **Reports** → **Membership Report**.
## Workflow Instructions
### Enrolling a patient in a membership plan
Open the Membership Enrollment Form using one of the following methods:
* Clicking the **Membership** button at the top of your Practice Home.
* Opening the patient's demographics and clicking **+ add membership plan** in the **Insurance, Payment & Membership** section.
Fill in the following details:
* **Plan members**: The names of all the members that belong to the plan. If you're enrolling a patient from their demographics, this field will automatically be populated with their name.
* Individual Plans — This will just be the patient and they will be the primary member by default.
* Group Plans — The primary member of the plan (typically the one paying) should be listed first, followed by the other plan members.
* **Plan name**: Select the plan from your list of [membership plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments).
* **Amount**: The total amount the primary member is to be charged each time the membership renews. The default amount will be the Billing Amount assigned to the membership plan. To adjust the **Amount**, click **Override**.
* If you override the default Billing Amount of a membership plan for a specific patient, the new amount will remain in effect even if you change the default Billing Amount of the entire membership plan.
* **Start date**: The start date of the membership plan. The default start date will be **today**.
To allow patients to split a total charge across multiple saved payment methods, make sure to select **Automatically charge payment method on file**.
If the patient has a card on file and you want to automatically charge the card, check the **Automatically charge payment method on file** box.
Click **Enroll**.
### Patient self-enrolling in a membership plan
#### Refer to this article to learn how you can allow patients to submit an enrollment request on their own.
### Editing a patient's membership plan
While you can edit a patient's membership plan from both their demographics and the Membership Report, we recommend editing it from the demographics as it gives you the most convenient view:
Go to the patient's chart and open their demographics.
Go to the **Insurance, Payment and Membership** section.
To allow patients to split a total charge across multiple saved payment methods, make sure to select **Automatically charge payment method on file**.
Click **Edit** and make any necessary changes to the subscription. You can change the following:
* **Billing Amount** (by clicking **Override**)
* **Start date** — The **Start date** can only be changed if the date is after the current date.
* **Next renewal date** (by clicking **Override**) — Overriding the next renewal date changes only when this patient is next billed. It does not shift any renewals after that; those continue to fall on the plan's billing frequency. Use this to move a single patient's renewal without unenrolling them — for example, to align an enrolled patient with a corrected billing frequency on the plan.
* **Automatically charge card on file**
Click **Update Enrollment**.
All edits will take effect on the new renewal date. Patients will receive a notification about any edits to their Membership Subscription.
### Pausing a patient's membership plan
Go to the patient's chart and open their demographics.
Go to the **Insurance, Payment & Membership** section.
Click **Pause**.
Click **Pause billing**.
Once a membership plan is paused, the patient will not be charged until the subscription is resumed. Patients will not receive any notifications about their subscription being paused or resumed.
**Resuming a patient's membership plan**
Go to the patient's chart and open their demographics.
Go to the **Insurance, Payment & Membership** section.
Click **Resume**.
Click **Resume billing**.
Once a membership plan is resumed, the patient will be invoiced again on the next renewal date. Patients will not receive any notifications about their subscription being resumed.
### Removing a patient from a membership plan
Go to the patient's chart and open their demographics.
Go to the **Insurance, Payment & Membership** section.
Click **Unenroll**.
Click **Unenroll & remove**.
Once a patient is unenrolled from a membership plan, they will no longer receive any invoices about the subscription. Patients will not receive any notifications about the un-enrollment.
📖 **Next Article to Read**
[Membership Management- How Patients Receive Communications](/articles/Membership-Management-How-Patients-Receive-Communications)
## Related Articles
* [Introduction to Membership Management with Elation](/articles/Introduction-to-Membership-Management-with-Elation)
* [Membership Management - Patient Self-Enrollment](/articles/Membership-Management-Patient-Self-Enrollment)
* [Membership Management- How to Manage Plans](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments)
* [Membership Management- How Patients Receive Communications](/articles/Membership-Management-How-Patients-Receive-Communications)
* [Membership Management- How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
* [Membership Management - Frequently Asked Questions](/articles/Membership-Management-Frequently-Asked-Questions)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
# Membership Management - Patient Self-Enrollment
Source: https://help.elationhealth.com/articles/Membership-Management-Patient-Self-Enrollment
Learn how your patients to self-enroll in your membership plans
## Overview
### What is the patient self-enrollment feature?
Patients can submit enrollment requests for your membership plans through a secure public enrollment page. Their form submission creates a patient chart (if one doesn’t already exist), captures payment information, and sends the request to your practice for review. You can stay in control by approving or denying the request before any charges begin.
### Why should I use patient self-enrollment?
* Reduces administrative work by letting patients submit enrollment requests to your practice on their own.
* Helps your practice grow more efficiently by collecting key patient details and payment upfront.
* Ensures charges won’t begin until your team activates the membership.
## Setup
### Pre-requisite Configurations
In the top right corner of Elation, click your email address and go to **Settings**, then click **Membership Management**.
Locate the plan for which you'd like to enable self-enrollment. Click the **toggle** for **Enable self enrollment** until it turns green. If you haven't created any membership plans yet, [follow these instructions](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments) to create one first.
Select a **default physician** that will be associated with any brand new charts that are created. The patient's first name, last name, date of birth, and sex at birth will be used to determine if there's a match with one of your existing charts. If no match is found, a new chart will be created.
Optionally click the **Customize** button to customize the Enrollment URL.
**Copy** the URL so that you can share it with your patient.
## Workflow Instructions
Self-enrollment involves two steps. First, your patient must complete the online request form for the plan. Next, someone from your practice must approve or deny the request.
### Submitting the online request form (performed by the patient)
Open the **enrollment URL** for the membership plan. On this page, the patient will see the plan name, description, and cost.
Fill out the fields within the following sections: Patient Information, Contact Information, and Payment Information.
![Patient self-enrollment form showing Patient Information, Contact Information, and Payment Information sections with Card payment selected, alongside the Basic Adult Plan summary at $50.00/month.]()
Click **Continue to Confirmation**.
Review the enrollment details on the confirmation page. If any changes need to be made, click **Back**. Otherwise, click **Confirm Membership**.
### Reviewing a self-enrollment request (performed by the practice)
In the top blue bar of your Elation account, click **Reports** → **Memberships Report**.
Locate the patient's enrollment request. Requests that require your attention show up as **Pending** under the Status column. For convenience, you can use the Status dropdown menu to filter for **Pending** or search for the patient's name.
If you need to **modify the start date** of the patient's plan, you **must make this edit before you activate the plan**. Once a plan is activated, you won't be able to adjust the start date.
Click the **...** button that corresponds with the patient's request and take the appropriate next step:
* **Edit**: Allows you to modify the **start date** and/or **payment method** of the plan.
* **Activate**: Activates the plan and charges the patient's payment method on file.
* **Unenroll**: Denies the patient enrollment request.
Once activated, the status in the Membership Report will change to **Active**.
## Frequently Asked Questions
### Why does Elation require the practice to review each enrollment request?
This allows you to confirm right fit, schedule a meet and greet, or collect additional information before activating the plan.
### Are there limitations around who/when someone can enroll?
No, anyone with the plan's public URL can enroll.
**Can a patient remove themselves from a membership plan?**
No, only the practice can unenroll a patient from an existing membership.
### What email correspondence will the patient receive?
The patient will not receive an email when they submit their enrollment form, but they will be notified when the membership is activated.
## Related Articles
* [Membership Management Introduction](/articles/Introduction-to-Membership-Management-with-Elation)
# Michigan State- MCIR- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Michigan-State-MCIR-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Michigan State Immunization Registry [MCIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Michigan State Immunization Registry (MCIR).
## What is the MCIR Immunization Registry Interface?
The MCIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to MCIR, the Michigan State Immunization Registry known as Michigan Care Improvement Registry. Practices can also query MCIR for vaccination history or forecast.
## Why is the MCIR Immunization Registry Interface valuable?
With the MCIR Immunization Registry Interface, practices no longer need to separately log in to MCIR to enter vaccination records for their patients. Once the vaccination is recorded in MCIR during the patient encounter, the information can be sent immediately from the patient's chart in Elation to MCIR. You can also pull vaccination history for specific patients from MCIR to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & MCIR
The Elation Team will assist you with initiating interface with MCIR. To notify us of your interest, please follow the instructions below:
1. Register with [Michigan Health System Testing Repository](https://mimu.michiganhealthit.org/)
2. Follow the instructions listed in this guide: [https://michiganhealthit.org/wp-content/uploads/HSTRUserGuide.pdf](https://michiganhealthit.org/wp-content/uploads/HSTRUserGuide.pdf)
3. Make sure the following information is filled in during the registration process:
* \*Registration Type:\***Professional**
* *HL7 version:* **2.5.1** *Is EHR configured to capture the MCIR HL7 fields?:* **Yes**
* *Does this Registration participate with MAPS?* MAPS is the Michigan Prescription Monitoring Program (PMP). **You should indicate Yes if your team has a MAPS login.**
* *Our EHR System is:* **Elation Health**
* *EHR Vendor:* **Elation Health**
* *EHR Product / Version:* **ElationEMR v3**
* *EHR Implementation Date:* **the date you started using Elation**
2. [Click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
* Does your practice participate in VFC? If so, what is your VFC PIN?
* What is your MCIR site ID number? You can follow [these instructions](https://www.mcir.org/wp-content/uploads/2014/08/Finding-Site-ID-Number.pdf) to find your MCIR ID.
* Who will be the point of contact for this interface setup? Please also provide a backup contact (backup required by MCIR).
* Does your practice administer vaccines? Do you have any other physical locations that administer vaccines?
* Does your practice have a relationship with MiHIN (Michigan Health Information Network)?
## How to submit vaccination data to MCIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to MCIR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using MCIR
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Minnesota State- MIIC- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Minnesota-State-MIIC-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Minnesota State Immunization Registry [MIIC] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Minnesota State Immunization Information Connection (MIIC).
## What is the MIIC Immunization Registry Interface?
The MIIC Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to MIIC; the Minnesota Immunization Information Connection. Practices can also query MIIC for vaccination history or forecast.
## Why is the MIIC Immunization Registry Interface valuable?
With the MIIC Immunization Registry Interface, practices no longer need to separately log in to MIIC to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to MIIC. You can also pull vaccination history for specific patients from MIIC to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & MIIC
The Elation Team will assist you with initiating interface with MIIC. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. Do you participate in Medicare, Medicaid, or both?
2. What is your MIIC organization code?
3. How many vaccinations do you administer per year?
## How to submit vaccination data to MIIC using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to MIIC. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
MIIC currently does not receive race and ethnicity information.
## How to query for vaccination history/forecast using MIIC
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Missouri State- ShowMeVax- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Missouri-State-ShowMeVax-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Missouri State Immunization Registry [ShowMeVax] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Missouri State Immunization Registry (ShowMeVax).
## What is the ShowMeVax Immunization Registry Interface?
The ShowMeVax Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to ShowMeVax, the Missouri State Immunization Registry. Practices can also query ShowMeVax for vaccination history or forecast.
## Why is the ShowMeVax Immunization Registry Interface valuable?
With the ShowMeVax Immunization Registry Interface, practices no longer need to separately log in to ShowMeVax to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to ShowMeVax. You can also pull vaccination history for specific patients from ShowMeVax to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & ShowMeVax
The Elation Team will assist you with initiating interface with ShowMeVax. To notify us of your interest, please [complete this form](/files/immunization-mo-showmevax-form.pdf), then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation. Afterwards, a member of the Elation team will collect the completed form from you.
1. Does your practice currently administer vaccines?
2. Is your practice enrolled in ShowMeVax
3. What country are you in?
## How to submit vaccination data to ShowMeVax using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to ShowMeVax. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ShowMeVax
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Multi-Factor Authentication Guide - Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Multi-Factor-Authentication-FAQ
This FAQ walks through real-world MFA situations and how to handle them safely. For an overview of MFA concepts and factor types, see [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA).
## Getting Started
### Does the entire practice need to enroll in multi-factor authentication at the same time?
Each user must independently set up an authentication factor but it does not have to be done at the same time.
### How do I update my authentication factor(s)?
[Click here for instructions on updating authentication factors](/articles/Updating-authentication-factors-for-MFA).
## Account Lockout and Login Issues
### I am not able to sign in to Elation to reset my authentication factor. What should I do?
If you find yourself locked out, **ask an Admin Level User in your practice to reset your authentication factors for you** in the [Manage Accounts](https://app.elationemr.com/settings/allaccounts/) settings page ([click here for instructions](/articles/Resetting-authentication-factors-for-MFA)). If you are the sole administrator of an Elation practice, [click here](https://app.elationemr.com/support/) to contact the Support Team. We will send you an email to verify your identity and reset your authentication factor(s) on your behalf.
After you have successfully logged in, set up additional authentication factors as back up in case this happens again.
### I set up an authentication factor but cannot log in to my Elation account, what should I do?
If you find yourself locked out, **ask an Admin Level User in your practice to reset your authentication factors for you** in the [Manage Accounts](https://app.elationemr.com/settings/allaccounts/) settings page ([click here for instructions](/articles/Resetting-authentication-factors-for-MFA)).
For security reasons, Admin Level Users are responsible for resetting authentication factors for their practice; Elation will not readily do so on a user's behalf. If you are the sole administrator of an Elation practice, [click here](https://app.elationemr.com/support/) to contact the Support Team. We will send you an email to verify your identity and reset your authentication factor(s) on your behalf.
After you have successfully logged in, set up additional authentication factors as back up in case this happens again.
### I lost my phone or got a new phone. What should I do?
If you can no longer access the device you used for MFA (for example, you lost your phone or replaced it with a new one), you will need to reset your MFA factors and set them up again.
#### Step 1: Contact your practice admin first
Your practice admin is your first line of support for MFA and login issues. They can:
* Reset your MFA from Settings → Manage Accounts → Reset multi-factor so you can enroll new factors.
* Confirm that your user account is active and not disabled.
If your practice does not have an active admin, or your admin cannot access Manage Accounts, please contact Elation Support.
#### Step 2: Re‑enroll MFA on your new device
After your admin resets MFA:
| 1 | Sign in - Sign in to Elation with your username and password. |
| - | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Set up factors - Follow the prompts to set up at least one **reusable factor** , such as: An authenticator app (recommended), and/or • Email verification codes. |
| 3 | Avoid single-device factors - Avoid relying on only device‑bound factors (for example, Touch ID/Face ID or platform security keys) on a single device, since those do not transfer automatically when you change devices. |
We strongly recommend configuring **at least two factors** so you have a backup if you lose access to one.
## Authentication Factor Types and Compatibility
### Which Authenticator Apps can I use?
Any Authenticator App that uses the same TOTP (Time-Based One-Time Password) algorithm as Google Authenticator can be used. Common TOTP Apps include:
* Google Authenticator
* Microsoft Authenticator
* Symantec VIP Access (mobile app)
* Authy
* Duo Mobile
* 1Password (with integrated TOTP support)
* LastPass Authenticator
* FreeOTP
* andOTP
* OTP Auth
### Which Security Keys and Biometric Authenticators can I use?
Any software or hardware that verifies your identity using public-key cryptography can be used. Common examples include:
* Password managers that store a Security Key (e.g. 1Password, LastPass, etc.)
* Windows Hello (pin)
* YubiKey
* Feitian ePass / K27 / BioPass
* Google Titan Security Key
* SoloKey
* Thetis FIDO U2F Key
* OnlyKey
* MacBook Touch ID
* Apple Face ID
* Windows Hello fingerprint
* Windows Hello Face
* USB fingerprint readers
### Can I use SMS as an authentication factor?
Security research has shown that SMS is less secure than other authentication factors. It is possible for your cell phone number to be compromised in a **SIM Swap** attack, where a bad actor tricks your carrier to port over your phone number to them. When a bad actor has access to your phone number, they can then receive the security codes used for multi-factor authentication, increasing their chances of successfully gaining unauthorized access to your account. As a result, Elation decided to only support other more secure factors for multi-factor authentication.
### Okta Verify is showing me a screen with 3 numbers instead of a "Yes, It's Me" confirmation. What do I do?
Okta Verify occasionally challenges a push notification with number matching instead of a simple confirmation. When this happens, your Elation sign-in screen displays a single number, and the Okta Verify app on your phone displays three numbers to choose from. Select the number in the app that matches the number shown on your Elation sign-in screen, then click Verify on your sign-in screen to complete authentication.
### Can I set up more than one authentication factor for a single account?
Yes, you can set up more than one authentication factor for a single account and this is recommended practice. Note that you can only set up one of each type of factor (e.g. one Authenticator App, one Security Key). You can follow [these instructions](/articles/Multifactor-Authentication-MFA#options) to learn how to choose which factor you want to use when logging in.
### Can I log in to my account from different devices using a single authentication factor?
You can log in to your account from different devices using a single authentication factor if the authentication factor is not a Security Key or Biometric Authenticator as those are typically device specific. If you want to use a Security Key or Biometric Authenticator when logging in through your computer set up an additional authentication factor like Google Authenticator for logging in through other devices.
### I use Elation on multiple computers and my phone. Which MFA factors should I choose?
If you regularly access Elation from more than one device (for example, a work desktop, a laptop, and your phone), choose factors that are easy to use across all of them.
#### Recommended setup
* Primary factor: An authenticator app on your mobile device.
* Backup factor: Email verification codes.
This combination:
* Works on any browser where you can enter a one‑time code.
* Avoids getting locked into a single device's built‑in biometric or security hardware.
You can also enable device‑specific options like Touch ID/Face ID on trusted devices. Remember:
* Some factors (for example, platform biometrics and certain security keys) are **device‑specific** and will not automatically work on another computer.
* The **remember this device** or **keep me signed in** behavior only applies to the specific device and browser where you chose it, and for a limited period of time.
For more details on factor types and timeouts, see [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA).
## Email Authentication
### If I choose to use Email Authentication, do I have to use the email address associated with my Elation account?
Yes, when using the Email Authentication option for multi-factor authentication, the email account must be the email address you use to log in to your Elation account.
To use a different email for Email Authentication, update your login email address from your Account Details Settings page in Elation first.
### Why am I unable to set up Email Authentication from my Elation Settings?
Email Authentication is deemed as the least secure authentication method; therefore, we want you to set up a more secure authentication factor when possible. However, if Email Authentication is the only authentication factor you can use, log out of your Elation account and you'll be able to set up Email Authentication from the login screen.
### I am setting up Email Authentication but I have not received the email with my Verification Code, what should I do?
The Verification Code can take a few minutes to arrive in your email inbox. If you've waited a few minutes and still do not see the email with the Verification Code, click Send again on the verify screen in Elation to prompt Elation to email the code to you again. If you continue to not receive the email, [click here](https://app.elationemr.com/support/) to contact the Support Team.
## Login Behavior and Sessions
### Why is Elation automatically logging me out even when I checked the 24 hour box?
MFA login must still comply with your device's and browser's security as well as Elation's timeout policy.
* The 24-hour MFA bypass is tied to **both your device and the browser** that was in use at the time you signed in.
* If log in from a different device, switch browsers, or use an incognito/private window, Elation will ask for your MFA again for security reasons- **even if the 24-hour box was checked.**
* The bypass does not override Elation's **session timeout policy**.
* If you are logged out due to inactivity (the standard timeout is 2 hours), you will be asked to re-authenticate when logging back in- **even if the 24-hour box was checked.**
For higher‑risk workflows (e.g., multiple staff working on the same visit note, stepping away from computer, etc.), it's still best practice to explicitly click Save as Draft & Close in your visit note to reduce any chance of data conflicts or loss.
### How often do I have to re-authenticate when using multi-factor authentication to log in?
By default, you are required to re-authenticate each time you log in. Check off the Do not challenge me on this device for the next 24 hours box if you want to bypass multi-factor authentication while logging in and out of Elation for the next 24 hours for that browser and device.
If your account is logged out due to inactivity, you'll need to re-authenticate unless you previously chose to skip authentication for 24 hours and that time hasn't fully elapsed.
### Will multi-factor authentication still allow me to be logged in to multiple places at the same time?
Yes, you can still be logged in to multiple places at the same time.
### Will I need to use my authentication factor when logging in to Elation Go (Elation's mobile application)?
Yes, you will need to use your authentication factor when logging in to Elation Go. This is great use case for setting up multiple authentication factors, especially if you are using a Security Key or Biometric Authenticator when logging in through your computer - these will not work on your phone. Setting up an additional authentication factor like Google Authenticator will allow you to login to Elation Go on your phone.
## Scribes, SSO, and Shared Accounts
### My scribe needs to login to complete my visit notes daily. How do I give them access to my authentication factor?
You cannot share accounts while using multi-factor authentication. It's important to highlight that shared, or generic, user accounts or passwords are strictly prohibited by [Elation's Terms of Use](https://www.elationhealth.com/terms-of-use/) and security policies. Individuals who use the EHR must log in using their own, unique account.
### My scribe can't log in. How should we set up MFA for scribes?
Each person who documents or works in Elation must use **their own user account** with their own MFA factors. Shared logins are not permitted for security and compliance reasons.
#### Recommended pattern
* Scribes should have staff-level accounts tied to the supervising clinician, with appropriate permissions configured by a practice admin. For more about provider vs staff capabilities, see [Provider vs staff level account privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges).
* Scribes set up MFA on their own accounts, just like any other user.
#### If a scribe cannot log in
| 1 | Verify credentials - Confirm they are using **their own username and password** , not the clinician's. |
| - | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Admin assistance - Ask the practice admin to: Confirm that the staff account is active (not disabled), and • Reset the user's MFA from Settings → Manage Accounts if needed. |
| 3 | Contact Support - If your practice has no active admin or your admin cannot perform these steps, contact Elation Support. |
For additional security guidance, see [Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure).
### Can I use the single sign-on feature with multi-factor authentication?
If your organization uses its own single sign-on (SSO) provider to access Elation, all the security—like checking your password and asking for a verification code—is already handled by your company. As a result, you will not be required to use Elation's built-in MFA feature.
Learn more about the Single Sign-On feature through our [User Accounts Guide – Using Single Sign-On to access your Elation EHR account](/articles/single-sign-on) Help Center article.
## Patient Passport
### Will patients need to use multi-factor authentication for their Patient Passport account?
No, patients will not need to use multi-factor authentication for their Patient Passport account.
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
* [Multi-Factor Authentication - Updating authentication factors](/articles/Updating-authentication-factors-for-MFA)
* [Multi-Factor Authentication - Resetting authentication factors](/articles/Resetting-authentication-factors-for-MFA)
* [Multi-Factor Authentication - Quick Start Guide](/articles/Multi-Factor-Authentication-Quick-Start-Guide)
* [Provider vs staff level account privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges)
* [Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure)
# Multi-Factor Authentication Guide - Changing authentication factors
Source: https://help.elationhealth.com/articles/Multi-Factor-Authentication-Guide-Changing-authentication-factors
This article walks you through switching from one authentication factor to a different authentication factor for multi-factor authentication.
## Overview
Sometimes you may need to switch from one authentication factor (e.g. Email) to another authentication factor (e.g. Authenticator App) for more convenience. Follow the instructions in this article to complete the switch seamlessly.
## Workflow Instructions
### Switching to an Authenticator App
| **1** | Sign in to Elation. If you're unable to sign in, ask an Admin Level User to reset your authentication factors. Afterwards you can proceed to **Step #5** to setup an Authenticator App. |
| ------ | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Account Details** -> **Edit factors** . |
| **3** | Click **Remove** next to the authentications factor you wish to remove (e.g. Email Authentication). |
| **4** | Click **Delete** to confirm removal. |
| **5** | Click **Setup** next to Authenticator App. |
| **6** | Select your device type by clicking either **iPhone** or **Android** . |
| **7** | Click **Next** . A QR Code will appear. Keep this screen on and QR code visible for the next step. |
| **8** | **(As needed)** Install/download the Google Authenticator app on your mobile device if you do not have the app yet. Proceed to step #9 if you already have the app installed. Install via the App Store if you are using an iPhone. • Install via the Google Play Store if you are using an Android device. |
| **9** | Link your Elation account to the Google Authenticator app by using your device’s camera to scan the QR Code on your Elation screen. Open the Google Authenticator app on your mobile device. • Press **Get started**. • Specify if you want to use Google Authenticator with your Google account or without an account. • Press the **+** button at the bottom right of the Google Authenticator app to add a new software application. • Press **Scan a QR Code** and then point your device’s camera at the QR Code that appears in Elation to scan it. • Your Elation account will now appear in Google Authenticator. • Go back to your Elation screen and click **Next**. • In the **Enter Code** box on your Elation screen, enter the **6 digit number** from your Google Authenticator app and then click **Verify**. |
| **10** | You have successfully set up Google Authenticator for multi-factor authentication. |
### Switching to Okta Verify
| **1** | Sign in to Elation. If you're unable to sign in, ask an Admin Level User to reset your authentication factors. Afterwards you can proceed to **Step #5** to setup Okta Verify. |
| ------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Account Details** -> **Edit factors** . |
| **3** | Click **Remove** next to the authentications factor you wish to remove (e.g. Email Authentication). |
| **4** | Click **Delete** to confirm removal. |
| **5** | Click **Setup** next to Okta Verify. |
| **6** | Select your device type by clicking either **iPhone** or **Android** . |
| **7** | Click **Next** . A QR Code will appear. Keep this screen on and QR code visible for the next step. |
| **8** | **(As needed)** Install/download the Okta Verify app on your mobile device if you do not have the app yet. Proceed to **Step #9** if you already have the app installed. Install via the App Store if you are using an iPhone. • Install via the Google Play Store if you are using an Android device. |
| **9** | Link your Elation account to the Okta Verify app by using your device’s camera to scan the QR Code on your Elation screen. Open the Okta Verify app on your mobile device. • Press **Add Account** in your Okta Verify app. • Press **Other**. • Press **Scan QR Code** and then point your device’s camera at the QR Code that appears in Elation to scan it. • You will see a confirmation on your screen that says **Account Added**. Click **Done** to close the notification. |
| **10** | You have successfully set up Okta Verify for multi-factor authentication. |
### Switching to a Security Key or Biometric Authenticator
| **1** | Sign in to Elation. If you're unable to sign in, ask an Admin Level User to reset your authentication factors. Afterwards you can proceed to **Step #5** to setup a Security Key or Biometrics Authenticator. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Account Details** -> **Edit factors** . |
| **3** | Click **Remove** next to the authentications factor you wish to remove (e.g. Email Authentication). |
| **4** | Click **Delete** to confirm removal. |
| **5** | Click **Setup** next to Security Key or Biometric Authenticator. |
| **6** | Click **Activate** . |
| **7** | Follow the on-screen prompts to set up a Security Key or Biometric Authenticator. |
Detailed instructions are unavailable for this setup process as the exact workflows depend on your browser, enabled browser extensions, your computer’s operating system, and/or available hardware keys. For this reason, Elation will not be able to troubleshoot issues around this authentication factor. Only select this authentication option if you are familiar with this type of authentication factor and are comfortable resolving potential issues on your own.
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication Guide - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
# Multi-Factor Authentication Guide - Quick Start Guide
Source: https://help.elationhealth.com/articles/Multi-Factor-Authentication-Quick-Start-Guide
Click here for a breakdown of the different chapters in this video.
* 00:06 - Who needs MFA?
* 00:25 - MFA Overview
* 01:05 - Login Workflow
* 02:47 - Roles & Responsibilities
* 03:55 - Comparison of Authentication Factors
* 05:06 - Setup from Settings
* 05:46 - Setup From Login Screen
## What is Elation's multi-factor authentication (MFA) feature?
Elation's multi-factor authentication feature requires all users to enter their login email address and password as the first authentication method and at least one additional authentication factor in order to access their Elation EHR account.
To comply with proposed cybersecurity guidelines from the U.S. Department of Health and Human Services, follow security best practices, address the growing threat of cyber attacks and protect your patient’s data, Elation requires all users to use either multi-factor authentication or [single sign-on](/articles/single-sign-on).
## What are the benefits of using multi-factor authentication with Elation?
Multi-factor authentication significantly lowers the risk of unauthorized access to sensitive patient data, supporting ongoing HIPAA compliance. Multi-factor authentication helps prevent cyber attackers from accessing your account by requiring both your login credentials and a verification factor—something they are unlikely to have, even during phishing attempts.
## Who does what for multi-factor authentication?
Here’s how responsibilities are shared when it comes to multi-factor authentication at your practice:
| **Everyone** | **Admin Level Users** |
| --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Each user** must set up their own authentication factor(s) under their Account Settings. Set up **multiple authentication methods** even though only one is required. • Choose the authentication methods you are most familiar with that are most suitable for your workflows. | **Admin Level Users** can maintain the use of multi-factor authentication for the entire practice by resetting authentication factors for users who are logged out. If an Admin Level User is unavailable, contact Elation. |
## Comparing authentication factors
Choose from four types of authentication factors for multi-factor authentication. While only one is required, we recommend setting up **multiple** options so you have a backup if one becomes unavailable.
| **Authentication Factor** | **Verification Method** | **Use Case** | **Additional Considerations** |
| ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Authenticator App** (i.e. Google Authenticator, Windows Authenticator, Authy, etc.). [Click here for additional examples](/articles/Multifactor-Authentication-MFA#authenticator_apps). | Enter a code that is generated from a mobile app. | You always carry a mobile device (e.g. your phone) with you. • You share computers with other users in your practice. | **Default option for most.** • You must have a smart phone or tablet. • You can be locked out if your phone is lost or misplaced. • Can be used across devices. |
| **Okta Verify** | Enter a code that is generated from the Okta Verify mobile app **OR** send a push notification to the Okta Verify mobile app. | You always carry a mobile device (e.g. your phone) with you. • You share computers with other users in your practice. | You must have a smart phone or tablet. • You can be locked out if your phone is lost or misplaced. • Can be used across devices. • Ideal option if your company/business uses Okta to manage the accounts you have access to. |
| **Security Key or Biometric Authenticator** (i.e. password manager, Touch ID, Face ID, Windows Hello, etc.) [Click here for additional examples](/articles/Multifactor-Authentication-MFA#Security_Keys_Biometric_Authenticators). | Use a key stored on your computer/laptop **OR** a biometrics reader that is connected to your computer/laptop. | You access Elation on a single, personal device. | Not suitable if you are working in multiple environments (e.g. home & office) on different devices. • Can be more complex to set up. **Recommendation**: Set up an additional authentication factor in case you need to access Elation on a different device. |
| **Email Authentication** | Enter a code sent to your login email address. | You are unable to use other authentication factors. | **Least secure.** • You can only set up Email Authentication when setting up authentication factors for the **first time** through the login screen workflow. • If you are using Email Authentication as a backup, set up Email Authentication first. • Verification code email can be blocked by IT or spam filters. |
## Setting up your own authentication factors
Each user in the practice should set up their own authentication factors. [Click here for step by step instructions](/articles/Setting-up-authentication-factors-for-MFA).
## Signing in with multi-factor authentication
With multi-factor authentication, each time you log in to your Elation EHR account, you will be prompted to enter your login email address, password, and your authentication factor before you are granted access to your account.
* If you have multiple authentication factors, click the ⏷ button to select the authentication factor you want to use.
* Check off the **Do not challenge me on this device for the next 24 hours** box on the authentication screen if you want to bypass multi-factor authentication while logging in and out of Elation for the next 24 hours for that browser and device.
![Elation MFA login screen showing the dropdown to select an authentication factor, with the "Do not challenge me on this device for the next 24 hours" checkbox highlighted.]()
[Click here for more information about signing in](/articles/Multifactor-Authentication-MFA#signing_in_with_MFA).
## Resetting authentication factors (if locked out)
If you find yourself locked out, **ask an Admin Level User in your practice to reset your authentication factors for you** by clicking **Reset Multi-factor** next to your name in the [Manage Accounts](https://app.elationemr.com/settings/allaccounts/) settings page. If you are the sole administrator of an Elation practice, [click here](https://app.elationemr.com/support/) to contact the Support Team. We will send you an email to verify your identity and reset your authentication factor(s) on your behalf.
![Manage Accounts settings page showing Active Users list with "Reset Multi-factor" buttons highlighted next to user names Keith Smith, MD and Alie Hera, MD.]()
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication Guide - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Updating authentication factors](/articles/Updating-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Resetting authentication factors](/articles/Resetting-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Frequently Asked Questions](/articles/Multi-Factor-Authentication-FAQ)
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
* [User Accounts Guide- Using Single-Sign On to access your Elation EHR account](/articles/single-sign-on)
# Multi-Factor Authentication Introduction
Source: https://help.elationhealth.com/articles/Multifactor-Authentication-MFA
This article will describe how to use Elation's multi-factor authentication (MFA) feature to ensure higher security over your patient's data.
**REQUIREMENT** All Elation EHR users are **required** to use multi-factor authentication for security and compliance purposes.
## Overview
### What is multi-factor authentication (MFA)?
Multi-factor authentication (MFA) is a security process that requires two or more verification methods to access an application or online account.
Elation's multi-factor authentication feature requires all users to enter their login email address and password as the first authentication method and at least one additional authentication factor in order to access their Elation EHR account.
**FOR PRACTICE ADMINS** You are the first line of support for MFA and login issues at your organization. From Settings → Manage Accounts , you can unlock accounts and reset multi-factor authentication for your users. Contact Elation Support only if your practice has no active admin or an admin cannot access Manage Accounts .
### What are the benefits of using multi-factor authentication with Elation?
Multi-factor authentication significantly lowers the risk of unauthorized accessto sensitive patient data, supporting ongoing HIPAA compliance. Multi-factor authentication helps prevent cyber attackers from accessing your account by requiring both your login credentials and a verification factor—something they are unlikely to have, even during phishing attempts.
### Which authentication factors are available for Elation?
There are currently 4 authentication factors you can use. Choose the authentication factor that is most suitable for your workflows. You are only required to set-up one of these, but we recommend setting up additional factors. This way you have a back up in case one becomes compromised or you run into issues using one of your authentication factors.
| Authentication Factor | Verification Method | Use Case | Additional Considerations |
| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Authenticator App (i.e. Google Authenticator, Windows Authenticator, Authy, etc.). [Click here for additional examples](#authenticator_apps). | Enter a code that is generated from a mobile app. | • You always carry a mobile device (e.g. your phone) with you. • You share computers with other users in your practice. | Default option for most. • You must have a smart phone or tablet. • You can be locked out if your phone is lost or misplaced. • Can be used across devices. |
| Okta Verify | Enter a code that is generated from the Okta Verify mobile app OR send a push notification to the Okta Verify mobile app. | • You always carry a mobile device (e.g. your phone) with you. • You share computers with other users in your practice. | • You must have a smart phone or tablet. • You can be locked out if your phone is lost or misplaced. • Can be used across devices. • Ideal option if your company/business uses Okta to manage the accounts you have access to. |
| Security Key or Biometric Authenticator (i.e. password manager, Touch ID, Face ID, Windows Hello, etc.) [Click here for additional examples](#Security_Keys_Biometric_Authenticators). | Use a key stored on your computer/laptop OR a biometrics reader that is connected to your computer/laptop. | You access Elation on a single, personal device. | • Not suitable if you are working in multiple environments (e.g. home & office) on different devices. • Can be more complex to set up. Recommendation : Set up an additional authentication factor in case you need to access Elation on a different device. |
| Email Authentication | Enter a code sent to your login email address. | You are unable to use other authentication factors. | Not recommended. Least secure. • You can only set up Email Authentication when setting up authentication factors for the **first time** through the login screen workflow. • If you are using Email Authentication as a backup, set up Email Authentication first. • You will be unable to login if the verification code email is blocked by your IT or spam filters. |
SMS or phone calls are not supported by Elation due to known vulnerabilities (e.g. SIM Swapping & phishing).
For guidance on shared logins and protecting your devices, see [Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure).
## Set-up
### Enabling multi-factor authentication for the practice
Multi-factor authentication is automatically enabled for every practice.
### Setting up authentication factors
[Click here for instructions on how to set up authentication factors](/articles/Setting-up-authentication-factors-for-MFA).
## Workflow Instructions
You cannot share accounts while using multi-factor authentication. Shared, or generic, user accounts or passwords are strictly prohibited by [Elation's Terms of Use](https://www.elationhealth.com/terms-of-use/) and security policies. Individuals who use the EHR must log in using their own, unique account.
### Signing in with multi-factor authentication
With multi-factor authentication, each time you log in to your Elation EHR account, you will be prompted to enter your login email address, password, and your authentication factor before you are granted access to your account.
* If you have multiple authentication factors, click the ⏷ button to select the authentication factor you want to use.
* Check off the Do not challenge me on this device for the next 24 hours box on the authentication screen if you want to bypass multi-factor authentication while logging in and out of Elation for the next 24 hours in that browser and device.
![Elation MFA login screen showing the authentication factor dropdown expanded with "Security Key or Biometric Authenticator" and "Google Authenticator" options, and the "Do not challenge me on this device for the next 24 hours" checkbox highlighted.]()
| Authenticator App \* If you use an authenticator app other than Google Authenticator, you can still enter its code when prompted for a Google Authenticator code during login. | • Enter your Elation login email address and password and then click Sign In. • Enter the 6 digit number that appears on your Google Authenticator app in the Enter Code field. • Click Verify to complete authentication and proceed to the Practice Home. |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Okta Verify | • Enter your Elation login email address and password and then click Sign In. • Click Send Push to send a notification to your Okta Verify app for you to confirm your identity. • If the Okta Verify app shows a number matching prompt, select the number that matches the one shown on your Elation sign-in screen instead of simply tapping Yes, It's Me. • Alternatively click Or enter code to enter the 6 digit number that appears on your Okta Verify app in the Enter Code field. • Click Verify to complete authentication and proceed to the Practice Home. |
| Security Key or Biometrics Authentication | • Enter your Elation login email address and password and then click Sign In. • Follow the prompts on your screen to verify your identity and proceed to the Practice Home. Examples: |
| Email | • Enter your Elation login email address and password and then click Sign In. • Click Send me a code. Elation will send a verification code to the email address you use to log in to Elation. • Look for an email with the subject line One-time verification code. • Enter the 6 digit number from the email into the Verification code box. • Click Verify to complete authentication and proceed to the Practice Home. |
### Updating authentication factors
[Click here for instructions on updating authentication factors](/articles/Updating-authentication-factors-for-MFA).
### Resetting authentication factors (if locked out)
[Click here for instructions on resetting authentication factors if you are locked out of Elation](/articles/Resetting-authentication-factors-for-MFA).
## Frequently Asked Questions (FAQ)
[Click here for answers to common MFA questions—including troubleshooting login issues, choosing authentication factors, and more—see our dedicated](/articles/Multi-Factor-Authentication-FAQ).
## Related Articles
* [Multi-Factor Authentication Guide - Frequently Asked Questions](/articles/Multi-Factor-Authentication-FAQ)
* [Multi-Factor Authentication Guide - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Updating authentication factors](/articles/Updating-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Resetting authentication factors](/articles/Resetting-authentication-factors-for-MFA)
* [Multi-Factor Authentication - Quick Start Guide](/articles/Multi-Factor-Authentication-Quick-Start-Guide)
* [User Accounts Guide – Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
* [User Accounts Guide – Using Single Sign-On to access your Elation EHR account](/articles/single-sign-on)
# Nebraska State- NEIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Nebraska-State-NEIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Nebraska State Immunization Registry [NEIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Nebraska Immunization Information System (NEIIS).
## What is the NEIIS Immunization Registry Interface?
The NEIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to NEIIS; the Nebraska Immunization Information System. Practices can also query NEIIS for vaccination history or forecast.
## Why is the NEIIS Immunization Registry Interface valuable?
With the NEIIS Immunization Registry Interface, practices no longer need to separately log in to NEIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NEIIS. You can also pull vaccination history for specific patients from NEIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NEIIS
The Elation Team will assist you with initiating interface with NEIIS. To notify us of your interest, please
[click here to fill out our contact form](https://help.elationemr.com/s/contactsupport)
, select **Immunization Registry** as the
*Request Type*
, and send the following information to Elation:
1. Is your practice currently active and registered in NEIIS? If so, what is your NEIIS ORG ID?
2. Is your practice currently submitting or has your practice previously submitted data to NEIIS through another EHR?
## How to submit vaccination data to NEIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit the data to NEIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using NEIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
*'*
[Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Nevada State- NV WebIZ- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Nevada-State-NV-WebIZ-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to Nevada’s Statewide Immunization Information System [NV WebIZ] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Nevada’s Statewide Immunization Information System (NV WebIZ).
## What is the NV WebIZ Immunization Registry Interface?
The NV WebIZ Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to NV WebIZ, Nevada’s Statewide Immunization Information System. Practices can also query NV WebIZ for vaccination history or forecast.
## Why is the NV WebIZ Immunization Registry Interface valuable?
With the NV WebIZ Immunization Registry Interface, practices no longer need to separately log in to NV WebIZ to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NV WebIZ. You can also pull vaccination history for specific patients from NV WebIZ to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NV WebIZ
In order to utilize the NV WebIZ interface, your practice must administer vaccines. You will not be able to use the interface to only query for immunization data.
The Elation Team will assist you with initiating interface with NV WebIZ. To notify us of your interest please complete [this form for NV WebIZ](/files/immunization-nv-webiz-form.pdf), then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the \*\*Request Type \*\* and send the following information to Elation. A member of the Elation team will collect the completed NV WebIZ form from you.
1. Is your practice already enrolled with Nevada WebIZ? (i.e. Your practice can log in to the immunization registry and submit immunizations.)
2. How many practice locations administer vaccines? If more than one, please provide the name of each location.
3. What is the estimated number of vaccines your practice gives annually?
4. Who is the point of contact for your practice for the immunization registry?
5. Does your practice need to register your intent to electronically submit data for Meaningful Use (i.e. for MIPS)? If so, which providers at your practice need to register their intent?
## How to submit vaccination data to NV WebIZ using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to NV WebIZ. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
Patients must consent to sharing their Personally Identifiable Information (PII) in order for you to electronically send their vaccination information to NV WebIZ. You can document the patient's consent by selecting the ' **Yes, patient consents to sharing their PII with the registry** ' option for the question **Patient consents to sharing Personally Identifiable Information?** .
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using NV WebIZ
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Immunization Registry Interface Introduction](/articles/Immunization-Registry-Interface-Introduction)
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# New Hampshire - NHIIS - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/New-Hampshire-NHIIS-Immunization-Registry-Interface-User-Guide
This article describes how you can submit vaccination data to the New Hampshire Immunization Information System [NHIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the New Hampshire State Immunization Registry known as NHIIS.
## What is the NHIIS Immunization Registry Interface?
The NHIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to NHIIS, the New Hampshire Immunization Information System. Practices can also query NHIIS for vaccination history or forecast.
## Why is the NHIIS Immunization Registry Interface valuable?
With the NHIIS Immunization Registry Interface, practices no longer need to separately log in to NHIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NHIIS. You can also pull vaccination history for specific patients from NHIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NHIIS
The Elation Team will assist you with initiating an interface with NHIIS. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry would you like to connect to?
* Does your practice participate in Vaccines for Children (VFC)? If so, what is your VFC pin?
* Does your practice serve pediatrics and adolescents only (0-18 years) only, adults only (18+ years), or all ages?
* What are the average number of administered vaccines per year for each group?
* Who is the primary practice decision maker and who is the primary point of contact for onboarding?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to NHIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to NHIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
In order to submit vaccination data to NHIIS, the following details are required for patients and vaccines: Store the **Race** and **Ethnicity** for ALL patients in their [Patient Demographics](/articles/Patient-Demographics-Guide).
Store the **Emergency Contact** information in the [Patient Demographics](/articles/Patient-Demographics-Guide) for patients 18 years and younger.
Type the **Unit of sale** NDC (rather than “unit of use” NDC) in the **NDC #** field of the Vaccination Form.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using NHIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# New Jersey - NJIIS - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/New-Jersey-NJIIS-Immunization-Registry-Interface-User-Guide
This article describes how you can submit vaccination data to the New Jersey Immunization Information System [NJIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the New Jersey State Immunization Registry known as NJIIS.
## What is the NJIIS Immunization Registry Interface?
The NJIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to NJIIS, the New Jersey Immunization Information System. Practices can also query NJIIS for vaccination history or forecast.
## Why is the NJIIS Immunization Registry Interface valuable?
With the NJIIS Immunization Registry Interface, practices no longer need to separately log in to NJIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NJIIS. You can also pull vaccination history for specific patients from NJIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NJIIS
The Elation Team will assist you with initiating an interface with NJIIS. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry would you like to connect to?
* Are you currently enrolled in NJIIS (i.e. do you have a login to NJIIS)
* What is your NJIIS facility ID?
* Do you participate in VFC (Vaccines for Children)? If so, what is your VFC PIN?
* What is your Tax ID?
* What County and Municipality is your practice in?
* What is the approximate number of vaccines administered in your practice per year? Please do not overestimate because NJIIS will require you to submit a corresponding number of vaccinations during the testing period. If you overestimate, it will be difficult to meet testing requirements.
* What is the approximate number of patients under 7 seen at your practice?
* Who is the main contact at your practice to set up this interface?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to NJIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to NJIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using NJIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# New Mexico State- NMSIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/New-Mexico-State-NMSIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the New Mexico Immunization Information System [NMSIIS] directly within Elation.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the New Mexico State Immunization Registry known as NMSIIS.
## What is the NMSIIS Immunization Registry Interface?
The NMSIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to NMSIIS; the New Mexico State Immunization Information System. Practices can also query NMSIIS for vaccination history or forecast.
## Why is the NMSIIS Immunization Registry Interface valuable?
With the NMSIIS Immunization Registry Interface, practices no longer need to separately log in to NMSIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NMSIIS. You can also pull vaccination history for specific patients from NMSIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NMSIIS
The Elation Team will assist you with initiating interface with NMSIIS. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry would you like to connect to?
* Do you participate in Medicare?
* Do you participate in Medicaid?
* Are you an ED/HIDD or Birth Defect provider?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm you contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to NMSIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to NMSIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ASIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# New York City- CIR- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/New-York-City-CIR-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the New York City Immunization Registry [CIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the New York City Immunization Registry (CIR).
## What is the CIR Immunization Registry Interface?
The CIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to CIR, the New York City Immunization Registry. Practices can also query CIR for vaccination history or forecast.
## Why is the CIR Immunization Registry Interface valuable?
With the CIR Immunization Registry Interface, practices no longer need to separately log in to CIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to CIR. You can also pull vaccination history for specific patients from CIR to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & CIR
The Elation Team will assist you with initiating an interface with WyIR. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/).
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**.
4. Enter the following information in the **Details** field:
* Which Immunization Registry do you want to connect to?
* What CIR facility code(s) or PIN(s) has CIR provided to your organization?
* You may search for your organization's CIR facility code(s) by logging into the CIR facility manager system here: CIR Facility Registration and Management. If this facility does not have a CIR facility code, please enroll the site in the facility manager system.
* CIR facility codes may be in this format ####A## or #####A##.
* CIR PINs may be four-digit code (####) or AA###
* How many facilities are in your organization that administer vaccinations? For each facility, please provide the following information:
* Point of contact name, title, email, and phone number
* Facility CIR code
* Address
* Age range of patients receiving vaccinations (min to max age in years)
* Is this site enrolled in Vaccines for Children (VFC)?
* Funding type for the vaccine stock: 0-18 year old Public, 19+ Public, and/or Private
* Type of vaccines administered: Childhood and adult vaccines, travel vaccine, influenza vaccine, COVID-19 vaccine, and/or Mpox vaccine
* Average weekly volume of vaccines administered (excluding flu and COVID-19)
* Does this facility have a CIR web portal account?
* Does this site use CIR to manage vaccine inventory? If yes, which vaccine inventory is managed in CIR?: 0-18 year Public, 19+ Public, and/or Private
* Does your practice already have a live CIR interface with another EHR?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Print & fill out [this Confidentiality Statement](/files/immunization-nyc-cir-confidentiality.pdf) & then click **Add Attachment** to share the completed file with us.
8. Click **Next**.
9. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to CIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to CIR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
Parent recall historical vaccinations are not accepted by CIR.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ASIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
### Can I send immunization information electronically to NYSIIS (New York State Immunization Information System)?
Yes, please review the
[New York State- NYSIIS- Immunization Registry Interface User Guide](/articles/New-York-State-NYSIIS-Immunization-Registry-Interface-User-Guide)
for more information about sending immunization information to NYSIIS. The NYSIIS interface is different from the CIR interface.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# New York State- NYSIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/New-York-State-NYSIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the New York State Immunization Information System [NYSIIS] directly within Elation.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the New York State Immunization Registry known as NYSIIS.
## What is the NYSIIS Immunization Registry Interface?
The NYSIIS Immunization Registry Interface allows connected practices to
**send**
vaccination information from their Elation EHR directly to NYSIIS; the New York State Immunization Information System.
## Why is the NYSIIS Immunization Registry Interface valuable?
With the NYSIIS Immunization Registry Interface, practices no longer need to separately log in to NYSIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NYSIIS. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NYSIIS
The Elation Team will assist you with initiating interface with NYSIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**.
## How to submit vaccination data to NYSIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to NYSIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## Frequently Asked Questions (FAQ)
### Can I retrieve immunization history from NYSIIS in Elation?
You can only send vaccination history from Elation to NYSIIS using this current interface. In the future Elation will work with NYSIIS to also allow you to retrieve immunization history from NYSIIS.
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### Can I send immunization information electronically to CIR (New York City Immunization Registry)?
Yes, please review the
[New York City- CIR- Immunization Registry Interface User Guide](/articles/New-York-City-CIR-Immunization-Registry-Interface-User-Guide)
for more information about sending immunization information to CIR. The CIR interface is different from the NYSIIS interface.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# North Carolina State- NCIR- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/North-Carolina-State-NCIR-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the North Carolina State Immunization Registry [NCIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the North Carolina State State Immunization Registry known as NCIR.
## What is the NCIR Immunization Registry Interface?
The NCIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to NCIR, the North Carolina State Immunization Registry. Practices can also query NCIR for vaccination history or forecast.
## Why is the NCIR Immunization Registry Interface valuable?
With the NCIR Immunization Registry Interface, practices no longer need to separately log in to NCIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NCIR. You can also pull vaccination history for specific patients from NCIR to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NCIR
The Elation Team will assist you with initiating interface with NCIR. To begin the process, you will need to
1. Register for intent with NCIR.
2. Complete an NCIR Provider Agreement. [Click here](/files/immunization-nc-ncir-agreement.pdf) to download a copy of the agreement.
To register for intent with NCIR, login to your NCIR account by [clicking here](https://idpprod.nc.gov:8443/nidp/idff/sso?id=6\&sid=0\&option=credential\&sid=0\&target=https%3A%2F%2Fncid.nc.gov%2FLAGBroker%3F%2522https%3A%2F%2Fncdphmeaningfuluse.org%2Fmup%2Fpublic%2Flogin.action%2522) and then clicking **Start Registration**. [Click here](https://ncdphmeaningfuluse.org/NC_RegistrationofIntent_UserGuide.pdf) to view a guide on how to register for intent on the NCIR website. Use the information below to fill out the registration- answers are in italics:
* Please select the EHR Vendor for this provider: *Other*
* Other Vendor: *Elation Health*
* Product name: *ElationEMR*
* Software version: *3*
* Is your EHR capable of sending 2.5.1 transactions?: *Yes*
* Which of the following interfaces are you planning to implement?: *Update transaction (HL7 2.5 VXU/ACK)*
* Does your EHR support real-time messaging using web services?: *Yes*
* Do you have a hub through which all your organizations will send data, so that a single connection can be made to NCIR?: *Yes*
* Do you have a test environment?: *Yes*
* Please provide the name of the person who will be the primary contact for addressing errors/rejects in HL7 messages: *[escalations@elationhealth.com](mailto:escalations@elationhealth.com)*
* Are you planning to connect directly with the NCIR or go through the NC HIE?: **Direct**
* How adaptable is the software being used? are you able to change aspects of the software for NCIR requirements, if needed?: *Yes*
* Is your EHR capable of creating VXU 2.5.1 messages?: *Yes*
* Is your EHR capable of accepting and processing ACK HL7 2.5.1 messages?: *Yes*
* Is your EHR capable of creating 2.5.1 QBP messages and accept resulting RSP messages?: *No*
* How does your application handle reporting errors/warnings (ACKs returned in response to VXU)?: *Regularly reviews and investigates ACK errors*
Once you have completed the two steps above, [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**. A member of the Elation team will collect the completed NCIR Provider Agreement from you.
## How to submit vaccination data to NCIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to NCIR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using NCIR
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# North Dakota State- NDIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/North-Dakota-State-NDIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the North Dakota State Immunization Registry [NDIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the North Dakota Immunization Information System (NDIIS).
## What is the NDIIS Immunization Registry Interface?
The NDIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to NDIIS, the North Dakota Immunization Information System. Practices can also query NDIIS for vaccination history or forecast.
## Why is the NDIIS Immunization Registry Interface valuable?
With the NDIIS Immunization Registry Interface, practices no longer need to separately log in to NDIIS to enter vaccination records for their patients. Once the vaccination is recorded in NDIIS during the patient encounter, the information can be sent immediately from the patient's chart in Elation to NDIIS. You can also pull vaccination history for specific patients from NDIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & NDIIS
The Elation Team will assist you with initiating interface with NDIIS. To notify us of your interest, please follow the instructions below:
1. Complete [this form for NDIIS](/files/immunization-nd-ndiis-form.pdf)
2. [Click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation. Afterwards, a member of the Elation team will collect the completed NDIIS form from you.
* Does your practice participate in MIPS?
* Does your practice administer vaccines?
* If so, does your practice administer vaccines purchased through public programs (e.g. Vaccines for Children \[VFC])?
* If so, does your practice administer vaccines purchased with private funds (e.g. purchased directly by your practice)?
* Who is the main contact at the practice for the NDIIS interface setup?
## How to submit vaccination data to NDIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to NDIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using NDIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Note Assist Introduction (Add-On)
Source: https://help.elationhealth.com/articles/Note-Assist-Guide
This article describes Elation's AI-powered ambient scribing and note-writing solution.
Reference [this Best Practice Recommendations Guide](/articles/Note-Assist-Guide-Best-Practice-Recommendations) if you are looking for quick start up tips.
## Overview
### What is Note Assist?
Note Assist is Elation’s leading ambient scribe clinical documentation tool. It’s built right into your workflow and automatically turns your conversation with the patient into a structured, detailed visit note.
Note Assist listens to your visit and generates a comprehensive visit note in a single pass immediately following the patient encounter, organizing the content just like you would.
### What are the benefits of using Note Assist?
Note Assist helps you spend more time delivering personalized patient care by creating visit notes from your conversations with patients—no extra setup, software, or copying and pasting is needed. It works with Visit Note Templates and uses details from the patient’s chart, like existing patient problems, pronouns or other clinical details, to create more personalized, accurate notes.
Note Assist also tracks the action items you want your patient to complete after their visit, creating a real-time checklist so you can quickly take the necessary steps to carry out those actions or orders in their Care Plan.
With [custom instructions](/articles/Note-Assist-Guide-Preparation#setting-up-custom-instructions), you can tailor how Note Assist writes each section of your visit note to match your documentation style, reducing post-visit editing and helping you finish charts faster.
**To help you reclaim time for patient care, your Elation subscription includes 10 AI-generated Note Assist notes each month.** Seamlessly integrated into the EHR, this empowers you to accelerate documentation, lighten administrative load, and stay focused on delivering high-quality, personalized care.
## Using your free monthly Note Assist allowance
The free AI-generated notes option will be gradually rolled out to groups of customers until it’s available to everyone.
Every provider-level user has access to create **10 AI-generated Note Assist notes per month — at no cost.** Each time you use Note Assist in a visit note, it counts toward your monthly total, whether the note is signed or deleted.
### When does my free monthly allowance reset?
Your 10 free AI-generated notes reset on the **1st of each calendar month at 12:00 AM UTC**. Any unused notes from the previous month do not carry over — the count resets to 10 regardless of how many you used.
### What counts as a use of Note Assist?
Each time Note Assist generates note content for a visit, it counts as one use toward your monthly allowance. Specifically:
* **Starting a scribe session** and finishing a recording that generates note content counts as one use.
* **Retrying** note generation (clicking the retry button) on the same visit does **not** count as an additional use.
* If you **delete** a visit note draft that used Note Assist, the use still counts — it is not refunded.
* **Editing** the AI-generated text manually after it has been generated does not count as an additional use.
**Ready for more?**
An optional unlimited upgrade is available beyond the 10 free notes per month. If you're interested in upgrading to unlimited AI-generated notes, simply [fill out this form](https://www.elationhealth.com/note-assist-signup/) and we’ll contact you to discuss details and pricing.
## Workflow Instructions
### Preparing to use Note Assist
[Click here for a list of recommended steps to take before using Note Assist](/articles/Note-Assist-Guide-Preparation).
### Using Note Assist for encounter documentation
[Click here for instructions on how to use Note Assist](/articles/Note-Assist-Guide-Using-Note-Assist).
### Applying best practices
[Click here for a list of best practices when using Note Assist](/articles/Note-Assist-Guide-Best-Practice-Recommendations).
## Frequently Asked Questions
[Click here for a list of Frequently Asked Questions about Note Assist](/articles/Note-Assist-Guide-FAQ).
## Related Articles
* [Note Assist Guide - Preparing to use Note Assist](/articles/Note-Assist-Guide-Preparation)
* [Note Assist Guide - Using Note Assist for encounters](/articles/Note-Assist-Guide-Using-Note-Assist)
* [Note Assist Guide - Best Practice Recommendations](/articles/Note-Assist-Guide-Best-Practice-Recommendations)
* [Note Assist Guide - Frequently Asked Questions](/articles/Note-Assist-Guide-FAQ)
* [Note Assist - Early Access Features](/articles/Note-Assist-Guide-Feature-Updates)
* [Note Assist Guide - Microphone Set-up and Troubleshooting](/articles/Note-Assist-microphone)
* [Note Assist Guide - Feature Updates](/articles/Note-Assist-Guide-Feature-Updates)
* [Visit Note Documentation Guide - Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
* [User Accounts Guide - Provider Level Account vs. Staff Level Account Privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges)
# Note Assist Guide - Best Practice Recommendations
Source: https://help.elationhealth.com/articles/Note-Assist-Guide-Best-Practice-Recommendations
This article describes the best practice recommendations when using Note Assist.
## Overview
Curious about where to begin? Need a quick refresher? This article helps you make the most of Note Assist.
## Workflow Instructions
## Preparing to use Note Assist
| **1** | Use a supported browser: **Computer/laptop:** Firefox, Chrome • **Android devices:** Chrome • **iPhones/iPads:** Safari |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Apply the recommended visit note format to your [visit note category defaults](/articles/visit-note-categories#Default). **Best supported formats:** • Partially supported formats: |
| **3** | Document vital signs ahead of the visit as usual by having your support staff, such as Medical Assistants or other clinicians, enter them in advance. |
| **4** | Import Clinical Profile information or apply **Visit Note Templates** to the visit note before using Note Assist. When you import the patient’s problem list into the **HPI** or **Assessment/Plan** sections, Note Assist keeps those diagnoses and adds relevant details from the conversation if it detects those problems. |
### Using Note Assist
| **1** | Create a new visit note and prepare the visit note as you normally would. |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Scribe** at the bottom right of the chart to open Note Assist. |
| **3** | Apply any Visit Note Templates as needed. [Click here for guidance on template creation and examples](/articles/Note-Assist-Guide-Preparation#visit_note_templates). |
| **4** | Allow Note Assist to use a specified microphone connected to your device. [Click here for full instructions on preparing your microphone for recording](/articles/Note-Assist-microphone). |
| **5** | Review your settings to ensure the correct **Language**, **Microphone** and **Personalization** preferences are applied. |
| **6** | Optimize how Note Assist populates your visit note by: Speaking clearly and as close to the microphone as possible. • Narrating vital sign readings to automatically record them in the appropriate **Vitals** fields. • Narrating your physical exams to automatically populate discrete **Physical Exam** fields. • Narrating care plan recommendations explicitly by prefacing those with a statement such as **For your care plan…** followed by the instructions. • Verbalizing your corrections, if any. |
| **7** | Review Care Plan Actions. [Click here for instructions on how to use Care Plan Actions](/articles/Note-Assist-Guide-Using-Note-Assist#Actions). |
Note Assist generates detailed content for most parts of the note, including the **HPI**, **Vitals**, and **Assessment & Plan** (A\&P). If you turn them on in Advanced Settings, it can also fill in the **PE**(Physical Exam), **F/U** (Follow-Up), and **Care Plan** sections. Note Assist currently **does not** fill out the **ROS** (Review of Systems) section.
## Related Articles
* [Note Assist Introduction (Add-On)](/articles/Note-Assist-Guide)
* [Note Assist Guide - Preparing to use Note Assist](/articles/Note-Assist-Guide-Preparation)
* [Note Assist Guide - Using Note Assist for encounters](/articles/Note-Assist-Guide-Using-Note-Assist)
* [Note Assist Guide - Best Practice Recommendations](/articles/Note-Assist-Guide-Best-Practice-Recommendations)
* [Note Assist Guide - Frequently Asked Questions](/articles/Note-Assist-Guide-FAQ)
* [Note Assist Guide - Microphone Set-up and Troubleshooting](/articles/Note-Assist-microphone)
# Note Assist Guide - Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Note-Assist-Guide-FAQ
Find answers to the most frequently asked questions about Note Assist.
## Frequently Asked Questions
* [Access & Consent](#access-&-consent)
* [Who can use Note Assist?](#who-can-use-note-assist)
* [What counts as an AI-generated note?](#what-counts-as-an-ai-generated-note)
* [Why do I only get 10 free AI-generated notes each month?](#why-do-i-only-get-10-free-ai-generated-notes-each-month)
* [When does my free monthly allowance reset?](#when-does-my-free-monthly-allowance-reset)
* [Does retrying, deleting, or editing a note use an additional credit?](#does-retrying-deleting-or-editing-a-note-use-an-additional-credit)
* [Does a new provider automatically get unlimited Note Assist if my practice already upgraded?](#does-a-new-provider-automatically-get-unlimited-note-assist-if-my-practice-already-upgraded)
* [Do I need patient consent to record the visit?](#do-i-need-patient-consent-to-record-the-visit)
* [Feature Functionalities](#feature-functionalities)
* [Can I customize how Note Assist writes my notes?](#can-i-customize-how-note-assist-writes-my-notes)
* [Can I use Note Assist with any web browser?](#can-i-use-note-assist-with-any-web-browser)
* [Can I use Note Assist with all visit note formats?](#can-i-use-note-assist-with-all-visit-note-formats)
* [Why are 2-column visit note formats preferred?](#why-are-2-column-visit-note-formats-preferred)
* [Can I use Note Assist on a draft note with existing content?](#can-i-use-note-assist-on-a-draft-note-with-existing-content)
* [Does using a Visit Note Template help?](#does-using-a-visit-note-template-help)
* [How often does Note Assist update the note?](#how-often-does-note-assist-update-the-note)
* [What happens if I switch to another patient chart without finishing the recording?](#what-happens-if-i-switch-to-another-patient-chart-without-finishing-the-recording)
* [What happens if I close the Note Assist dialog before clicking the Finish Recording button?](#what-happens-if-i-close-the-note-assist-dialog-before-clicking-the-finish-recording-button)
* [Why don't I see the Scribe button?](#why-dont-i-see-the-scribe-button)
* [Is there a time limit for using Note Assist during a visit?](#is-there-a-time-limit-for-using-note-assist-during-a-visit)
* [Does Note Assist require verbal cues to identify sections like the physical exam?](#does-note-assist-require-verbal-cues-to-identify-sections-like-the-physical-exam)
* [Can Note Assist tell the difference between similar terms (e.g. Hypertension vs. Hypotension)?](#can-note-assist-tell-the-difference-between-similar-terms-e-g-hypertension-vs-hypotension)
* [Will chit chat or side conversations be excluded from the visit note?](#will-chit-chat-or-side-conversations-be-excluded-from-the-visit-note)
* [How do I correct mistakes when recording?](#how-do-i-correct-mistakes-when-recording)
* [Does Note Assist add ICD-10 codes to the Assessment or Billing Details of the visit note draft?](#does-note-assist-add-icd-10-codes-to-the-assessment-or-billing-details-of-the-visit-note-draft)
* [Transcriptions](#transcriptions)
* [Is my data being used to train AI models?](#is-my-data-being-used-to-train-ai-models)
* [Is the transcription created in real-time?](#is-the-transcription-created-in-real-time)
* [Can Note Assist translate my conversation with the patient in real time?](#can-note-assist-translate-my-conversation-with-the-patient-in-real-time)
* [How do I access my transcripts?](#how-do-i-access-my-transcripts)
* [How long is the transcript available?](#how-long-is-the-transcript-available)
* [If I amend the visit note, can I still access the transcript of the original Note Assist session?](#if-i-amend-the-visit-note-can-i-still-access-the-transcript-of-the-original-note-assist-session)
* [If I delete and then restore a visit note draft, is the transcript also restored?](#if-i-delete-and-then-restore-a-visit-note-draft-is-the-transcript-also-restored)
* [There's missing information in the Note, what should I do?](#theres-missing-information-in-the-note-what-should-i-do)
* [Can I restore the first version of the Note after clicking retry?](#can-i-restore-the-first-version-of-the-note-after-clicking-retry)
* [Technical Specifications & Usage](#technical-specifications-&-usage)
* [Do the patient and I need to sit close to the microphone?](#do-the-patient-and-i-need-to-sit-close-to-the-microphone)
* [What happens if I lose internet connection while recording?](#what-happens-if-i-lose-internet-connection-while-recording)
* [Can I use Note Assist for telehealth/virtual encounters?](#can-i-use-note-assist-for-telehealth/virtual-encounters)
* [Can I use Note Assist on a mobile device or tablet, if so, do I need to download an application? Which internet browsers are specifically supported on a mobile device/tablet?](#can-i-use-note-assist-on-a-mobile-device-or-tablet-if-so-do-i-need-to-download-an-application-which-internet-browsers-are-specifically-supported-on-a-mobile-device/tablet)
* [Can I use a keyboard shortcut or an external microphone's button to start or stop recording?](#can-i-use-a-keyboard-shortcut-or-an-external-microphones-button-to-start-or-stop-recording)
### Access & Consent
#### Who can use Note Assist?
Any Provider-Level User can start using Note Assist right away. Note Assist integrates seamlessly into your everyday workflow, delivering AI-driven documentation directly in your Elation EHR. With your [free monthly allowance of 10 AI-generated notes](/articles/Note-Assist-Guide#using-your-free-monthly-note-assist-allowance), you immediately save time on charting, reduce administrative burdens, and spend more of your clinical day engaged with patients rather than documentation.
#### What counts as an AI-generated note?
An AI-generated note is defined as each time you use Note Assist in a visit note - whether the note is signed or deleted.
#### Why do I only get 10 free AI-generated notes each month?
Your Elation subscription includes 10 AI-generated notes each month at no extra cost, allowing you to experience the benefits of AI-powered documentation firsthand. This helps you see how Note Assist can transform your charting before considering higher volume usage.
#### When does my free monthly allowance reset?
Your 10 free AI-generated notes reset on the **1st of each calendar month at 12:00 AM UTC**. Any unused notes from the previous month do not carry over — the count resets to 10 regardless of how many you used. For example, if you only use 3 notes in March, you will still receive 10 fresh notes on April 1st, not 17.
#### Does retrying, deleting, or editing a note use an additional credit?
* **Retrying** note generation on the same visit does **not** count as an additional use.
* **Deleting** a visit note draft that used Note Assist does **not** refund the use — it still counts toward your monthly total.
* **Manually editing** the AI-generated text after it has been generated does **not** count as an additional use.
Only the initial generation of note content from a scribe session counts as one use toward your monthly allowance. See [Using your free monthly Note Assist allowance](/articles/Note-Assist-Guide#using-your-free-monthly-note-assist-allowance) for more details.
#### Does a new provider automatically get unlimited Note Assist if my practice already upgraded?
No. An unlimited Note Assist subscription is tied to a specific Provider Level account, not to the practice as a whole. When you add a new provider, their account starts with the standard [free monthly allowance of 10 AI-generated notes](/articles/Note-Assist-Guide#using-your-free-monthly-note-assist-allowance) even if other providers at your practice have the unlimited upgrade.
To extend unlimited access to a newly added provider, reach out to Elation Support or your Customer Success Manager and request that the provider be added to your practice's unlimited Note Assist subscription.
#### Do I need patient consent to record the visit?
Yes, when using Note Assist, you may be subject to laws about recording conversations. These rules vary by location. It's your responsibility to understand the laws where you practice and get your patient’s consent—ideally before or during their visit.
Here’s an example of consent language you can use:
| *Some state and federal laws require patient consent to use ambient scribing solutions. Today, I'm using a software tool within my electronic health record system to make it easier to write my medical notes. It helps me spend more time focused on your care, and less time on the computer. This tool will listen to our conversation and convert it into a summary, which I will review and edit for accuracy. The tool will have access to the audio of our conversation during our visit, but it will not be saved. Your medical information will stay private and only shared with those you allow.* *Do you consent to the use of this tool during our visit today and future visits?* |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
[Click here for additional information about Patient Consent Regulations](/articles/Patient-Consent-Regulations-Guide).
### Feature Functionalities
#### Can I customize how Note Assist writes my notes?
Yes. Custom instructions let you control how Note Assist structures and writes each section of your visit note, such as the HPI and A\&P. You can specify preferences for style, format, and content so the AI-generated output matches your documentation approach.
To set up custom instructions, go to **Settings** -> **AI Personalization** and scroll to the **Note Assist** section. Click on a visit note section to expand it and add your instruction. Custom instructions are available for all Note Assist customers, including both paid and freemium plans.
[Click here for more information about setting up custom instructions](/articles/Note-Assist-Guide-Preparation#setting-up-custom-instructions).
#### Can I use Note Assist with any web browser?
Note Assist works on:
* **Computer/laptop:** Firefox, Chrome
* **Android devices:** Chrome
* **iPhones/iPads:** Safari
#### Can I use Note Assist with all visit note formats?
**Best supported formats:**
* Complete H\&P Note (2 column)
* Complete H\&P Note (2 col-A/P)
These formats have more structured sections, so Note Assist can better organize content and avoid overwriting your input.
**Partially supported formats:**
* SOAP Note
* Complete H\&P Note (1 column)
These formats are less structured, so formatting may be less organized.
**Unsupported formats:**
* Simple Note
* Pre-op Note
* Non-Visit Note
* Phone Note
* Email Note
Note Assist won’t work at all with these formats—even if you click **Scribe**.
#### Why are 2-column visit note formats preferred?
2-column visit note formats offer more structure, helping Note Assist better organize the note and avoid overwriting existing content.
Here are more details around how Note Assist detects and populates specific fields in the 2 column Visit Note Formats:
* Vital readings spoken aloud during encounters will be automatically recorded directly into the appropriate vital fields in the visit note.
* Physical evaluations will be recorded in discrete **PE** (Physical Exam) fields.
* Patient instructions will be recorded in the **Care Plan**.
* Symptoms and conditions will be organized in the **HPI** section.
* Diagnoses, including suspect conditions, will be grouped and labeled in the **Assessment** and/or **Plan** sections.
* Note Assist populates the **Assessment** section with the diagnosis name if your conversation mentions any and this jumpstarts the search for ICD-10 codes in our system. Simply click the name of a diagnosis and the system will launch the diagnosis search to narrow down the search results for you.
**Exception:** Note Assist will not generate data in the **Review of Systems** (ROS) section of any visit note formats at this time.
#### Can I use Note Assist on a draft note with existing content?
Yes, you can use Note Assist on a draft note that already has content, such as [Visit Note Templates](/articles/Note-Assist-Guide-Preparation#visit_note_templates). Note Assist will update the note with new information. If there's a conflict, the new data may replace what's already written.
#### Does using a Visit Note Template help?
Yes, Visit Note Templates help Note Assist understand what information to include and how to organize the information in the note.
#### How often does Note Assist update the note?
Note Assist updates the note at the end of the session.
#### What happens if I switch to another patient chart without finishing the recording?
Note Assist only records one chart at a time. If you open a new chart, the previous recording will pause automatically.
#### What happens if I close the Note Assist dialog before clicking the Finish Recording button?
If you close the Note Assist dialog before clicking the **Finish Recording** button, you will be prompted to
* Click **End Session** to save and stop recording.
* Click **Keep Recording** to continue recording.
#### Why don't I see the Scribe button?
The **Scribe** button is hidden while the Note Assist dialog is open. This includes when the dialog is minimized — a minimized dialog shows only a compact title row, so it can look like the button is gone.
Look for the Note Assist dialog on your screen and click **Maximize** to expand it and continue your session. To bring the **Scribe** button back, close the dialog by clicking **Close** or **X**. If a recording is still in progress, you'll be prompted to click **End Session** to save and stop recording, or **Keep Recording** to continue.
#### Is there a time limit for using Note Assist during a visit?
No, there is no time limit. Note Assist will continue recording and transcribing until you click **Finish Recording**.
#### Does Note Assist require verbal cues to identify sections like the physical exam?
Verbal cues aren't always required, but they can enhance accuracy. When information could belong to multiple sections, using clear verbal cues ensures it is placed in your intended section.
#### Can Note Assist tell the difference between similar terms (e.g. Hypertension vs. Hypotension)?
Yes. Note Assist uses speech models and context clues in your conversation to make accurate guesses, similar to a human scribe. For example, if you and your patient are talking about high blood pressure or blood pressure readings that are high, it’s likely to predict that *Hypertension* was what was said and input the correct word.
#### Will chit chat or side conversations be excluded from the visit note?
Note Assist filters out obvious chit-chat (e.g. parking questions) but may include lifestyle details if they seem relevant.
#### How do I correct mistakes when recording?
If you made any mistakes while recording, simply speak your corrections and Note Assist will take them into consideration when generating your note contents. You can also pause the recording and start your recording again to speak any corrections.
#### Does Note Assist add ICD-10 codes to the Assessment or Billing Details of the visit note draft?
Note Assist does not add ICD-10 codes to the visit note draft. However, Note Assist will populate the **Assessment** or **Plan** with the diagnosis name so you can launch the ICD-10 search by clicking on the diagnosis name.
### Transcriptions
#### Is my data being used to train AI models?
No, your patient data is not being used to train AI models nor do we allow any of our third party vendors to retain or train on data. We delete patient transcript data after a short period reserved for troubleshooting or data recovery at your request.
#### Is the transcription created in real-time?
Yes, the transcription is created real-time. If there are internet issues then the transcription may briefly fall behind, but it will catch up once the internet is stable again.
#### Can Note Assist translate my conversation with the patient in real time?
No. Note Assist is designed to document the visit, not interpret it. It transcribes the language you select in real time and generates the final visit note in English, but it does not provide live English translation on screen or out loud during the encounter.
#### How do I access my transcripts?
Transcripts are stored in the Note Assist dialog, and visible to you, until you sign the visit note. Click **View transcript** in the **Recording Finished** screen to see the transcript.
Once the visit note is signed, you can download the transcript from the patient's chronological record. Click **Actions** on the note and select **Download Transcript**. This option is available for both Elation Notes and legacy notes.
![Actions menu on a legacy visit note showing the Download Transcript option]()
![Actions menu on an Elation Note showing the Download Transcript option]()
Once a visit note is signed, Elation keeps the transcript in an archive for 14 days. After that 14 day window, the transcript is no longer available. If you have inquired about a specific transcript via conversations with our Support Team, that transcription may be kept for up to 60 days.
If you need access to a transcript in our archive, submit a request via **I need help** -> **Contact Elation Support** and a member of our Support Team will be able to assist you.
#### How long is the transcript available?
Once a visit note is signed, Elation keeps the transcript in an archive for 14 days. After that 14 day window, the transcript is no longer available. If you have inquired about a specific transcript via conversations with our Support Team, that transcription may be kept for up to 60 days.
If you need access to a transcript in our archive, submit a request via **I need help** -> **Contact Elation Support** and a member of our Support Team will be able to assist you.
#### Is the recording saved & will I have access to the audio recordings?
No, the audio recordings are not saved and you will not have access to the audio recordings. Note Assist uses the audio recordings to generate the transcripts continually throughout the visit and then the audio recordings are erased once the transcript is available.
Before a visit note is signed, you will have access to the transcript by clicking **Scribe** and then **Transcript** at the top of the Note Assist dialog.
Once the visit note is signed, you can download the transcript from the patient's chronological record. Click **Actions** on the note and select **Download Transcript**.
Once a visit note is signed, Elation keeps the transcript in an archive for 14 days. After that 14 day window, the transcript is no longer available. If you have inquired about a specific transcript via conversations with our Support Team, that transcription may be kept for up to 60 days.
If you need access to a transcript in our archive, submit a request via **I need help** -> **Contact Elation Support** and a member of our Support Team will be able to assist you
#### If I amend the visit note, can I still access the transcript of the original Note Assist session?
Note Assist is not available when amending visit notes.
#### If I delete and then restore a visit note draft, is the transcript also restored?
Yes, the transcript will be restored with the visit note draft.
#### There's missing information in the Note, what should I do?
If the note is inaccurate, you can click the retry ![Retry icon used to regenerate a Note Assist note]()
icon to try generating it again. Keep in mind that once you do, you won't be able to go back to the previous version.
#### Can I restore the first version of the Note after clicking retry?
No, you won't be able to go back to the previous version once you click retry.
### Technical Specifications & Usage
#### Do the patient and I need to sit close to the microphone?
Yes. For best results, stay near the microphone and speak clearly. Check the volume bars or live transcription to confirm audio is being picked up.
#### What happens if I lose internet connection while recording?
If you lose internet connection, Note Assist will pause recording and resume transcribing once your connection is restored. Previously recorded data will be saved and processed.
#### Can I use Note Assist for telehealth/virtual encounters?
Yes, you can use Note Assist for telehealth/virtual encounters. However, avoid using headphones. The microphone needs to pick up the patient’s voice through your device’s speakers.
#### Can I use Note Assist on a mobile device or tablet, if so, do I need to download an application? Which internet browsers are specifically supported on a mobile device/tablet?
Yes, you can use Note Assist on a mobile device or tablet by logging into your EHR through a supported mobile browser. Use Mobile Safari on Apple devices or Mobile Chrome on Android. If the browser isn’t already installed, you may need to download it. Note Assist does not work with the Elation Go Mobile App at this time.
*©2025 Google*
#### Can I use a keyboard shortcut or an external microphone's button to start or stop recording?
Currently, Note Assist does not support keyboard shortcuts or hardware buttons (such as a programmable button on an external microphone) to start, pause, resume, or finish recording. Use the on-screen **Start Recording**, **Pause**, **Resume**, and **Finish Recording** buttons in the Note Assist dialog instead.
## Related Articles
* [Note Assist Introduction (Add-On)](/articles/Note-Assist-Guide)
* [Note](/articles/Note-Assist-Guide-Preparation)[Assist Guide - Preparing to use Note Assist](/articles/Note-Assist-Guide-Preparation)
* [Note Assist Guide - Using Note Assist for encounters](/articles/Note-Assist-Guide-Using-Note-Assist)
* [Note Assist Guide - Best Practice Recommendations](/articles/Note-Assist-Guide-Best-Practice-Recommendations)
* [Note Assist Guide - Microphone Set-up and Troubleshooting](/articles/Note-Assist-microphone)
# Note Assist Guide - Feature Updates
Source: https://help.elationhealth.com/articles/Note-Assist-Guide-Feature-Updates
Learn about the latest features and enhancements for Note Assist.
## Overview
This article summarizes the new features and enhancements for Note Assist.
## Updates
### April 2026
#### Custom instructions for Note Assist (now generally available)
Custom instructions for Note Assist are now generally available for all Note Assist customers, including both paid and freemium plans. This feature lets you control how Note Assist structures and writes each section of your AI-generated visit note—such as the HPI and A\&P—so the output matches your preferred documentation style.
Custom instructions are configured in **Settings** -> **AI Personalization** under the Note Assist section. [Click here for more information about setting up custom instructions](/articles/Note-Assist-Guide-Preparation#setting-up-custom-instructions).
### December 12, 2025
#### Clearer processing engine selection
It is now easier to select the processing engine you wish to use to generate each note. Simply click **Scribe** and then go to **Personalizations** -> **Processing engine** and choose one of the following.
* **New version (recommended)**
* Have Note Assist generate the full note at the end of the visit.
* Results in a cleaner more high quality draft.
* **Legacy version (retiring 12/31/25)**
* Have Note Assist generate the visit note draft every 5 minutes instead of after you stop recording.
* May result in more verbose and redundant notes.
#### Merge feature for Elation Note users
For Elation Note users, a **Merge Note Content** ![Merge Note Content button icon]()
button will appear after a recording completes. This will merge AI-generated content into the open Elation Note where it will avoid duplicates while preserving unique content from both the AI output and your edits.
#### Designated feedback button
A **Feedback** ![Merge Note Content button icon]()
button will now always be visible for you to submit feedback about AI generated content.
### November 18, 2025
#### Improved note generation
Note Assist, by default, will generate the visit note draft after you stop recording instead of while you're recording.
* A Setting, called **Use legacy Note Assist**, is now available if you prefer the previous note generation interval of every 5 minutes.
You asked, we listened. Our newest note-generation engine now delivers an entire, comprehensive visit note in a single pass—right after the patient encounter. The old real-time approach sometimes added noise and increased post-visit cleanup. With a renewed focus on quality and speed, this upgraded engine gives you an instantly polished draft so you can stay fully engaged with your patients and spend less time editing notes.
Key benefits of Note Assist’s new engine:
* Significantly More Succinct: Final notes capture relevant detail without unnecessary bloat or redundancy.
* Worry-Free Editing: Providers can write into their note during the visit without the previous concern of conflict with scribe’s output.
* High Quality Output: Early feedback from providers reported a significantly improved quality in scribe output, resulting in less post-visit editing of their notes.
* Faster Note Generation: Quicker note generation at the end of the visit maximizes the precious seconds between patient encounters.
### November 6, 2025
#### New note generation Setting
Added a Setting for:
* Reducing verbal, repetition and overwriting of manual notes.
* Having Note Assist generate the visit note draft after you stop recording instead of while you're recording.
Simply toggle on the \*\*Improved Note Assist generation \*\* Setting prior to starting a recording. [Click here for more information about this Setting](/articles/Note-Assist-Guide-Using-Note-Assist#recording_settings).
### August 21, 2025
#### Improved access to Note Assist Settings
Updated Note Assist Settings to show the personalization preferences immediately on the screen. [Click here for more information about Note Assist Settings](/articles/Note-Assist-Guide-Using-Note-Assist#recording_settings).
#### Generate the Care Plan in the patient's preferred language
Added a personalization preference for generating care plan instructions in the patient's preferred language. [Click here for more information about this Note Assist Setting](/articles/Note-Assist-Guide-Using-Note-Assist#recording_settings).
### August 15, 2025
#### Retry note generation
Added a retry button to the Transcript to allow you to regenerate the transcript if you did not like the quality of the initial version. [Click here for more information about this feature](/articles/Note-Assist-Guide-Using-Note-Assist#review).
### May 21, 2025
#### Additional supported languages
Note Assist now supports 14 languages in total:
* Arabic
* Chinese (Cantonese)
* Chinese (Mandarin)
* English
* French
* German
* Hindi
* Japanese
* Korean
* Portuguese
* Russian
* Spanish
* Tagalog
* Vietnamese
#### Care Plan Actions (Beta)
Note Assist not only tracks the action items you want your patient to complete after their visit—it also enables you to quickly take the necessary steps to carry out those actions or orders in their Care Plan. [Click here to learn more about this beta feature](/articles/Note-Assist-Guide#Actions).
### December 5, 2024
#### Problem List linking
When you and a patient discuss a condition already on their problem list, Note Assist will automatically add that problem to the **Assessment**, including your problem description and the ICD-10 code(s). If the patient presents symptoms related to that condition, Note Assist will use the problem name as a header in the **HPI**.
#### Enhanced Care Plan structure
Care Plan instructions are now organized by condition to clarify information and recommendations, allowing patients to better understand their follow-up actions.
#### Improved overall note quality
Note Assist now generates more consistent, relevant notes with better template alignment and polished medical language—helping you finish notes faster.
#### Preserving manual edits
To avoid overwriting manual edits to notes, Note Assist will now skip any bullets that were last updated by the provider—both new entries and modifications of content generated by Note Assist or imported from a template; as long as you are using the supported 2 column visit note formats.
#### Enhanced Template content
Note Assist is better at filling out visit note templates, allowing details and health information to flow more naturally into the final note.
#### Easier Synopsis updates
Use the new **Add Synopsis** button in each **Assessment** to quickly add bullets generated by Note Assist to the **Problem List Synopsis** in the Clinical Profile—making problem documentation faster and easier.
### October 16, 2024
#### Protect specific content
To keep certain text exactly as written (e.g. signatures or standard phrases) in Visit Note Templates or in the visit note draft, add an asterisk (\*\*\*\*\*) to the beginning of the bullet. Note Assist will not modify these bullets.
## Related Articles
* [Note Assist Introduction (Add-On)](/articles/Note-Assist-Guide)
* [Note Assist Guide - Preparing to use Note Assist](/articles/Note-Assist-Guide-Preparation)
* [Note Assist Guide - Using Note Assist for encounters](/articles/Note-Assist-Guide-Using-Note-Assist)
* [Note Assist Guide - Best Practice Recommendations](/articles/Note-Assist-Guide-Best-Practice-Recommendations)
* [Note Assist Guide - Microphone Set-up and Troubleshooting](/articles/Note-Assist-microphone)
* [Note Assist Guide - Frequently Asked Questions](/articles/Note-Assist-Guide-FAQ)
# Note Assist Guide - Preparing to use Note Assist
Source: https://help.elationhealth.com/articles/Note-Assist-Guide-Preparation
## Overview
### Preparing to use Note Assist
Follow the recommended steps in this article before using Note Assist to ensure a smooth experience.
## Workflow Instructions
### Using supported browsers
Use one of the following supported browsers:
* **Computer/laptop:** Firefox, Chrome
* **Android devices:** Chrome
* **iPhones/iPads:** Safari
### Ensuring patient consent requirements are met
When using Note Assist, you may be subject to laws about recording conversations. These rules vary by location. It's your responsibility to understand the laws where you practice and get your patient’s consent—ideally before or during their visit.
Here’s an example of consent language you can use:
| *Some state and federal laws require patient consent to use ambient scribing solutions. Today, I'm using a software tool within my electronic health record system to make it easier to write my medical notes. It helps me spend more time focused on your care, and less time on the computer. This tool will listen to our conversation and convert it into a summary, which I will review and edit for accuracy. The tool will have access to the audio of our conversation during our visit, but it will not be saved. Your medical information will stay private and only shared with those you allow.* *Do you consent to the use of this tool during our visit today and future visits?* |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
[Click here for additional information about Patient Consent Regulations](/articles/Patient-Consent-Regulations-Guide).
### Preparing your microphone
[Click here for instructions on preparing your microphone for recording](/articles/Note-Assist-microphone).
### Using supported Visit Note Formats
**Best supported formats:**
* Complete H\&P Note (2 column)
* Complete H\&P Note (2 col-A/P)
With these two formats, Note Assist will skip any bullets that were last updated by the provider—both new entries and modifications of content generated by Note Assist or imported from a template.
**Exception:** Note Assist will not generate data in the Review of Systems section of any visit note formats at this time.
If you manually type any content in the **F/U** or **PE** fields, Note Assist may overwrite your content when incorporating new content from the transcription.
**Partially supported formats:**
* SOAP Note
* Complete H\&P Note (1 column)
If you manually type any content in any SOAP Note or Complete H\&P Note (1 column) visit note fields during the encounter, Note Assist may overwrite your content when incorporating new content from the transcription.
A warning will appear if you select a Visit Note Format that is not compatible with Note Assist.
### Using Visit Note Templates
Note Assist works well with Visit Note Templates. Just apply your template at the start of the visit, and Note Assist will fill it in based on what’s said during the appointment.
To get the best results, try these tips when setting up your templates:
* Ask questions clearly
* Write each question as a separate bullet.
* Use ‘fill-in-the-blanks’
* Use curly brackets\*\*\{ }\*\* for blanks you want Note Assist to fill. Add helpful hints or options inside, like (i.e. *Patient has a fever: \{yes|no}*)
* Avoid using fixed statements
* Avoid writing fixed statements like ‘Denies visual abnormalities.’ Instead, let Note Assist insert the finding based on what the patient says. (i.e. **Visual Abnormalities: \{Patient reports visual abnormalities|Patient denies visual abnormalities}**)
* Protect specific content
* To keep certain text exactly as written (like signatures or standard phrases), add an asterisk (\*\*\*\*\*) at the beginning of the bullet. Note Assist will not alter these bullets.
#### Visit Note Template formatting examples
| **Elements** | **Previous Formatting** | **Recommended Formatting** |
| --------------------------------------------------- | ----------------------------------------------------------- | -------------------------------------------------------------------------------------------------- |
| Option (including Boolean) | Dosage: \_\_\_\_\_\_ Unit: mg or ml | Dosage: \_\_\_\_\_\_ Unit:\{mg\|ml} |
| Does the patient have rugs in the house: Yes or no? | Does the patient have rugs in the house? \{Yes\|No} | |
| Fill-in-the-blanks (any data type) | Amount of exercise that the patient gets per week: \_\_\_\_ | Amount of exercise that the patient gets per week: \{Amount in hours} |
| Name of gynecologist: \_\_\_\_\_\_\_\_\_\_ | Name of gynecologist: \{Clinician name} | |
| Number of vaccinations: \_\_\_\_\_\_\_\_\_\_ | Number of vaccinations: \{Number} | |
| Multi-select | Recent vaccinations: \{COVID, HPV, Flu, Pertussin} | Recent vaccinations: COVID: \{Yes\|No} • HPV: \{Yes\|No} • Flu: \{Yes\|No} • Pertussis: \{Yes\|No} |
### Setting up custom instructions
Custom instructions let you control how Note Assist structures and writes each section of your AI-generated visit note. Use them to tailor the style, format, and content of specific sections—such as the HPI and A\&P—to match your preferred documentation approach.
#### Accessing custom instructions
1. Navigate to **Settings** -> **AI Personalization**.
2. Scroll to the **Note Assist** section, below the custom instructions for Elation AI and Wordsmith.
3. Click on a visit note section (e.g., **HPI**, **A\&P**) to expand it and add your custom instruction.
#### How custom instructions work
* You can add a custom instruction for each visit note section individually.
* When Note Assist generates your note, it follows your instructions for each section where you've provided guidance.
* Sections with a custom instruction will auto-expand in the settings page to show the contents.
* Custom instructions apply to all future Note Assist sessions until you update or remove them.
Custom instructions are available for all Note Assist customers, including both paid and freemium plans, and work with both legacy and Elation Note formats.
#### Tips for writing effective custom instructions
* Be specific about your preferences (e.g., "Use bullet points instead of paragraphs for the HPI" or "Include a differential diagnosis list in the A\&P").
* Focus on the sections where you most frequently edit Note Assist output.
* You can update your instructions at any time to refine the results.
## Related Articles
* [Note Assist Introduction (Add-On)](/articles/Note-Assist-Guide)
* [Note Assist Guide - Using Note Assist for encounters](/articles/Note-Assist-Guide-Using-Note-Assist)
* [Note Assist Guide - Best Practice Recommendations](/articles/Note-Assist-Guide-Best-Practice-Recommendations)
* [Note Assist Guide - Frequently Asked Questions](/articles/Note-Assist-Guide-FAQ)
* [Note Assist Guide - Microphone Set-up and Troubleshooting](/articles/Note-Assist-microphone)
# Note Assist Guide- Scribing visit notes as a Staff Level User (Beta)
Source: https://help.elationhealth.com/articles/Note-Assist-Guide-Staff-Level-Users
This article describes a beta feature of Note Assist that allows Staff Level Users to scribe visit notes.
## Scribing Visit Notes as a Staff Level User
### Overview
Staff Level Users can use the Note Assist feature to scribe visit notes. This comes in handy when Staff Level Users assist clinicians or other providers in the practice with prepping visit note content prior to a patient encounter. [Click here to learn more about Note Assist](/articles/Note-Assist-Guide).
This feature is currently in a beta testing phase and is only available to a select number of practices.
### Frequently Asked Questions
#### How do Staff Level Users at my practice get access to Note Assist during the trial period?
For customers who are beta testing this feature, Elation will automatically give all Staff Level Users at your practice access to Note Assist during the trial period, which starts January 28, 2025 and ends February 5, 2025.
**How does Note Assist work for Staff Level Users?**
Note Assist works the same for Staff Level Users as it does for physicians and other providers. Once the feature is enabled during the trial, the orange **Scribe** button will display in patient charts and visit notes. Staff Level Users would simply select it to start recording with the patient.
When the Staff Level User is finished with the patient, they will click **Finish Recording** to end their session with the patient, and Note Assist will populate the visit note with the appropriate content.
**Can my MA start a note using Note Assist that I later finish? What happens with the transcription?**
Yes, your MA can start a note using Note Assist that you later finish. We recommend the following workflow:
* When the Staff Level User is finished with the patient, they should click **Finish Recording** to end their session with the patient, and Note Assist will populate the visit note with the appropriate content.
* When the provider opens the same in-progress visit note, they will see the note contents from the staff user. The clinician will click **Start Recording** to capture the visit conversation with the patient; they will see the earlier transcript of the exchange between the staff and patient, as well as the updated transcript of their conversation with the patient.
**Do Staff Level Users have access to Advanced Settings?**
Yes, Staff Level Users can modify the **Note Assist Advanced Settings**.
**Do staff members need to have the same Advanced Settings as clinicians?**
No. Advanced settings are specific to each user and will only impact the Note Assist session specific to each user. For instance, a Staff Level User may toggle off the generation Physical Exam, Care Plan, or Follow-up content. When the staff user generates a note, it will not include those details if discussed. However, if the physician opts to generate content in those sections via their Advanced Settings, Note Assist notes will include relevant content in those sections.
We are not expecting the Advanced Settings to be applicable to staff users since they are typically not discussing these details with patients.
**How do customers provide feedback to Elation on staff-level access to Note Assist?**
We ask that you provide feedback about the Staff Level User's access to Note Assist using the solution’s star rating workflow. The rating workflow is available from the Note Assist **Recording Finished** screen. Simply select the number of stars under **How would you rate the generated note?**. You can also share feedback details, comments, and suggestions after selecting a rating which will help us understand your experience better. Users can provide feedback multiple times, but there's no need to resubmit feedback if your rating or comment remains the same.
**Is there a cost associated with staff-level access to Note Assist?**
We anticipate that there will be additional subscription fees for Staff Level User access to Note Assist. We are evaluating pricing options at this time and would welcome your feedback.
## Related Articles
* [Note Assist Guide- Scribing visit notes in Elation EHR (Add-On)](/articles/Note-Assist-Guide)
# Note Assist Guide - Using Note Assist for encounters
Source: https://help.elationhealth.com/articles/Note-Assist-Guide-Using-Note-Assist
This article describes how to use Note Assist during a patient encounter.
## Overview
### Using Note Assist for encounters
Follow the instructions in this article to use Note Assist during your patient encounters.
### Tracking your monthly free AI-generated note usage
The free AI-generated notes option will be gradually rolled out to groups of customers until it’s available to everyone.
At the beginning of each month, a **# remaining** banner will appear at the top of the Note Assist dialog to tell you how many [free AI-generated notes](/articles/Note-Assist-Guide#free_allowance) you have left for the month. The counter will decrease each time you use Note Assist with a visit. If you dismiss the banner then it will automatically reappear once you have 2 AI-generated notes left.
An optional unlimited upgrade is available beyond the 10 free notes per month. If you're interested in upgrading to unlimited AI-generated notes, simply [fill out this form](https://www.elationhealth.com/note-assist-signup/) and we’ll contact you to discuss details and pricing.
If you’ve upgraded to unlimited AI-generated notes, usage tracking is not necessary and won’t appear in the Note Assist dialog.
## Workflow Instructions
### 1. Launching Note Assist
| **1** | Create a new visit note and prepare the visit note as you normally would (i.e. reference Clinical Profile information or apply [Visit Note Templates](/articles/Note-Assist-Guide-Preparation#visit_note_templates) ). |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Scribe** at the bottom right of the chart to open Note Assist. ![Open visit note for Emily Jones showing the Scribe button highlighted in the bottom-right corner of the note editor, which launches Note Assist.]()
|
### 2. Allowing Note Assist to use your specified microphone
The first time you use Note Assist, your browser will prompt you to allow microphone access. Click **Allow** to give Note Assist permission to use the microphone you specify. Here are samples of what the prompts may look like for Firefox & Chrome:
| **Firefox** | **Chrome** |
| ----------- | ---------- |
| | |
[Click here for full instructions on preparing your microphone for recording](/articles/Note-Assist-microphone).
### 3. Specifying recording settings
![Note Assist settings panel showing Language set to English, Microphone set to MacBook Pro Microphone (Built-in), and all three Personalization toggles (Generate PE, Generate Care Plan, Generate F/U) enabled, with Start Recording button at bottom.]()
Adjust any of the following settings as needed for each session:
* **Language**
* Note Assist defaults to English. If needed, use the drop-down to choose another supported language. Your conversation will be transcribed in that language, but the visit note will be translated and written in English.
* Arabic
* Chinese (Cantonese)
* Chinese (Mandarin)
* French
* German
* Hindi
* Japanese
* Korean
* Portuguese
* Russian
* Spanish
* Tagalog
* Vietnamese
* **Microphone**
* Note Assist will use your default microphone settings. You can choose a different microphone if needed.
* **Personalization**
* **Generate PE**: Allow Note Assist to write in the **PE** (Physical Exam) section.
* **Generate Care Plan**: Allow Note Assist to write in the **Care Plan** section.
* Specify if you want the Care Plan to be generated in English (default) or the patient's Preferred Language.
* **Generate F/U**: Allow Note Assist to write in the **F/U** (Follow-Up) section.
* **Custom instructions**: Tailor how Note Assist writes each section of your visit note (e.g., HPI, A\&P) to match your documentation style. Configure these in **Settings** -> **AI Personalization**. [Click here for more information about custom instructions](/articles/Note-Assist-Guide-Preparation#setting-up-custom-instructions).
### 4. Recording a conversation
For best results, keep speakers close to the microphone and speak clearly during a recording.
**1**
Click **Start Recording** to let Note Assist capture your conversation with the patient using ambient AI.
* A solid red dot in the upper left corner means it’s recording.
* Transcriptions will appear in real time in the Note Assist dialog.
* Content will appear once you stop recording (see step #4).
* Any text generated by Note Assist will be highlighted in light orange.
* If you made any mistakes while recording, simply speak your corrections and Note Assist will take them into consideration when generating your note contents. You can also pause the recording and start your recording again to speak any corrections.
**2**
Click the pause button anytime to pause the recording. The red dot will turn hollow.
**3**
Click the resume button to start recording again.
**4**
For Elation Note users,
To provide Elation feedback about the AI generated content, click the Feedback button and fill out the feedback form.
Click **Finish Recording** at the end of the visit. Note Assist will then add the transcribed content to your note.
* Click **Start Recording** again to pick up where you left off.
* Close the Note Assist dialog by clicking **Close** or **X**.
* View the full transcript by clicking **View transcript**.
Seeing a **Note Update Timeout** message? Click the retry icon to try generating the transcript again.
### 5. Reviewing the AI-generated visit note
![Visit note Subjective section with two AI-generated problems highlighted in light orange: "1: General Health – Reports not feeling well" and "2: Right Wrist Pain" with two detail bullets.]()
Text generated by Note Assist will appear with a light orange highlight. You can edit any part of the visit note—once you do, the highlight will disappear. Afterwards, complete your usual follow-up and action items (see below), and sign the visit note as you normally would.
View the full transcript by clicking **Scribe** -> **Transcript**.
* If the note is inaccurate, you can click the retry icon (shown below) to try generating it again. Keep in mind that once you do, you won't be able to go back to the previous version.
![Note Assist dialog open during a visit, showing the Transcript tab with timestamped conversation and a "Start Recording" button. The Actionables tab shows a badge of 4 tracked items.]()
### Using Note Assist Care Plan Actions
When you and a patient discuss the **care plan** follow-ups or **actions** to be completed at the end of, or after their visit, Note Assist will automatically organize those actions into the following categories:
* Medications
* Lab Orders
* Imaging Orders
* Referrals
* Other
* Office Messages
* Provider Letters
After you finish recording, click the **Actionables** tab in the Note Assist dialog to review and execute on tracked **Actions**.
* For medications, lab orders, imaging orders and referrals, completed actions will automatically be marked off within a few seconds. You can also manually mark any item as complete by clicking the checkmark.
* To manually add an actionable, type the action in the **Describe a care plan item...** box.
![Actionables tab in Note Assist dialog showing 4 tracked care plan actions: lab order, imaging order, referral, and office message/provider letter, with an arrow highlighting the Actionables tab.]()
#### Prescribing Medications
Prescription intent is tracked and grouped into categories to help you take action easily.
| Rx New Actions identifies that a prescription needs to be written for a new medication. | Click the **Rx: Create…** button to create a new prescription draft for the new medication. The identified medication name & strength will appear first in the medication search. • The following fields can be prefilled: |
| -------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Rx Refill Actions identifies that a medication in the patient’s medication list needs to be refilled. | Click the **Rx: Refill…** button to create a new prescription draft for the medication that needs to be. The following details may be prefilled, provided the information is available from the most recent prescription order: |
| Rx Change Actions identifies that a medication in the patient’s medication list needs to be changed. | Click the **Rx: \[Draft]…** button to create a new prescription draft for the medication that needs to be changed. The following details may be prefilled, provided the information is available from the most recent prescription order: |
| Rx Discontinue Actions identifies that a medication in the patient’s medication list needs to be discontinued. | Click the **Rx: View History** button to open the patient’s medication history and locate the medication that needs to be discontinued. |
#### Ordering Labs
Lab order intent is tracked- click **Lab: Create** to open a blank Lab Order Form and draft an order.
#### Ordering Imaging
Imaging order intent is tracked- click\*\* Imaging: Create\*\* to open a blank Imaging Order Form and draft an imaging order.
#### Creating Referrals
Referral order intent is tracked- click\*\* Referral: Create\*\* to open a blank Referral Form and draft a referral.
#### Writing an Office Message
Office Message intent is tracked- click **Message: Create** to open a pre-filled Office Message draft with the content from the visit conversation.
#### Writing a Provider Letter
Intent to contact external collaborators is tracked- click **Letter: Create** to open a blank Provider Letter.
#### Tracking other actions
Other Care Plan actions that don’t fit the above categories are tracked as To Do items for you to review. These actions aren’t linked to any other features.
## Related Articles
* [Note Assist Introduction (Add-On)](/articles/Note-Assist-Guide)
* [Note Assist Guide - Preparing to use Note Assist](/articles/Note-Assist-Guide-Preparation)
* [Note Assist Guide - Using Note Assist for encounters](/articles/Note-Assist-Guide-Using-Note-Assist)
* [Note Assist Guide - Best Practice Recommendations](/articles/Note-Assist-Guide-Best-Practice-Recommendations)
* [Note Assist Guide - Frequently Asked Questions](/articles/Note-Assist-Guide-FAQ)
* [Note Assist Guide - Microphone Set-up and Troubleshooting](/articles/Note-Assist-microphone)
* [Note Assist Guide - Feature Updates](/articles/Note-Assist-Guide-Feature-Updates)
# Note Assist Guide - Microphone Setup and Troubleshooting
Source: https://help.elationhealth.com/articles/Note-Assist-microphone
This article covers how to set up your microphone for Note Assist and how to troubleshoot common microphone issues.
## Overview
Use the instruction below for your device type and operating system (OS) to properly enable your microphone. We advise doing this prior to using Note Assist to avoid potential audio issues.
## Workflow Instructions
### Setup for laptop and desktop devices
Click the **Start** menu and select **Settings** (gear icon).
In the left-hand menu of the Settings window, click **Privacy & Security**.
Under the App permissions section, scroll down and click **Microphone**.
In the left-hand menu of the Settings window, click **System** and then **Sound**.
* Under **Input**, go to Choose a device for speaking or recording, and select the device you want.
Windows does not have a built-in ambient listening feature, but third-party applications or **Windows Dictation** can be used for continuous listening.
* Check specific app settings for ambient listening features (e.g., accessibility apps).
Search for and open the **Voice Recorder** app on your computer.
* Click the record button to test if your microphone is working properly.
Click the Apple logo in the top-left corner of the screen.
Click **System Settings** (or **System Preferences** in older macOS versions).
In the left-hand menu of the System Settings window, click **Privacy & Security.**
* Under the **Privacy** section, click **Microphone**.
* You’ll see a list of applications and toggles for controlling microphone access. Ensure the toggle next to the internet browser with which you use Elation is toggled **ON**.
In the left-hand menu of the same System Settings window, click **Sound**.
* Click the **Input** tab.
* Select your **preferred microphone** and adjust the **input volume slider** to the desired level.
![Mac System Settings with Sound selected in the sidebar, Input tab active, MacBook Pro Microphone selected as input device, with input volume slider visible.]()
macOS does not have a direct ambient listening mode, but some apps or accessibility features (e.g., **Live Listen** with AirPods) can offer this functionality. Check app settings for such features.
Search for and open the **Voice Memo** app on your computer.
* Click the record button to test if your microphone is working properly.
![Mac Voice Memos app with a new 13-second recording selected and the red record button highlighted, showing the app is ready to test microphone input.]()
### Setup for mobile devices
Open the **Settings** app on your iOS device.
Scroll down and tap **Safari.**
Scroll down and tap **Microphone**.
* Select **Ask** or **Allow**.
![iOS Safari Settings screen with Microphone option highlighted, showing Page Zoom, Request Desktop Website, Reader, Camera, Microphone, and Location settings.]()
![iOS Safari Microphone settings screen with "Allow" selected and checked, enabling microphone access on all websites.]()
*To use Live Listen with your AirPods, AirPods Pro, AirPods Max, Powerbeats Pro, or Beats Fit Pro, your iPhone or iPad device needs iOS or iPadOS 14.3 or later.*
* Connect your AirPods or compatible hearing devices.
* Open **Settings** > **Control Center**, then tap the **+** button next to **Hearing**.
* Return to your home screen.
* From the top right corner of your device, [swipe down to reveal the Control Center](https://support.apple.com/en-us/108330).
* Tap the **ear button** and turn on **Live Listen** and use your device’s microphone to listen to the environment through your AirPods.
You can test the microphone in any audio or video app (e.g., Voice Memos) to ensure it’s working properly.
Open the **Settings** app on your Android device.
Scroll down and tap on **Privacy** or **Apps** (varies by device). Select **Permissions Manager** (or **App Permissions**).
Tap **Microphone** to view apps that have requested microphone access.
* Toggle the switch **On** next to the internet browser with which you use Elation.
You can test your microphone by using apps like **Google Assistant**, **Voice Recorder**, or a similar app to ensure it’s working properly.
Android doesn’t have a direct ambient listening feature, but you can use **Live Transcribe** for live speech-to-text.
* Some third-party apps also offer ambient listening features.
## Troubleshooting
### General Tips
If you’ve followed the setup instructions above, but Note Assist is still not recognizing your microphone device, test a two-person call on a third-party microphone test site such as: [https://www.onlinemictest.com](https://www.onlinemictest.com)
If the audio indicator line doesn’t move during your microphone test:
* Check that your microphone is connected to the correct (normally pink) socket in your computer. If it's a mic with a USB connector just make sure it is properly connected to the USB socket (you will not use the pink microphone in this case).
* Check that your microphone is not muted - sometimes the mic has a mute button on it or on the wire that is connected to it.
* Check that the volume on the microphone is not turned all the way down.
If the microphone doesn’t work with this type of test, it’s a strong indicator that the issue is unrelated to Note Assist. We recommend that you connect directly with your microphone’s hardware or IT support.
* Additional troubleshooting tips:
* For [Windows 10](https://www.onlinemictest.com/microphone-settings/windows-10/) or [Windows 11](https://support.microsoft.com/en-us/windows/fix-microphone-problems-5f230348-106d-bfa4-1db5-336f35576011)
* For [Mac OS](https://www.onlinemictest.com/microphone-settings/mac-os-x/)
* For [additional OS](https://www.onlinemictest.com/) tips
### Virtual Visit Tips
During a virtual visit, if Note Assist is only picking up the provider's audio but not the patient's audio, it’s important to disable **all** noise suppression, cancellation, and enhancement features for audio recording across all software, operating system, and hardware. This includes disabling noise cancellation in both the **operating system sound settings** and in any additional **audio control software associated with the microphone**.
Below are some steps to help:
* **Use the browser version of the video conferencing tool** and run it in a separate tab within the same browser instance as the Elation App.
* **Disable Zoom Noise Suppression or Filters (Desktop and Web Client).**
* Follow these instructions for [Configuring Professional Audio Settings for Zoom Meetings](https://support.zoom.com/hc/en/article?id=zm_kb\&sysparm_article=KB0059985) to ensure noise suppression is not enabled.
* **Disable Noise Suppression in Windows.**
* Go to **System Sound Settings.**
* Right-click on the sound icon in the taskbar and select **Sound Settings**.
* Click on **More Sound Settings**, switch to the **Communications** tab, and select **Do nothing** to prevent Windows from altering audio during calls.
* **Check Audio Control Software from Manufacturer.**
* Check if any model/manufacturer-specific audio software is installed, as it may include advanced microphone settings. Examples include:
* Realtek Audio Console
* Realtek HD Audio Manager
* Dell Audio / Dell Optimizer / Waves MaxxAudio
* HP Audio Control / Omen Audio Control
* Acer Purified Audio Console
* Lenovo Vantage
* Refer to this[Zoom Community Thread](https://community.zoom.com/t5/Zoom-Meetings/Disable-Any-sort-of-quot-Suppress-Background-noise-quot/m-p/68152) for more information on disabling noise suppression in these applications.
* **Use an External Microphone and Speaker Setup**:
* If issues persist, consider using an external microphone and speaker setup. Disable your built-in microphone and configure the external devices as the input and output sources.
## Related Articles
* [Note Assist Introduction (Add-On)](/articles/Note-Assist-Guide)
* [Note Assist Guide - Preparing to use Note Assist](/articles/Note-Assist-Guide-Preparation)
* [Note Assist Guide - Using Note Assist for encounters](/articles/Note-Assist-Guide-Using-Note-Assist)
* [Note Assist Guide - Best Practice Recommendations](/articles/Note-Assist-Guide-Best-Practice-Recommendations)
* [Note Assist Guide - Frequently Asked Questions](/articles/Note-Assist-Guide-FAQ)
* [Note Assist Guide - Feature Updates](/articles/Note-Assist-Guide-Feature-Updates)
# Office Message Feature Guide- The enhanced inter-office communications tool
Source: https://help.elationhealth.com/articles/Office-Message-Feature-Guide
## What is the Office Message feature?
Elation’s Office Message feature allows you to send messages about specific patients to anyone who has a user account for your EHR. Recipients of Office Messages can easily track and reply to messages on their Elation Practice Home page, and closed threads become archived in the patient’s chart for future reference.
## Why is the Office Message feature valuable?
The Office Message feature facilitates internal communication, allowing you to keep track of conversations and tasks that need to be completed by anyone in your office. You can also set reminders for yourself, your colleagues and your staff to follow up on action items. Since Office Messages are visible to everyone in the practice, this feature fosters transparency to ensure that nothing falls through the cracks.
## Sending Office Messages
### Initiating a new Office Message
You can initiate an Office Message from 3 different locations in the EHR:
1. From the Practice Home page by clicking **Message**:
![Message button highlighted in the Practice Home toolbar, located between New Chart and Handouts]()
1. From the gray navigation bar at the top of a patient's chart by clicking **Msg**:
![Msg button highlighted in the patient chart toolbar for Robert Jones, showing its location among Visit Note, Notes, Rx, Orders, and other chart actions]()
1. From any Order, Report, Letter, Visit Note, or Note by clicking **Actions** --> **Office Message**:
![Actions menu expanded on a Visit Note showing "Office Message" highlighted under the Send section, demonstrating how to initiate an Office Message from a note.]()
*
With this third method, the Order, Report, Letter, Visit Note or Note will be attached to the Office Message so that it can be referenced.
### Composing a new Office Message
To compose a new Office Message:
1. Enter the patient's name in the **Pt** box to indicate who the message is about.
* If you need to correct the name, click the **Actions** button next to the patient’s name followed by **Remove**.
* If you initiated the Office Message from the patient's chart, the patient’s name will be automatically populated
2. Search for and select recipients from the dropdown menu in the **To** box- choose individuals or try adding a [User Group](/articles/user-groups)
*
If you are Premium EHR user, reference the [Premium EHR features section](#premium_EHR) below for important details and additional features tied to selecting recipients.
3. Compose your message in the **Msg** box.
![New Message dialog showing three required steps highlighted: Pt field for patient name, To field for recipients, and Msg field for composing the message, with Send and Discard buttons.]()
#### Additional Office Message configuration options
* The **Keep Requiring Action** checkbox allows you to pin Office Message threads to your **Office Messages** inbox in your Practice Home Requiring Action Queue, even after you’ve sent your message. Doing so allows you to quickly locate and reference high priority threads. For more information on this feature, please see the [Using the **Keep Requiring Action** checkbox](#keep_requiring_action) section of this article.
* Recipients will continue to see the Office Message in their own **Office Messages** inbox.
* The **Urgent** checkbox will add the office message to the recipient's ‘Urgent’ inbox in their Practice Home Requiring Action Queue in addition to their **Office Messages** inbox.
### Sending new Office Messages
You have two timing options when sending a new Office Message:
1. Clicking **Send** will send the new Office Message immediately to all selected recipients.
2. Entering a date in the Pd box will allow you to send the message at a later date. The message will be sent at 12:00am local time on the date selected. This option can be used to create a [reminder for yourself or recipients](/articles/Office-Messages-Feature-Guide-Using-office-messages-for-reminders) to follow up on a specific task at a future date or time.
*
You can enter a relative date, for example **1 week** or **1 month** into the **Pd** field and Elation will automatically calculate the date for you.
![New Message dialog with the Pd (Post Date) field highlighted and the Send button outlined, showing options to send immediately or schedule delivery for a later date.]()
## Viewing and replying to active Office Message threads
You can view active (unsigned) Office Message threads on Elation’s Practice Home page as well as in the patient’s chart.
### Viewing active Office Messages from the Practice Home Requiring Action Queue
You can find all active (unsigned) Office Messages that require your attention in the **Office Messages** inbox of your Practice Home Requiring Action Queue.
![Practice Home Requiring Action Queue with "Office Messages" selected and highlighted, showing 2 messages. View Queue For is set to "Everyone," displaying two patient message threads.]()
The Requiring Action Queue in the Practice Home comes with a **View Queue For:** menu that will allow you to look at other Providers'/staff members’ Requiring Action items.
*
The **View Queue For:** option comes in handy when you need to assist colleagues or other staff members with open items while they are unavailable. Administrative users can also use this feature to keep track of responsibilities and productivity.
### Viewing active Office Messages from the patient’s chart
Active (unsigned) Office Messages may appear in two different sections at the top of the patient's chart:
* Any Office Messages that have been delivered to you, and presumably required your attention as a next step, will appear in the **Requiring Action** section of the patient's chart.
* Any Office Messages that are waiting on a response from other members of your practice will be located in the **Outstanding Items** section of the patient’s chart.
![Patient chart for Winston B. Addington showing one Office Message in the "Requiring Action" section (a Sep 22 2021 message to call patient with lab results) and one in "Outstanding Items" (a Mar 29 2024 reminder for annual visit).]()
### Replying to Office Message threads
![Patient chart showing an active Office Message in the Requiring Action section, with the Reply text box and Quick Reply button highlighted at the bottom of the thread.]()
* Click the **Reply** box at the bottom of any active (unsigned) Office Message threads to write a custom reply.
* Your reply will be delivered to the individuals whose specific names are listed as recipients.
* If there are any User Groups listed as recipients, only the members of the User Group who have already responded to the thread will receive your reply.
* Optionally, click **Quick Reply** to select from a list of standardized reply templates:
* **Recall patient** = ‘Please call patient in for appointment.’
* **Get patient on phone** = ‘Please get patient on phone.’
* **Information patient of results** = ‘Please call and inform patient of results.’
* **Should have appointment already book** = ‘Patient should have appointment already booked.’
### Viewing Office Message threads with multiple replies
When an Office Message thread already has a history of replies, you will see the buttons **Show # reply** or **Hide # reply** in the Office Message thread. Click on these prompts to reveal or collapse all previous replies in the Office Message thread.
* By default, active (unsigned) Office Message threads will be expanded so you can optionally click **Hide # reply** to collapse.
* By default, closed Office Messages threads will be collapsed so you can optionally click **Show # reply** to expand.
## Managing recipients in active Office Message threads
![Edit Recipients dialog open on patient Robert Jones's Office Message thread, showing Front Office (Group), Tracy Stanton, and Beverly Crusher, MD as current recipients with X buttons to remove each.]()
When replying to active Office Message threads, any user can click the **Edit** button next to the recipients list to add or remove recipients from the Office Message thread. This feature comes in handy when you:
* have multiple team members with similar responsibilities so they should all be notified
* have team members rotating in and out of the office
* need to redirect attention to the correct team member
### Adding or removing recipients
Any user can add or remove recipients from active Office Message threads to adjust the team members who need to receive the message. To add or remove recipients:
1. Click the **Edit** button next to the recipient’s list at the top of the Office Message
2. Type in names of individuals or User Groups to add them to the Office Message thread
*
If you are a Premium EHR user, reference the [Premium EHR features section](#premium_EHR) below for important details and additional features tied to selecting recipients.
3. Click the **X** button at the end of an individual or User Group’s name to remove them from the Office Message thread
4. Click the **Save** button to save your changes
* If any recipients were added or removed, a note will appear in the Office Message thread to indicate this change.
![Patient chart for Charles Burns showing an Office Message thread in Outstanding Items. A reply from Beverly Crusher, MD is highlighted with a red border, displaying "[Removed: Felix Grey.]" — the system-generated note indicating a recipient was removed.]()
If at least one Provider Level User is on an Office Message thread, a Provider Level User will be required to sign the thread in order to close it.
Removing all Provider Level Users from an Office Message thread means that any user will be able to close the Office Message thread.
Removing any recipient from an Office Message means they will no longer be notified of subsequent replies to the thread. Take caution when removing recipients.
## Using the "Keep Requiring Action" checkbox
![New Office Message dialog with the "Keep Requiring Action" checkbox checked and highlighted, addressed to Front Office (Group) for patient Alexis Long.]()
When sending an office message, you can optionally select the **Keep Requiring Action** checkbox if you’d like to keep a copy of the Office Message thread in your own Practice Home Requiring Action Queue. If this checkbox is not selected, the Office Message thread will not appear on your Practice Home until someone replies to you within the thread. Use this feature when there are Office Message threads that you want to keep an eye on from your Practice Home page.
If the Office Message thread that you’re writing to includes a User Group in the **To** field, the **Keep Requiring Action** checkbox has the added effect of sending the Office Message to the Practice Home Requiring Action Queues of everyone in the User Group. If **Keep Requiring Action** is not selected in this scenario, after the initial message is sent, replies to the message thread will only be displayed on the Practice Home of User Group members who at some point personally replied to the thread.
### Replying to a note you sent only to yourself
When you reply to a note you sent only to yourself, the **Keep in my Requiring Action list** checkbox on the reply form controls whether the thread stays in your queue after you send. Check the box's state before clicking **Send**:
* **Checked** → the thread stays in your Requiring Action queue (useful for a reminder you're still working on).
* **Unchecked** → the thread leaves your queue once you reply.
To close out a self-thread without replying, use the **Mark Complete** button on the thread (**Sign Off** for Provider Level Users). This removes it from your Requiring Action queue immediately — the checkbox does not apply.
On multi-recipient threads that include you, the same checkbox appears labeled **Keep Requiring Action** and behaves the same way per reply — check it to keep the thread in your queue after replying, or leave it unchecked to clear it from your queue when you reply. The thread stays in the other recipients' queues until they act on it.
If you're on the thread through a User Group (for example, **Front Desk**) rather than by name, that checkbox governs the group's Requiring Action status — leaving it unchecked when you reply clears the thread from the group's queue for everyone in the group, not just from your own view.
## Closing Office Message threads
To close an Office Message thread, your user type and the user type of other recipients in the thread, will determine what type of button you’ll see:
* Provider Level Users will always see **Sign off**
* Staff Level Users will see **Mark Complete** if there are only Staff Level Users in the Office Message thread
Although labeled differently, these two buttons serve the same purpose - to close the message thread and archive it into the Chronological Record of the patient’s chart.
### **Sign Off**
Provider Level Users are allowed to sign any Office Message thread - regardless of whether they are part of the thread’s recipient list.
![Office Message thread for Winston B. Addington showing the upper "Sign Off" button highlighted, and the "Send & Sign Off" button highlighted below the reply box.]()
The **Sign** action can be taken from 2 areas of the message thread:
1. If no written reply from the Provider Level User is necessary, they should click the upper **Sign Off** button.
2. If the Provider Level User wishes to type a response before closing the thread, they should click the **Send & Sign Off** button beneath the reply box.
If the Provider Level User typed a response before signing the thread, everyone on the recipient list will receive the written response in their **Office Messages** inbox of their Practice Home Requiring Action Queue. and will need to click an **Acknowledge** button to dismiss the thread.
#### **Acknowledge**
![Practice Home Office Messages inbox showing two active threads. The second thread for William Love has an "Acknowledge" button highlighted, which staff must click to dismiss the signed-off message.]()
This feature ensures that all recipients (in any Office Message thread containing Provider Level Users) view the final reply of the Office Message thread after it has been signed off by the Provider Level User. When a Provider Level User clicks **Send & Sign Off**, recipients must click **Acknowledge** after reading the latest replies to dismiss the Office Message thread from their Requiring Action Queue and only store the completed Office Message thread in the patient’s chart.
If there are multiple Provider Level Users in the Office Message thread, all Provider Level Users who did not sign the Office Message thread must click **Acknowledge** to dismiss the Office Message thread from their own Requiring Action Queue.
### **Mark Complete**
![Patient chart for Charles Burns showing a Requiring Action Office Message thread from Felix Grey with "Mark Complete" button highlighted in red, used to close staff-only threads.]()
Office Messages threads that only contain Staff Level Users on the recipient list can be closed out by any of those Staff Level Users. By clicking the **Mark Complete** button, the Office Message will be dismissed from everyone’s Practice Home Requiring Action Queue and become filed into the Chronological Record of the patient’s chart.
Clicking **Mark Complete** on the thread clears it from your Requiring Action queue on its own. If you instead close a self-thread by replying, the **Keep in my Requiring Action list** checkbox on the reply form determines whether the thread stays in your queue — see [Replying to a note you sent only to yourself](#replying-to-a-note-you-sent-only-to-yourself).
This button was previously named **Acknowledge for Group**.
## Viewing closed Office Messages in the Chronological Record
Closed Office Messages, after they are signed off or marked complete, will be stored in the patient’s Chronological Record as shown below. To reveal the history of replies on the thread, click **Show # replies**.
![Closed Office Message thread in patient Charles Burns's Chronological Record, showing a signed Apr 1, 2024 message with a "Show 2 replies" link collapsed beneath it.]()
## Removing or deleting an Office Message thread
You can remove an Office Message by going into the patient's chart and clicking **Actions** --> **Remove** at the top right corner of any Office Message thread. This action will delete the thread from the patient’s record.
![Patient chart for Charles Burns showing an Office Message thread with the Actions menu open, highlighting the "Remove" button used to delete the thread from the patient's record.]()
## Premium EHR features
The features listed in this section are part of Elation's Premium EHR offering. If you are already a Premium EHR user and you are interested in using any of these features, click the **I need help** button to notify Elation and a member of the Elation Team will activate the feature for you.
If you are interested in upgrading to Premium EHR to use any of these feature, click the **I need help** -> **Contract Elation Support** button and a member of the Elation team will assist you.
### Sending Office Messages to User Groups only
Premium EHR users can request a feature that customizes how Office Messages are sent. When the feature is activated, you can only select [User Groups](/articles/user-groups) in the **To:** field when selecting recipients and you will not be able to select individual user's names. This feature makes it easier to route communications and tasks to the appropriate team by sending messages to users according to their function or responsibilities.
### Allowing Staff Level Users to sign off messages on behalf of Provider Level Users
Premium EHR users can assign specific User Groups as office message delegates, allowing all Staff Level Users in the group to sign Office Messages on behalf of all Provider Level Users in the EHR. These Staff Level Users will have the same sign off workflows as a Provider Level User. [Click here to learn more about Office Message Delegates](/articles/staff-permissions--staff-delegates#practice-office-message-delegates).
### Workspaces
If you are using Elation's Workspaces feature for Premium EHR users, [reference this guide](/articles/workspaces-guide#People_List) to ensure the correct users appear in your Workspace User Groups so that the appropriate recipients appear for selection when writing Office Messages. If you only see the Provider List Setting and you do not see the People List Setting in your Workspaces Settings, please use the **I need help** button at the top of your account to notify us and a member of the Support Team will assist you with enabling the People List Setting.
## Frequently Asked Questions
### Can I restore a deleted Office Message?
There isn't a self-service "Recently Deleted" option for Office Messages. If you accidentally delete a thread, click **I need help** -> **Contact Elation Support** with the patient's chart ID and we'll attempt to recover it.
### I accidentally acknowledged an Office Message and don't remember which patient it was for. How do I find it?
Go to **Reports** -> **User Activity Log**, then filter by **Action: Acknowledge** and **Record Type: Office Message**. The results list the patient tied to each acknowledged thread and link directly to that patient's chart. See the [User Activity Log guide](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice) for more on using the filters.
### Can I send an Office Message that’s NOT affiliated with a specific patient?
Office Messages must be affiliated with a patient chart, but you can create a chart with a generic name (ex. First Name: Internal, Last Name: Office Messages), and then use that generic patient chart to send Office Messages that are not patient-specific.
### Can I send an Office Message to multiple team members?
Yes, you can send an Office Message to any combination of individuals by selecting their names from the drop down in the **To** field and/or you can use the [User Groups feature](/articles/user-groups) to group specific office members together. For example, I may send an Office Message to all 5 medical assistants in my office by adding the 5 medical assistants to a user group called **Medical Assistants** and then selecting **Medical Assistants (Group)** from the **To** drop down.
*
If you are a Premium EHR user, reference the [Premium EHR features section](#premium_EHR) above for important details and additional features tied to selecting recipients.
### What’s the difference between inputting individual user names versus User Groups?
You should input individual user names if each person needs to be equally informed and involved in the message thread. When individual names are listed as recipients, each person will always be notified of subsequent replies to the thread on their Practice Home.
You should use a User Group when only 1 (or a few) of the members of the group needs to take action (for example, among a team of Schedulers, once one Scheduler takes ownership of a request, the rest of the Schedulers can disregard the thread). When a User Group is listed as the recipient, every member of the User Group will receive the initial message on their Practice Home, but only people who have personally written at least one message on the thread will see subsequent replies on their Practice Home.
### How do I add a new recipient to an active Office Message thread?
To add recipients to active Office Message threads:
1. Click the **Edit** button next to the recipient’s list at the top of the Office Message
2. Type in names of additional recipients or User Groups to add them to the Office Message thread
*
If you are a Premium EHR user, reference the [Premium EHR features section](#premium_EHR) above for important details and additional features tied to selecting recipients.
3. Click the **Save** button to save your changes
* A note will appear in the Office Message thread to indicate this change.
4. Afterwards you can type a reply if needed.
*
You can add a recipient to an Office Message thread without writing a reply if you simply wish to grant them visibility into the existing information in the Office Message thread.
All individuals whose specific names are listed as recipients will be notified that you added a new recipient from their **Office Messages** inbox of their Practice Home Requiring Action Queue. If there are any User Groups listed as recipients, only the members of the User Group who have already responded to the thread will be notified that you added a new recipient in their **Office Messages** inbox of their Practice Home Requiring Action Queue.
If a Provider Level User is added to the Office Message thread, a Provider Level User will be required to sign the thread in order to close it.
### How do I add myself to an active Office Message?
Anyone can add themselves to an active Office Message thread by replying to the Office Message. When this happens, all individuals whose specific names are listed as recipients will be able to see your reply from the **Office Messages** inbox of their Practice Home Requiring Action Queue. If there are any User Groups listed as recipients, only the members of the User Group who have already responded to the thread will see your reply in the **Office Messages** inbox of their Practice Home Requiring Action Queue.
If a Provider Level User is added to the Office Message thread, a Provider Level User will be required to sign the thread in order to close it.
### How do I remove a recipient from an active Office Message?
To remove a recipient from an active Office Message thread:
1. Click the **Edit** button next to the recipient’s list at the top of the Office Message
2. Click the **X** button at the end of the recipient’s or User Group’s name to remove them from the Office Message thread
3. Click the **Save** button to save your changes
* A note will appear in the Office Message thread to indicate this change.
Take caution when removing recipients. Removing all Provider Level Users from an Office Message thread means that any user will be able to close the Office Message thread. Removing any recipient from an Office Message means they will no longer be notified of subsequent replies to the thread.
### How can I tell who removed me from an Office Message thread I was once part of?
To see who removed you from an Office Message thread you were once part of, find the Office Message thread in the patient’s chart and then find the note about who removed you along with the date and time of the action. The note will look like this:
![Patient chart for Charles Burns showing an Office Message thread in Outstanding Items. A reply from Beverly Crusher, MD reads "[Removed: Felix Grey.]" highlighted with a red border, indicating how removed recipients appear in the thread.]()
### How do I reopen a closed Office Message thread?
Once an Office Message thread is signed or marked complete, it cannot be reopened. You will need to start a new Office Message thread to continue the conversation.
### How do I edit recipients of a closed Office Message thread?
Once an Office Message thread is signed or marked completed you can no longer edit its recipients.
### I no longer see the **Acknowledge for Group** button in the Office Message thread. What happened?
The **Acknowledge for Group** button has been renamed **Mark Complete**. When a Staff Level User clicks the **Mark Complete** button, the Office Message will be dismissed from everyone’s Practice Home Requiring Action Queue and become filed into the Chronological Record of the patient’s chart.
### I am a Staff Level User but I cannot see the **Mark Complete** button in the Office Message thread. What happened?
The **Mark Complete** button is only available for Staff Level Users if there are only Staff Level Users in the Office Message thread. If there are any Provider Level Users in the Office Message thread then Staff Level Users will need to wait for a Provider Level User to sign the Office Message thread in order to complete it. If a Provider Level User was accidentally added to the Office Message thread, you can follow these steps to remove them from an active Office Message thread:
1. Click the **Edit** button next to the recipient’s list at the top of the Office Message
2. Click the **X** button at the end of the Provider Level User’s name to remove them from the Office Message thread
3. Click the **Save** button to save your changes
* A note will appear in the Office Message thread to indicate this change.
### Why am I seeing a message in my Requiring Action Queue if I already acknowledged it?
If you are viewing group queues (such as **Everyone**, **All Provider** or **All Staff**) from the Practice Home page, you may sometimes see that a closed Office Message thread that you have acknowledged is still visible in the **Office Messages** inbox. This is because ALL recipients of an Office Message thread containing Provider Level Users must acknowledge the message for it to be dismissed from their Requiring Action Queue.
Check with the other recipients of the message to make sure they have clicked the **Acknowledge** button.
### Can I add my own Quick Reply messages to Elation?
We currently do not have a feature for users to customize and/or add their own quick reply messages. You can [use Templating Softwares alongside Elation](/articles/using-templating-softwares-with-elation) if you want to add any custom text templates in the EHR.
### I am unable to find a specific user in the recipients list. What happened?
If you are using Elation's Workspaces feature for Premium EHR users, you must make sure the correct users appear in your Workspace User Groups so that the appropriate recipients appear for selection when writing Office Messages. If you only see the Provider List Setting and you do not see the People List Setting in your Workspaces Settings, please use the **I need help** button at the top of your account to notify us and a member of the Support Team will assist you with enabling the People List Setting. [Click here to learn more about using the Office Message feature with Workspaces](/articles/workspaces-guide#People_List).
**Next Step**
**Send a message to yourself or a staff member to start coordinating on tasks!**
## Related Articles
* [User Groups Guide- Simplifying office messages & expanded calendar view](/articles/user-groups)
* [Office Messages Feature Guide- Using office messages for reminders and task follow-up](/articles/Office-Messages-Feature-Guide-Using-office-messages-for-reminders)
* [Practice Home Guide- Checking for requiring action items](/articles/check-for-your-offices-daily-to-do-list)
* [Templates Guide- Using templating softwares with Elation](/articles/using-templating-softwares-with-elation)
# Office Message Feature Guide- Using office messages for reminders and task follow-up
Source: https://help.elationhealth.com/articles/Office-Messages-Feature-Guide-Using-office-messages-for-reminders
**Contents**
* [What is the Office Message feature?](#description)
* [Using Office Messages for reminders](#using_office_messages_for_reminders)
* [Viewing Office Message reminders before the scheduled delivery date](#view_before_date)
* [Viewing Office Message reminders on the scheduled delivery date](#view_after_date)
* [Frequently Asked Questions (FAQ)](#faq)
## What is the Office Message feature?
Elation’s Office Message feature allows you to send messages about specific patients to anyone who has a user account for your EHR. Recipients of Office Messages can easily track and reply to messages on their Elation Practice Home page.
Another great use case for the Office Message feature is you can set reminders for yourself, your colleagues and/or your staff to follow up on action items. Some common use cases for reminders include:
* keeping track of patient due dates for specific exams or procedures (ex. annual wellness exams, well women's exams, etc)
* keeping track of patient care plan follow up (ex. checking on blood pressure readings taken at home, checking on status of sutures, etc)
* keeping track of office tasks and responsibilities
[Click here to learn more about the other users of the Office Message feature](/articles/Office-Message-Feature-Guide)
.
## Using Office Messages for reminders
Entering a date in the
**Pd**
box will allow you to send the message at a later date. The message will be sent at 12:00am on the date selected.
*
You can enter a relative date, for example **1 week** or **1 month** into the Pd field and Elation will automatically calculate the date for you.
![New Message dialog with Post Date (Pd) field highlighted, showing 02/01/2025 entered to schedule delivery of a reminder message to Front Office (Group).]()
## Viewing Office Message reminders before the scheduled delivery date
Office Messages that are scheduled to be delivered on a future date will sit at the top of the patient's chart in the 'Outstanding Items' section until the set date. You will see the date of delivery at the top of the Office Message.
![Outstanding Items section of patient chart Maria Allison showing a scheduled Office Message with "Message will be delivered on 08/26/2024" highlighted in red.]()
## Viewing Office Message reminders on the scheduled delivery date
Once the scheduled delivery date arrives, the Office Message be moved to the **Requiring Action** section of the patient's chart and **Office Messages** inbox in the Practice Home Requiring Action Queues for the listed recipients.
## Frequently Asked Questions
### Can I change the delivery date of the reminder?
No, delivery dates cannot be changed once the Office Message is sent. You can delete the message and create a new one with a new delivery date.
### Can I adjust the time of delivery for any of the date options?
No, the time of delivery cannot be adjusted.
### I no longer want the reminder to be sent on a future date. I want the recipient to see the Office Message immediately. What should I do?
If you want the recipients to see the Office Message immediately, you will need to copy the contents of the reminder to a new Office Message and then send the new Office Message. Afterwards you can delete the old reminder.
**Next Step**
**Send someone a reminder to follow up on a task at a future time!**
**Related Articles**
* [Office Message Feature Guide- The enhanced inter-office communications feature](/articles/Office-Message-Feature-Guide)
* [Practice Home Guide- Checking for requiring action items](/articles/check-for-your-offices-daily-to-do-list)
# Ohio State- ImpactSIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Ohio-State-ImpactSIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Ohio State Immunization Registry [ImpactSIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with Ohio's Statewide Immunization Information System (ImpactSIIS).
## What is the ImpactSIIS Immunization Registry Interface?
The ImpactSIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to ImpactSIIS; Ohio's Statewide Immunization Information System. Practices can also query ASIIS for vaccination history or forecast.
## Why is the ImpactSIIS Immunization Registry Interface valuable?
With the ImpactSIIS Immunization Registry Interface, practices no longer need to separately log in to ImpactSIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to ImpactSIIS. You can also pull vaccination history for specific patients from ImpactSIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & ImpactSIIS
The Elation Team will assist you with initiating interface with ImpactSIIS. To notify us of your interest please complete [this form for ImpactSIIS](/files/immunization-oh-impactsiis-form.pdf) and then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**. A member of the Elation team will collect the completed ImpactSIIS form from you.
## How to submit vaccination data to ImpactSIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to ImpactSIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using ImpactSIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
To ensure a successful query, please make sure patient address information is stored in the demographics.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Oklahoma State- OSIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Oklahoma-State-OSIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Oklahoma State Immunization Information System [OSIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Oklahoma State Immunization Registry known as OSIIS.
## What is the OSIIS Immunization Registry Interface?
The OSIIS Immunization Registry Interface allows connected practices to
**send**
vaccination information from their Elation EHR directly to OSIIS, the Oklahoma State Immunization Information System. Practices can also query OSIIS for vaccination history or forecast.
## Why is the OSIIS Immunization Registry Interface valuable?
With the OSIIS Immunization Registry Interface, practices no longer need to separately log in to OSIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to OSIIS. You can also pull vaccination history for specific patients from OSIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & OSIIS
The Elation Team will assist you with initiating interface with OSIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. Does your practice currently participate in Vaccines for Children (VFC)? If so, what is your VFC Pin #?
2. What is your OSIIS Site ID?
3. Is your practice a Pandemic COVID-19 Vaccine Program Provider?
4. Do you have an OSIIS account currently?
5. Who is the primary contact to work with OSIIS at your practice?
## How to submit vaccination data to OSIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to OSIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using OSIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Order Forms Guide - Putting lab orders on hold for specimen collection
Source: https://help.elationhealth.com/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection
Do you need to put a lab order on hold while you wait to collect the specimen from a patient?
## Overview
For in-house drawn labs, there may be situations where you need to sign off on a lab order but cannot document specimen collection because the specimens have not yet been collected from the patient. The lab order holding workflow allows you to sign off on the Lab Order and place it on hold until the specimens are collected and a specimen collection is documented.
## Workflow Instructions
### Placing signed Lab Orders on hold
#### Placing signed Lab Orders on hold when specimen collection date is not yet known
![Lab requisition form with "In-house draw" selected, COLL fields empty, and the "Sign & Hold" button highlighted — ready to place the order on hold without a collection date.]()
To place a Lab Order on hold while you wait for specimens to be collected on an unknown date:
1. Create a new [Lab Order](/articles/ordering-lab-tests-enhanced).
2. Select **In-house draw** under the **Site** field.
3. Complete the remainder of the Lab Order while leaving the collection (**COLL**) fields empty.
4. Click **Sign & Hold**.
5. Find the held Lab Order in the **Outstanding Items**, **Chronological Record**, or **Lab Reports** section of the patient’s chart when you are ready to input the specimen collection date. The Lab Order will have an **On hold** label in the title.
* The Lab Order will remain on hold until either one of the following actions are taken:
1. A [specimen collection date is documented](#document_specimen_collection_date).
2. The Lab Order is [canceled](#cancel_held_order).
![Quest Lab Order for Abigail Jones dated 02/03/2025 showing "On hold" status label, Comprehensive Metabolic Panel test, fasting 12 hours, with "Document collection" link visible indicating collection date is not yet documented.]()
#### Placing signed Lab Orders on hold with a specified specimen collection date
To place a Lab Order on hold while you wait for specimens to be collected on a specified date:
1. Create a new [Lab Order](/articles/ordering-lab-tests-enhanced).
2. Select **In-house draw** under the **Site** field.
3. Select **Schedule collection** and then enter a date in the subsequent field.
![Lab requisition form with COLL field set to "Schedule collection" and date 02/03/2025, with a highlighted warning that the on-hold order will appear in Outstanding Items because today's date was selected.]()
1. Complete the remainder of the Lab Order.
2. Click **Sign & Hold**.
* The scheduled collection is **Today** or prior to ‘Today’ - Find the held Lab Order in the **Outstanding Items** or **Lab Reports** section of the patient’s chart. The Lab Order will have an **On hold for specimen collection due** label in the title.
* The scheduled collection is after **Today** - Find the held Lab Order in the **Chronological Record** or **Reports** sections of the patient’s chart. The Lab Order will have an **On hold** label in the title.
* Once the scheduled collection date arrives, the Lab Order will appear in the **Outstanding Items** section of the patient’s chart. The Lab Order will have an **On hold for specimen collection due** label in the title.
* **Electronic Orders**: Electronic Orders will be held in the patients chart and NOT be sent to the lab until a specimen collection date is entered in the held order.
### Managing specimen collection dates of held Lab Orders
#### Documenting specimen collection for a held Lab Order
![The Actions dropdown menu for an on-hold Comprehensive Metabolic Panel lab order, with "Document Collection" highlighted under Specimen Collection options. The Lab Order panel also shows "Document collection" button highlighted in the Collection field.]()
To document specimen collection in a held Lab Order:
1. Click **Document collection** in one of the following areas:
2. The **Report** view of the Lab Order.
3. Under **Actions** from the lab order in the **Reports** view, **Outstanding Items** section, or **Chronological Record**.
4. Enter in the document collection **Date** and **Time** in the Document Collection dialog.
5. Click **Document Collection**.
6. Electronic orders will be sent to the lab immediately. Non-electronic orders can be printed.
#### Editing the specimen collection date of a held, non-electronic Lab Order
To edit the specimen collection date of a non-electronic Lab Order that was previously put on hold:
* Locate the non-electronic Lab Order with the specimen collection date you want to edit.
* Click **Actions** -> **Edit Collection**.
* Edit the document collection **Date** and **Time** in the Document Collection dialog.
* Click **Save Edits**.
The collection date cannot be edited under the following circumstances: The collection date belongs to a held electronic Lab Order that was immediately sent to the lab once the collection date was entered.
The collection date was stored in the Lab Order when the Lab Order was signed off (the Lab Order was never placed on hold).
#### Removing the specimen collection date from a held, non-electronic Lab Order
To remove the specimen collection date from a non-electronic Lab Order that was previously put on hold:
1. Locate the non-electronic Lab Order with the specimen collection date you want to remove.
2. Click **Actions** -> **Remove Collection**.
3. Click **Remove** to remove the collection date and time tied to the order.
The collection date cannot be edited under the following circumstances: The collection date belongs to a held electronic Lab Order that was immediately sent to the lab once the collection date was entered.
The collection date was stored in the Lab Order when the Lab Order was signed off (the Lab Order was never placed on hold).
### Canceling a held Lab Order
![Actions dropdown open on a held Comprehensive Metabolic Panel order, with "Cancel Order on Hold" highlighted in the Specimen Collection section.]()
To cancel a held Lab Order:
1. Find the held Lab Order in the **Outstanding Items** or **Lab Reports** section of the patient’s chart.
2. Click **Actions** -> **Cancel Order on Hold**.
3. (Optional) Specify a cancellation reason as needed.
4. Click **Cancel Order**.
5. The cancellation date and reason will display in the **Reports** and **Chronological Record** view of the canceled Lab Order.
## Frequently Asked Questions
### Is this feature still relevant to me if I don't use eOrdering?
Yes, you can still take advantage of this feature even if you do not use eOrdering. The lab order holding feature enables you to sign a lab order without having to wait to enter a specimen collection date. You no longer need to keep your lab orders in draft mode while waiting for specimen collection to take place.
## Related Articles
* [Order Forms Guide- Ordering lab tests with the Lab Order Form](/articles/ordering-lab-tests-enhanced)
# Order Forms Guide - Specifying diagnosis codes at the lab test level
Source: https://help.elationhealth.com/articles/Order-Forms-Guide-Specifying-diagnosis-codes-at-the-test-level
## Overview
### What are test-level diagnosis codes for labs?
You can now assign specific diagnosis codes to individual lab tests in a lab order to improve documentation accuracy and ensure precise coding.
![Lab requisition form showing a TSH test with "Add Dx" clicked, revealing the "Add test specific Dx code" input field highlighted in orange, with diagnosis R94.6 already assigned below the test name.]()
### What are the differences between test-level diagnosis codes and order-level diagnosis codes?
The table below highlights the differences between test-level diagnosis codes and order-level diagnosis codes. Both test-level and order-level diagnosis codes are optional, as long as each test has a diagnosis code assigned at either level.
| **Test-level diagnosis codes** | **Order-level diagnosis codes** |
| ----------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Test-level diagnosis codes link specific diagnosis codes to individual lab tests. | Order-level diagnosis codes link the specified diagnosis codes to all tests in the lab order, even if those lab tests have test-level diagnosis codes. |
| Test-level diagnosis codes provide greater precision in explaining the medical necessity of the test. | Order-level diagnosis codes conveniently apply a set of codes to all tests in the order, eliminating the need to assign the same diagnosis codes to each test individually. |
| Test-level diagnosis codes take precedence over order-level diagnosis codes. | Order-level diagnosis codes are secondary to test-level diagnosis codes. |
## Workflow Instructions
### Selecting test-level diagnosis codes in lab orders
| **1** | Create a new lab order using one of the methods outlined in [this article](/articles/ordering-lab-tests-enhanced#create) . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| 2 | Enter the test(s) you want the patient to complete. |
| 3 | Click **Add Dx** to any test to assign a test-specific diagnosis. |
| 4 | Type the diagnosis code or diagnosis description in the **Add test specific Dx code** field to search for and select the diagnosis you want to assign to the specific lab test. Assign as many test-level diagnosis codes as needed. Test-level diagnosis codes take precedence over order-level diagnosis codes. • If you assign multiple diagnoses for a given test, the sequence of test-level diagnosis codes indicates their level of importance. The first code in the list is considered the primary diagnosis, the second as the secondary diagnosis, and so on. |
| 5 | Proceed with completing the lab order. |
### Selecting order-level diagnosis codes in lab orders
| **1** | Create a new lab order using one of the methods outlined in [this article](/articles/ordering-lab-tests-enhanced#create) . |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Enter the test(s) you want the patient to complete. |
| 3 | Type the diagnosis code or diagnosis description in the **Add Dx codes that apply to all tests…** field to search for and select the diagnosis you want to assign to all tests in the lab order. Assign as many order-level diagnosis codes as needed, as long as the lab order does not exceed 120 unique diagnosis codes. Order-level diagnosis codes are secondary to test-level diagnosis codes (if any were added to specific tests). • If you assign multiple diagnoses to the order, the sequence of order-level diagnosis codes indicates their level of importance. |
| 4 | Proceed with completing the lab order. |
### Assigning diagnosis codes to order sets
Both test-level diagnosis codes and order-level diagnosis can be saved to lab order sets. Follow the instructions in[this help center article](/articles/ordering-lab-tests-enhanced#order_sets)and assign diagnosis codes as needed.
## Frequently Asked Questions
### Do I need to add a test-level diagnosis code to every test in the lab order?
No, adding a test-level diagnosis code to every test in the lab order is not required. Tests without a test-level diagnosis code will automatically be linked to the order-level diagnosis codes.
### Do I need to add order-level diagnosis codes to a lab order if it already has test-level diagnosis codes?
No, order-level diagnosis codes are not required if each test has an associated test-level diagnosis code. However, if any test lacks a test-level diagnosis code, you must either assign a test-level diagnosis code to that test or add an order-level diagnosis code.
### How does the lab interpret test-level diagnosis codes versus order-level diagnosis codes?
Test-level diagnosis codes take precedence over order-level diagnosis codes. See the example below:
![Lab requisition form showing CBC with no test-level Dx codes, BMP with test-level codes C22.1 and H40.1190, and order-level Dx code E11.9 applying to all tests.]()
* The CBC was not assigned any test-level diagnosis codes, so it will be linked only to the order-level diagnosis code E11.9, which will be treated as the primary diagnosis code for the CBC.
* The BMP was assigned two test-level diagnosis codes and is also linked to the order-level diagnosis code E11.9:
* C22.1 will be treated as the primary diagnosis code since it is the first test-level diagnosis code.
* H40.1190 will be treated as the secondary diagnosis code as it is the second test-level diagnosis code.
* E11.9 will be treated as the tertiary diagnosis code because it is associated at the order-level.
### Can I move a diagnosis code from the test-level to the order-level or vice versa?
Diagnosis codes cannot be relocated. To change their placement, remove the code from the current location and re-add it to the desired one.
### How many diagnosis codes can I add to a single lab order?
You can add up to 120 unique diagnosis codes per lab order.
**Related Articles**
* [Order Forms Guide- Ordering lab tests with the Lab Order Form](/articles/ordering-lab-tests-enhanced)
# Order Forms Introduction - Ordering medical tests for your patients
Source: https://help.elationhealth.com/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients
This article will provide you with an introduction to the lab (laboratory), imaging (radiology), cardiac, pulmonary and sleep order forms in Elation.
## Overview
### What are Order Forms?
Order forms allow providers to specify to patients and testing centers what medical tests they would like a patient to complete in a structured way. Order forms have clearly labeled fields to store essential information needed to satisfy testing requirements and allows providers to document testing instructions.
### Why are Order Forms useful?
Medical testing assists with detecting, diagnosing, or monitoring for diseases/conditions, disease/condition processes, susceptibility, or determining a course of treatment. Order forms allow providers to record their specifications for following up on patient health conditions, provide patients with a direction for a plan of care and dictate clear testing instructions for testing facilities.
### Order form types
Elation offers five structured order forms; all of which are accessible from the **Orders** button at the top of the patient's chart.
* [Lab](/articles/ordering-lab-tests-enhanced)
* [Imaging](/articles/ordering-imaging-tests)
* [Cardiac](/articles/ordering-cardiology-tests)
* [Pulmonary](/articles/ordering-pulmonary-tests)
* [Sleep](/articles/ordering-sleep-tests)
![Orders button selected in patient chart toolbar, showing dropdown menu with five order types: Lab Order, Imaging Order, Cardiac Order, Pulmonary Order, and Sleep Order.]()
## Workflow Instructions
### Sharing orders with patients
The best method of sharing orders with patients is via
[Patient Passport](/articles/elation-patient-passport-an-introduction)
as it is a secure and HIPAA-compliant portal and patients will always have access to the lab order. To share a order with a patient via Patient Passport:
**1**
Find the signed order in the Chronological Record or in the **Reports** tab and click **Actions** -> **Send Patient Letter.**
**2**
A new Patient Letter draft will open up with the order attached.
**3**
Feel free to reference [this Patient Passport Guide](/articles/Passport--Communicating-with-patients#sending-messages-records-via-a-patient-letter) for more information on completing a Patient Letter.
Complete the remaining fields of the Patient Letter as needed.
**4**
Click **Sign & Send** to send the order to the patient's Passport account.
The patient will receive a notification that new information was shared with them via their Passport account and the patient can sign in to their Passport account at any time to view and print the order.
Alternatively, you can always print an order and hand the order to the patient if the patient is in the office with you. To print a order, find the signed order in the Chronological Record or in the
**Reports**
tab and click
**Actions**
->
**Print**
.
### Sending orders to testing facilities
After you create and sign an Order Form in Elation, you can electronically fax it to a vendor via Elation's
**Letter to Provider**
feature.
Review [this list of electronic lab ordering vendors](https://www.elationhealth.com/integrations/?filter=partner_service:laboratories-bidirectional) to see a list of specific Lab Vendors that can receive electronic orders directly through an interface with Elation. You will not need to send a fax to these Lab Vendors.
| **1** | Find the signed order in the Chronological Record or in the Reports tab and click **Actions** -> **Send Provider Letter**. ![Chronological Record showing an X-ray order selected, with the Actions menu open and "Provider Letter" highlighted under the Send options.]()
|
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | In the **To** field, type the fax number of the vendor. If a search result appears in the [Provider Directory](/articles/Using-the-Provider-Directory) dropdown, click on the result to select an existing contact. If this is the first time you are faxing to the vendor and you are unable to find them in your directory, press the **TAB** key on your keyboard and a dialogue window will appear prompting you to save the fax number to a new contact. Select **Organization**, type the name of the vendor, and click **Save**. This will allow you to search for the vendor by their name moving forward. ![Save number dialog with "An organization" selected, name field filled with "HDRS", and Save button highlighted, for fax number 888-888-8888]()
|
| **3** | Type a subject and message to the vendor as needed. |
| **4** | Next, click on **Select Chart Items to Attach** . |
| **5** | Check the checkbox for **Patient Demographics** and click **Attach Items** . |
| **6** | At the bottom of the letter, check the checkbox for **Also fax copies of attachments** . |
| **7** | Click **Sign & Send** to fax the order to the vendor. ![Letter to Provider form addressed to HDRS (fax 888-888-8888) with 2 attachments, "Also fax copies of the attachments" checkbox checked, and Sign & Send button highlighted.]()
|
To fax the Order outside of Elation with your physical fax machine, you can print a copy of the Order by clicking **Actions** >> **Print** and then use your fax machine.
## Close-the-Loop
### Overview
Close-the-Loop is a feature that helps practices perform the necessary follow-up on a patient’s referrals and orders so that care is not delayed. The feature
1. Adds a status of **Outstanding** to referrals and orders until the applicable consult note or test results are received in the chart and allows a user to update the status to **Fulfilled**.
2. Allows you to schedule a reminder notification to appear in your Practice Home Reminders inbox if an order is not marked as **Fulfilled** by a specific date.
### Set-up
Click **I need help** -> **Contact Elation Support** and send Elation one of the following requests to enable the Close-the-Loop feature.
This feature gives you the option to list all of a patient’s outstanding referrals and orders together under the **Outstanding Items** chart section for easy access. Alternatively, you can choose to only see the Close-the-Loop status when you scroll to each referral and order in the **Chronological Record**. More details about this distinction can be found in the Workflow Guide below.
When requesting the Close-the-Loop feature, specify whether you would like to see outstanding referrals and orders in the **Outstanding Items** section of patient charts.
* \*\*Option 1:\*\**Please enable the Close-the-Loop feature. I want outstanding orders & referrals to always appear in the **Outstanding Items** section of my patient charts.*
* \*\*Option 2:\*\**Please enable the Close-the-Loop feature. I do not want outstanding orders & referrals to always appear in the **Outstanding Items** section of my patient charts.*
### Workflow Guides
[Click here for instructions on how to use the Close-the-Loop feature](/articles/follow-up-outstanding-orders-referrals).
## Frequently Asked Questions
### How can I order tests that do not fit into the existing form categories?
We recommend using the Referral form to order other testing that does not fit into our existing form types.
[Learn more about the Referrals feature here.](/articles/how-to-send-a-fax)
### Can staff members help me create orders?
Yes! Staff members can draft orders for any patient. Once they are done drafting an order, staff members can click **Save as Draft & Close** to keep the order in the **Requiring Action** section of the patient's chart for providers to complete and sign off.
If staff members need to sign and submit orders on your behalf:
A Provider Level User must assign them as an Authorized Order Delegate. This allows staff to sign and electronically send lab, imaging, cardiac, pulmonary, and sleep orders on the provider's behalf.
To set up an Order Delegate:
| **1** | The Provider Level User goes to **Settings** → **Provider Managed Delegates** (under User Settings). |
| ----- | ---------------------------------------------------------------------------------------------------- |
| **2** | Go to the **Sign Orders** section. |
| **3** | Click **Add new order delegate** and search for the staff member's name. |
| **4** | Click the staff member's name to add them. |
Once configured, the staff member will see **Sign on behalf of physician** options in the order form.
Learn more about staff delegates in the [User Accounts Guide - Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates) article.
## Related Articles
* [Order Forms Guide- Ordering lab tests with the Lab Order Form](/articles/ordering-lab-tests-enhanced)
* [Order Forms Guide- Ordering imaging (radiology) tests with the Imaging Order Form](/articles/ordering-imaging-tests)
* [Order Forms Guide- Ordering cardiology tests using the Cardiac Order Form](/articles/ordering-cardiology-tests)
* [Order Forms Guide- Ordering pulmonary tests using the Pulmonary Order Form](/articles/ordering-pulmonary-tests)
* [Order Forms Guide- Ordering sleep tests using the Sleep Order Form](/articles/ordering-sleep-tests)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Letters & Referrals Guide- Faxing lab, radiology or other orders to vendors](/articles/efaxing-lab-and-radiology-orders)
* [Letters & Referrals Guide- Managing & searching the provider directory](/articles/Using-the-Provider-Directory)
* [Orders Guide- Following up on outstanding lab, radiology or other orders](/articles/follow-up-outstanding-orders-referrals)
* [Letters & Referrals Introduction- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Staff Permissions / Staff Delegates](/articles/staff-permissions--staff-delegates)
# Ordering & Documenting COVID-19 Lab Tests in Elation
Source: https://help.elationhealth.com/articles/Ordering-COVID-19-Lab-Tests-in-Elation
Access our help center article on Ordering COVID-19 Lab Tests in Elation to learn how to send electronic orders to our eOrdering lab partners, create custom laboratory vendors and locations for printout orders, document point-of-care lab results and securely send patients COVID-19 test orders and results in Patient Passport.
The COVID-19 test order process will depend on your practice setup, location, and laboratory vendors. Your practice can order labs electronically with select vendors, or generate laboratory requisitions to be faxed or printed in Elation.
For practices collecting specimens in-house for COVID-19 tests, [make sure your practice is prepared](https://www.cdc.gov/coronavirus/2019-ncov/downloads/Clinic.pdf) for in-house draws and read CDC’s guidelines. Lab tests can be ordered electronically, by fax, phone, or a paper printout in Elation. Read below to find out how your practice can utilize Elation for COVID-19 testing.
In this article you will learn how to:
* [Send electronic orders to Clinical Labs of Hawaii, Diagnostics Laboratory Services, LabCorp, and Quest Diagnostics](#eOrdering)
* [LabCorp](#LabCorp)
* [Quest](#Quest)
* [Diagnostic Laboratory Services](#DLS)
* [Clinical Labs of Hawaii](#CLH)
* [Create custom laboratory vendors and locations for printout orders](#CustomLabs)
* [Documenting COVID-19 Test Results at the Point-of-Care](#documentpoc)
* [Receiving and reviewing COVID-19 electronic results](#reviewingresults)
* [Securely send patients COVID-19 test orders and results in Patient Passport](#Passport)
## Electronic lab ordering for COVID-19
COVID-19 tests for select vendors can be ordered electronically in Elation. To request a bi-directional or results interface [see this article for more information](/articles/lab-interface-requests). Lab testing facilities are requiring physicians to collect specimens for COVID-19 testing in-house. See below for instructions on how to send an electronic order for COVID-19 testing.
1. Select the **Orders** tool from a patient’s chart
2. Select the Lab Vendor that is setup with electronic ordering. You will know the laboratory vendor is setup for eOrdering if you select the vendor and the blue **eOrder** button appears. (You can also navigate to ‘Settings > Labs’ and confirm ‘Orders’ is set to LIVE next to the lab vendor.)
3. Select **In-House Draw** to enter the Collection Date and Time information for specimens collected during the visit
4. Begin typing **cov** in the **Tests** field and the COVID-19 test for the selected vendor will display (LabCorp example below). Quest Diagnostics requires COVID-19 lab tests to be ordered separately, scroll down to see instructions for ordering COVID-19 tests through Quest.
5. Select the COVID-19 test from the test dropdownmenu and complete all required information on the Lab Requisition Form. Minimum requirements to order are vendor, test name, and diagnosis. All entered information will be sent electronically and displayed on the Requisition printout.
6. Once you are ready to send the order, select **eOrder** to electronically send the order to all laboratory locations or click ‘eOrder and Print; to send the order and also immediately generate a requisition printout.
A requisition printout can also be generated from the **Actions** menu after the order is submitted. This order can also be sent to patients via Passport (see instructions in the last section of this article for more information).
### Electronic ordering COVID-19 test through LabCorp
COVID-19 tests ordered through LabCorp are not available for Patient Service Center testing. Your practice must collect specimens for testing on site. [See here](https://files.labcorp.com/labcorp-d8/2020-03/22767%20Coronavirus%20%28COVID-19%29%20External%20Q%26A%20March%202020_FINAL_1.pdf) for more information on ordering tests and receiving results for COVID-19 through LabCorp.
Search by keyword ‘covid19’,’corona’, or the COVID-19 LabCorp test code 139900.
### Electronic ordering COVID-19 test through Quest Diagnostics
COVID-19 tests ordered through Quest are not available for Patient Service Center testing. Your practice must collect specimens for testing on site. [See here](https://www.questdiagnostics.com/home/Covid-19/HCP/) for more information on ordering tests and receiving results for COVID-10 through Quest Diagnostics.
* Note: Quest requires COVID-19 tests to be ordered separately. This requires the ordering provider to create 2 or more tests for ordering COVID-19 with other lab tests.
Search ‘cov’ or the Quest Diagnostics COVID-19 test code 39433. Use the Ask on Entry questions to send any specific information in the **Note** field. Use the **Source** field to identify specimens collected ‘nasopharyngeal’ (Quest preferred) and/or ‘oropharyngeal’.
### Electronic ordering COVID-19 test through Diagnostics Laboratory Services
COVID-19 tests ordered through Diagnostic Laboratory Services (DLS) are not available for Patient Service Center testing. Your practice must collect specimens for testing on site. [See here](https://dlslab.com/documents/bulletins/molecular-testing-for-covid-19-3-18-2020.pdf) for more information on ordering tests and receiving results for COVID-19 through DLS.
Search ‘covid’ and select test code 7180 to order the COVID-19 test through DLS.
Select the specimen collected and the Collection Date and Collection Time
### Electronic ordering COVID-19 test through Clinical Laboratories of Hawaii
COVID-19 tests ordered through Clinical Labs of Hawaii (CLH) are not available for Patient Service Center testing. Your practice must collect specimens for testing on site. [See here](https://www.clinicallabs.com/physicians/coronavirus-disease-2019-covid-19/) for more information on ordering tests and receiving results for COVID-19 through CLH.
Search ‘cov’ or test code 4219
## Adding custom laboratories and locations to order COVID-19 test
Your practice may not be collecting specimens for COVID-19 testing at this time. Elation supports the ability to create custom lab vendors and add specific locations so your patients know where to get tested.
[See this article for more information on creating lab vendors.](/articles/labs-settings)
For the most up-to-date information on COVID-19 lab testing facilities, please visit your state department of health website for guidance. NBC News has also published a guide for state-specific COVID-19 lab testing updates [here](https://www.nbcnews.com/health/health-news/coronavirus-testing-information-covid-19-tests-according-state-health-departments-n1158041).
## Documenting COVID-19 Test Results at the Point-of-Care
Elation has added the latest COVID-19 tests to the Point-of-Care-Labs section which will allow your practice to document structured COVID-19 lab results that are administered on-site. Learn more about documenting test results on-site in the [Elation's Point-of-Care Labs article.](/articles/point-of-care-labs)
To document these Point-of-Care Labs:
* Click **Notes** in the grey action bar from within a patient chart and select **Point-of-Care Labs** from the dropdown menu that appears
![Notes menu expanded in a patient chart with "Point-of-Care Labs" highlighted, showing the dropdown options: Phone Note, Non-Visit Note, Email Note, and Point-of-Care Labs.]()
* Update the Collected & Resulted times as needed
* Scroll down to view the **COVID-19** section in the window that is opened.
![Point-of-Care Labs dialog open on a patient chart, showing the COVID-19 section highlighted with a red border in the list of available lab tests to document.]()
* Expand the section to find the appropriate COVID-19 test
* Enter in the COVID-19 lab result value and click **Sign** or **Sign & Export to Note**
Note: If you cannot find the test you are using, you may document the results under the **SARS-CoV-2 RNA-respiratory** or the **SARS-CoV-2 RNA-unspecified** tests. You can also send your recommendations for tests (along with the associated LOINC codes) to Elation using the **I need help** -> **Contact Elation Support** button.
Another way to enter Point-of-Care Lab results is to click on **Reports** from the grey action bar, select **Lab Reports** from the dropdown, and then click the hyperlinked **Enter Point-of-Care Lab Results**:
![Patient chart Chronological Record showing a Jan 6, 2020 Office Visit Note expanded with "For physician's record only" and time "With patient: 2s" visible, signed off by provider.]()
Similar to other lab results, these values can be trended over time using the Chronological Record search.
## Receiving and reviewing COVID-19 electronic results
**Viewing results**
Results are routed to the ordering provider’s Reports queue on the practice dashboard and directly to the patient’s chart. If a matching patient is not found, a new patient chart will be created.
Why does a new chart sometimes get created due to lab results Elation matches laboratory results to patient charts by first, middle, and last name, date of birth, and gender. We err on the side of caution, so all criteria must be an exact match. For example, if the patient's name in Elation is "Jess" but laboratory results are received for a **Jessica**, Elation will treat the two as separate patients. This will ensure that when a user receives results for two different patients with similar names, the results are not confused. To merge these two charts together, [please view this article.](/articles/merging-duplicate-charts)Elation will create an alias (i.e. "remember") when a chart created by a laboratory result is merged into an existing patient chart so that results will deliver correctly in the future.
### Embedded pdfs result reports
Electronic interfaces allow the vendor to send an embedded pdf, that is only available when the provider clicks **Download PDF version of report**. The HIPAA-compliant guidance is to download the report, drag and drop the report to the patient’s chart, and delete the pdf file from their computer.
**Lab value trending**
The last three values for a test will trend for each vendor. Values received by other vendors will not trend together. For example, if Quest tests Patient’s triglycerides and finds a value of 130 mg/dL and then LabCorp finds Patient’s triglycerides are 200 mg/dL, the Quest value will not appear as a previous value. Trending occurs within each vendor’s values. A LOINC code is required for trending to occur.
**Units and reference ranges**
Users must hover their mouse over the value to see units and the reference range. The units and reference range are provided by the laboratory and cannot be changed by Elation.
## Sending COVID-19 test orders and results to patients via Patient Passport
Patient Passport is Elation’s patient portal that allows your practice to send copies of lab orders and lab results to your patients. If your patient is getting tested at a temporary COVID-19 test center, you can send copies of the requisition order right to their passport account. [See this article](/articles/Passport--Communicating-with-patients#4) on more information for using Patient Passport.
# Orders Guide- Printing specimen labels using a DYMO printer
Source: https://help.elationhealth.com/articles/Orders-Guide-DYMO-printer
This article describes the EHR DYMO printer interface
## Who is DYMO®?
DYMO® is a major printer manufacturer. The DYMO printers we will focus on in this article are the printers used to print specimen labels. DYMO printers are known to be the preferred printer of Quest Diagnostics but many other laboratories’ customers also use DYMO printers.
## How does Elation support DYMO specimen labels?
Elation built an interface with DYMO’s [DYMO Connect software](https://www.dymo.com/support?cfid=dymo-compatibility-chart) to allow customers to print their lab specimen labels directly from the patient’s chart using DYMO label printers. This feature is ideal for customers who collect specimens in-house and use any DYMO label printer released since 2016.
*
The DYMO Connect software explicitly supports DYMO printers 450, 450 Duo, 450 Turbo, 550, 550 Turbo, and 450 XL. However, other printers may also be supported. Best practice is to review DYMO’s documentation to determine if the DYMO Connect software supports the DYMO printer model you own.
Elation currently supports the following four DYMO label types. Elation does not recommend any specific brand of labels, but some DYMO printer models require DYMO-specific labels. Reference DYMO’s documentation about recommended label types to use with your DYMO printer as needed.
* 30252 (3-1/2” x 1-1/8”)
* 30336 (2-1/8” x 1”)
* 30578 (3/4” x 2”)
* 30334 (2-1/4" x 1-1/4")
## How do I get started?
To use the DYMO printer interface, simply have the [DYMO Connect software](https://www.dymo.com/support?cfid=dymo-compatibility-chart) installed on the same computer device you use to create lab orders in Elation. Included in the installation is both the DYMO Connect software (printer drivers) and the appropriate web service.
* Windows users
* DYMO Connect Web Service must be running on your computer or laptop device in order to print specimen labels from the EHR.
* MacOS users
* DYMO Connect WebApi Service must be running on your computer or laptop device in order to print specimen labels from the EHR.
*
MacOS requires a Security Certificate to be set up on your MacOS device before DYMO Connect Service can properly communicate with Elation. If you have not installed the DYMO Connect software on your MacOS device yet, see the [Installing the DYMO Connect software on a MacOS device section](#install_software_MacOS) below to learn more about installing DYMO Connect Service on a MacOS device and setting up your Security Certificate.
If you already installed your MacOS device and run into printing issues, you may need to uninstall the DYMO Connect software and reinstall it to set up your Security Certificate. See the [Troubleshooting the DYMO Connect Software on my MacOS device after running into print issues with Elation section](#DYMO_MacOS_print_issue) below for more details.
## Printing DYMO specimen labels via Elation lab orders
Once you have the DYMO Connect software installed on the same device you use to [create lab orders](/articles/ordering-lab-tests-enhanced) in Elation, follow these steps to print your specimen labels:
1. Click **Actions** --> **Print DYMO® Specimen Labs** from any signed Lab Order.
2. The ***Print DYMO specimen label dialog***will open up with the following information:
3. **Label preview** - this contains the following information:
* Client #: Laboratory account number (e.g. Quest account number) associated with the laboratory order.
* Lab Ref #: Laboratory order requisition number.
* Pat Name: Patient’s name in the format LastName, FirstName.
* DOB: Patient’s date of birth in the format MM/DD/YYYY.
2. If this is your first time printing with DYMO, Elation will automatically detect if your DYMO Connect service is running and preselect a connected printer for you. If you have multiple printers connected, click on the **Printer** list to select the printer you wish to print with.
* For subsequent print jobs, the last used printer will be saved to your computer’s local storage and prefilled for you. This means the last used preferences will be based on the history from the computer you are using and is not tied to a specific Elation user account.
3. Click on the **Label size** dropdown to select the size of your labels. For subsequent print jobs, the last label size used will be saved to your computer’s local storage and prefilled for you. This means the last used preferences will be based on the history from the computer you are using and is not tied to a specific Elation user account.
* Elation currently supports the following four DYMO label types. Elation does not recommend any specific brand of labels. Reference DYMO documentation about recommended label types to use with your DYMO printer.
* 30252 (3-1/2” x 1-1/8”)
* 30336 (2-1/8” x 1”)
* 30578 (3/4” x 2”)
* 30334 (2-1/4" x 1-1/4")
4. Choose the number of **Copies** you want to print. The default copy amount is **1** and the last used copy quantity will not pre-populate in subsequent print jobs.
5. Click **Print & Close** to continue printing.
6. Elation will detect if the DYMO Connect service is running. Before the service is detected, the dialog will be momentarily locked.
7. Once the DYMO connect service is detected, the label(s) will print via the selected printer. If your printer is not connected then the print job will go to your computer’s print queue.
## Common Troubleshooting Tips
### Installing the DYMO Connect software on a MacOS device
Follow these instructions to install the **DYMO Connect For Desktop** software on your MacOS device.
*
When installing the **DYMO Connect For Desktop** software on your MacOS device make sure you also install the DYMO Security Certificate that is part of the installation package or else you will not be able to use the DYMO printer interface with Elation. Follow the instructions below to ensure you install all the essential components.
1. Download the **DYMO Connect For Desktop** software for the MacOS Operating System from [DYMO’s Software Download Center](https://www.dymo.com/support?cfid=dymo-compatibility-chart). Select the most up to date version of the software.
2. Select the Operating System that matches your device and then click **Download**.
Your MacOS device must be running MacOS 11 Big Sur or newer in order to use the **DYMO Connect for Desktop** software. To see which operating system you are using:
3. You should find the Installer Package with a name starting with 'DCDMac..' in your Downloads folder after downloading the package. Double click on the Installer Package to install the software.
4. Your MacOS installer will open. Click **Continue** to begin installation.
5. Read through the Software License Agreement and then click **Continue**.
6. Click **Agree** to agree with the terms of the Software License Agreement.
7. Click **Install** to continue installing the software. You may be prompted to enter your Password or Touch ID to approve the installation.
8. The installation will then begin and the Installer window will display the progress.
9. The important and crucial final step will be to set up the DYMO Security Certificate. Even though the Installer window will say that the installation is complete, installation is not complete until the Security Certificate is set up through the Terminal window that is opened by the installer (sometimes it might take a few seconds for the Terminal window to open automatically).
* To set up the Security Certificate:
1. Allow the installer to access your Terminal.
2. In the open Terminal window you will see a prompt to input your password. You will not see a cursor in the terminal and the cursor will not move as you type your password.
3. Proceed with typing your password as usual and then click **Enter**/**Return** on your keyboard to submit your password.
* If the password is entered incorrectly, the Terminal window will prompt you to enter it again.
4. When your password is correct you will see a **security** window pop up. Enter your password or Touch ID to approve the changes to your device’s System Certificate Trust Settings.
![Terminal window running sudo InstallCertificates.sh prompting for password, overlaid on the macOS installer showing "The installation was successful" on the Summary step.]()
1. Close the Terminal window and then close the installer. You will be prompted about moving the Installer Package to your Trash. You can keep the Installer Package or move it to trash.
2. The software is now properly installed on your MacOS device and ready for use with Elation.
### Troubleshooting the DYMO Connect Software on my MacOS device after running into print issues with Elation
If you are unable to print your DYMO specimen labels via the EHR, first follow these steps to troubleshoot the issue:
1. Click on the DYMO icon at the top of your MacOS device
2. Click **Diagnose…**
3. If the error is ***Error:SecureChannelFailure***, the issue is likely that the Certificate for DYMO was not set up properly on your MacOS device. The easiest solution is to uninstall the software and then reinstall the software to set up the Certificate property during installation. Follow the instructions below to uninstall the software.
1. Download the **DYMO Connect For Desktop** software for the MacOS Operating System from DYMO’s Software Download Center. Select the most recent version of the software.
2. Select the Operating System that matches your device and then click **Download**.
Your MacOS device must be running MacOS 11 Big Sur or newer in order to use the **DYMO Connect for Desktop** software. To see which operating system you are using:
3. You should find the Installer Package with a name starting with 'DCDMac..' in your Downloads folder after downloading the package. Double click on the Installer Package to install the software.
4. Your MacOS installer will open. Click **Continue** to begin installation.
5. Read through the Software License Agreement and then click **Continue**.
6. Click **Agree** to agree with the terms of the Software License Agreement.
7. Click **Customize** when you see the **Standard install on Macintosh HD** step
8. Check off the **DYMO Connect Uninstall** package and then click **Install** to uninstall the software. You may be prompted to enter your Password or Touch ID to approve the installation.
9. The uninstallation will then begin and the Installer window will display the progress.
10. Click **Close** once the uninstallation is complete.
11. Reinstall the software following [these installation instructions above](#install_software_MacOS).
### DYMO label service is unavailable: the DYMO Connect Service is either not installed or running. Install or start the service then refresh the page
The DYMO Connect software must be installed and the service must be running in order to print specimen labels.
* [Click here to download and install the software on your device](https://www.dymo.com/support?cfid=dymo-compatibility-chart).
* You can follow [these steps from above](#install_software_MacOS) to install the software on a MacOS device.
* If the software is installed, click the DYMO Connect icon on your device to confirm the service is running. Click **Start service** if you see this option to run the Dymo Connect software.
* Make sure you are running the latest version of the software by checking your Applications folder in your MacOS device or Programs folder of your Windows device.
### DYMO label service is unavailable: No printers found
If there are no printers installed on the computer, the ***Print DYMO specimen label dialog*** will show an error to indicate no printers are found. If a printer is installed on the computer, the printer will be available for selection, even if the printer is offline or not currently working. Follow your operating system’s instructions on how to set up a printer.
### DYMO label service is unavailable: DYMO Label Plugin is not installed
When the DYMO Connect software is not running, the ***Print DYMO specimen label dialog*** will indicate that the Plugin is not installed. To fix this:
1. Enable the DYMO Connect software on your device.
2. Refresh the patient chart.
3. Click **Actions** --> **Print DYMO® Specimen Labs** from any signed Lab Order.
### Specimen label print job is stuck in the print queue
After the specimen labels are printed from Elation, the print job will be sent to the selected printer. If the selected printer is not online, not connected to the computer, or not working correctly, the printer may not receive the print job successfully and the print job will remain in the print queue. Fix your printer and then open the print queue on your computer and release the print job from the queue to print the labels.
Here are some common printer issues. For all other issues, utilize DYMO resources or Support for assistance.
* DYMO printers are connected to your device through an Ethernet or USB cable. Ensure the appropriate cable is plugged in or try unplugging and plugging in the printer, if needed.
* DYMO 550 series printers will only print using label paper manufactured by DYMO and can detect if the label paper was manufactured by DYMO. If the DYMO printer indicates the wrong label paper is loaded in the printer, ensure the correct label paper is loaded and then restart the printer. If the incorrect label paper error still appears and the correct paper is loaded, turn the printer off and then press the power button 10 times before turning the power button back on.
## Frequently Asked Questions
### What should I do if the DYMO Connect service is not working?
First, ensure that the DYMO Connect Service software (DYMO WebApi app) is running and the icon is showing in either the application tray on Windows (it may be hidden) or in the top menu bar on MacOS. Click the DYMO connect icon to see a menu and use the **Diagnose** option to check the status of the service and see any helpful messages in the event something went wrong.
In general, restarting the DYMO Connect software will resolve most general issues. For additional assistance, we recommend utilizing DYMO’s online resources such as [DYMO’s Help Center](https://help.dymo.com/s/?language=en_US) or [contact DYMO directly](https://www.dymo.com/support?cfid=contact-us).
### How do I add a new type of DYMO label?
Elation supports the most common types of DYMO labels:
* 30252 (3-1/2” x 1-1/8”)
* 30336 (2-1/8” x 1”)
* 30578 (3/4” x 2”)
* 30334 (2-1/4" x 1-1/4")
If you are using a different label type than the ones listed here, click **I need help** --> **Contact Elation Support** --> **Request a feature** and let us know which label type you use. Our Product Team will review your request and let you know if we can support this label type in the future.
### What should I do if the printer is offline or not working?
The DYMO specimen label dialog is only checking if the DYMO Connect software is running on your computer and a printer is set up on your computer. If a printer is set up on your computer but the printer is not working or is offline, the specimen label print job will appear in the computer’s print queue after printing. You can then start the print job once the printer is connected again.
### Can I change the content printed on the label?
No, you cannot change the content printed on the label. Elation shows a label preview in the ***Print DYMO specimen label dialog*** and will always print the account number, requisition number, patient name, and date of birth.
### Can the printer name displayed in the dialog be changed?
Elation is displaying the name of the printer in the dialog as the printer name is set up on the computer. Typically, you set up the printer on the computer the printer name is specified. DYMO printer names default to the manufacturer’s printer name (e.g. “DYMO LabelWriter 550 Turbo”). You can follow your device’s operating system’s instructions to change the printer name as needed.
* [Here are instructions from the Microsoft customer forums on how to change the printer name](https://answers.microsoft.com/en-us/windows/forum/all/win10-how-to-change-printer-displayed-name/e0955b2a-2f2d-4e30-8e87-e28f2cf6497f).
* [Here are instructions from Apple Support on how to change a printer’s name on Mac](https://support.apple.com/guide/mac-help/change-a-printers-name-on-mac-mchl4da0cb05/mac).
### Are DYMO-brand labels (as opposed to generic or other brand labels) required for this specimen label support?
Elation does not require any specific label brand. However, DYMO has recommendations and requirements for specific types of labels supported by each DYMO printer. The 550 and 550 Turbo do require DYMO brand labels and we recommend reviewing DYMO’s guides to determine the appropriate type and brand of label to utilize with your printer.
### Can the client # or account number be changed on the label?
No, the contents of the label cannot be changed. Make sure you select the appropriate lab vendor when preparing your lab order. If you do not select a [bidirectional lab interface](/articles/Bidirectional-Lab-Interface-Guide) then no account number will display on the label.
## Related Articles
* [Order Forms Guide- Ordering lab tests with the Lab Order Form](/articles/ordering-lab-tests-enhanced)
# Visit Note Documentation Guide- Pain Scale
Source: https://help.elationhealth.com/articles/Pain-Scale
## What is the pain scale?
The pain scale is a field within the Vitals section of any note type in Elation. You can document a patient’s present perception of pain intensity on a scale of 0 (no pain) to 10 (highest pain) in the
**Pain**
field. You can also document a brief note next to the score, if needed.
## Why is the pain scale useful?
The pain scale is useful because it allows you to document a patient’s perception of pain intensity as structured data in Elation. When these scores are documented as structured data, you can
[trend the scores](#trending_scores)
over time to compare and track the progression.
## Using the pain scale field
The pain scale is available in the Vitals section of any note type in Elation. You can record the score in the
**Pain:**
field, and if needed, add additional detail for the pain score by clicking **+Note**.
![Visit note Vitals section with the Pain field (0-10 scale) highlighted by a red box and arrow, showing where to enter a pain score and access the +Note option.]()
### Trending pain scores
You can trend the pain scale scores over time to compare and track a patient’s progression. Please reference the
[Chronological Record Guide- Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
for more information on how to trend structured data in Elation.
## Using the Pain assessment coding automation
Premium EHR users can use the
*Pain*
assessment coding automation to automatically input the appropriate result related CPT® Category II Code in the billing section of the visit note.
[Click here to learn more about the Pain assessment coding automation feature](/articles/Automatic-Coding-Guide-Advanced-Coding-Automations#pain)
.
## Frequently Asked Questions
### Is the pain scale also available in non-visit notes?
Yes. You can document the pain scale in phone notes, non-visit notes, and email notes.
## Related Articles
* [Visit Note Documentation Introduction](/articles/Visit-Note-Documentation-Introduction)
* [Visit Note Documentation Guide- Best practices for documenting a patient encounter](/articles/Best-practices-for-documenting-a-patient-encounter)
* [Automatic Coding Guide- Advanced coding automations (Premium)](/articles/Automatic-Coding-Guide-Advanced-Coding-Automations)
# Elation Patient Passport Guide - Communicating with patients & sharing records
Source: https://help.elationhealth.com/articles/Passport--Communicating-with-patients
This article guides you on how to securely communicate with patients are share patient records with them.
## Overview
Patients will automatically have access to the following once they activate their Passport account:
* Messaging
* Patients can receive written messages and attachments from your practice.
* Settings are available to control whether patients can respond to your message and start their own message threads.
* Demographics
* Patients have real-time access to the following demographics information from their chart:
* **Date of birth**
* **Emergency Contact**
* **Provider Assigned in Practice**
* Clinical Profile
* Patients have real-time access to the following Clinical Profile details from their chart:
* **Allergies**
* **Drug Intolerances**
* **Medications**
* **Vaccines**
* Settings can be configured to automatically share more of the Clinical Profile. [Click here to review the four levels of sharing and learn how to set a preferred default](/articles/Setting-up-Patient-Passport#customize_preferences_for_all).
* Visit summaries
* Patients will automatically receive generated summaries when you sign a visit note. This includes the information documented in the following sections of signed visit notes:
* **Vitals**
* **Proc (Procedures)**
* **Tests/Treatments**
* **This includes any Referrals, medications and diagnostic test orders.**
* **Care Plan (Instructions)**
* **F/U (Follow-up)**
* Appointment details
* Date of upcoming appointment
* Date of last appointment
* Link to your Booking Site (if your [Elation Patient Booking Site](/articles/Patient-Booking-Site) has been set up)
Any other details or records not mentioned above must be shared
**manually**
via a
[Patient Letter](#sending-messages-records-via-a-patient-letter)
.
## Workflow Instructions
### Sharing visit summaries
Once a patient registers for their Patient Passport account, they'll immediately see all past visit summaries from signed visit notes. After that, new visit summaries will be automatically shared with them whenever a note is signed in Elation.
The patient will get an email or text—based on their notification preference—telling them to log in to their Passport account to view the new summary.
### Sending messages & records via a Patient Letter
To manually share records or message a patient, use the Patient Letter feature.
| **1** | Create a Patient Letter by clicking **Letter** -> **To Patient** . |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Fill out the remaining fields of the Patient Letter. Click here for a detailed breakdown of the different fields. Subject: Provide a brief overview or context to explain the purpose of the message.Body: Type the main content of your message. Use Wordsmith, our generative AI tool, to help you draft your correspondence if needed. Settings Post Date: Select a future date to send the Patient Letter.Unread Alert: Alert yourself if the Patient Letter has not been read by the patient by a specific timeframe.Print Header: Select the Print Header you want to appear on this Patient Letter. |
| **3** | Adjust/Add attachments as needed. Click here for a detailed breakdown of the attachment options. Default behavior If you initiated the letter from a patient record, the record will automatically be included as an attachment. Options for attaching records: Select Chart Items to Attach: Use this option to pick and choose individual patient records to attach to the letter. Attach Everything in Chart: Use this option to attach all attachable records, referenced below, to the letter. Records available as attachments include: Patient demographicsClinical ProfileImmunization HistoryMedication ListMedication HistorySigned Visit Notes & NotesSigned ReportsSigned OrdersPatient HandoutsCompleted office messagesOther signed letters or referralsGrowth Charts |
| **4** | Select the **Do not allow patient to respond to this letter** box if you want to prevent the patient from replying to your message. |
| **5** | **Sign & Send** the correspondence. Click here for a detailed breakdown of the different Send options. Sign & Send: Signs the letter and sends it to the patient’s Patient Passport account. Sign & Print: Signs the letter and prints the entire letter and its attachments.Sign, Send & Create Follow-up Letter: Signs the letters, sends it to the patient’s passport account and then creates a new draft letter. |
### Responding to messages from Patients
Look for new patient messages in the Patient Letters inbox on your Practice Home page. To reply, click
**Reply**
.
Unlike Office Messages, Patient Letters don't support editing the recipient list, so there's no way to remove yourself from a Patient Letter or reassign it to another staff member. Replying or signing off are the only two ways to clear a Patient Letter from your inbox.
Patient Letters stay in this inbox until someone from your practice either replies to the message or clicks
**Sign Off & End Conversation**
, which files the letter in the patient’s Chronological Record.
* Clicking **Sign Off & End Conversation** also:
* Prevents the patient from replying to the Patient Letter.
* Logs the user and the date and time the conversation ended in the Chronological Record.
There isn't a way to set an automated out-of-office or vacation reply for Patient Letters. As a workaround, use a [Bulk Letter](/articles/introduction-to-bulk-letters) to proactively notify patients ahead of time about the dates you'll be away and your expected response times.
### Importing attachments from messages
If the patient’s message comes with attachments (indicated by a paperclip icon), signing off on the letter will prompt you to file the attachments to the patient’s chart as a Report.
Select the attachments you want to file, then click
**Sign Off & File Checked Items as Reports**
. They will be filed under Misc Reports.
### Reviewing notifications about unread messages
Notifications for unread patient messages will appear in the Reminders inbox on your Practice Home page if a letter has not been opened by the patient by a specific date. You can also view these notifications in the Requiring Action section of the patient’s chart.
Options for addressing the notification are:
* **Resend** - Send the Patient Letter again.
* **Acknowledge** - Dismiss the notification.
* **Write Message** - Open an office message draft.
* **Notify me again later** - Postpone the notification by entering a new timeframe in the **Update Notification** box that appears.
## Related Articles
* [Elation Patient Passport Introduction](/articles/elation-patient-passport-an-introduction)
* [Elation Patient Passport Guide - Setting up Patient Passport](/articles/Setting-up-Patient-Passport)
* [Elation Patient Passport Guide - Managing Passport invitations](/articles/Managing-Passport-invitations)
* [Elation Patient Passport Guide - Helping patients troubleshoot Passport issues](/articles/troubleshooting-passport-with-patients)
* [Elation Patient Passport Guide - Patient's Point of View](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
# Patient Booking Site Guide
Source: https://help.elationhealth.com/articles/Patient-Booking-Site
This article walks you through the steps to set up your Patient Booking Site, including configuring appointment types, setting provider availability, and customizing booking site settings.
📖 **RECOMMENDED READING**
[Click here for instructions on how to set up you provider calendar independent of using Booking Site](/articles/calendar-and-booking-settings) .
## Overview
**Full name (a.k.a. preferred name) used on booking confirmation and form header.** When a patient has a Full Name (preferred/actual name) set in their demographics, that name—not their legal name—is shown on the booking confirmation and the booking patient form header. See the [Patient Demographics Guide](/articles/Patient-Demographics-Guide) for more on the Legal Name vs. Full Name fields.
### What is the Patient Booking Site?
The Patient Booking Site is a personalized web page, specific to your office, that patients can access remotely on any internet enabled devices to book an appointment with you. Patients can easily book an appointment with you from anywhere and at anytime. The Booking Site can be customized to your office's information and preferences and all booked appointments will appear on your Elation calendar in real time.
### Why is the Patient Booking Site useful?
The Patient Booking Site is useful because it allows patients to book an appointment with you from anywhere in the world and at any time during the day. Your availability will be displayed on the Booking Site in real time and all appointments booked through the Booking Site will also appear on your Elation Calendar in real time. This helps reduce the administrative workload of your front office staff.
Use of the Booking Site will also grant patients access to [Appointment Reminders](#AppointmentReminders) and [Patient Forms](#PatientForms) if you link all the features together.
## Workflow Instructions
### Accessing the Calendar & Booking Site Settings
To access your Calendar & Booking Settings page:
| 1 | Click on your email in the top right corner and click Settings . |
| - | --------------------------------------------------------------------------------- |
| 2 | Under **Practice Settings** , click **Calendar & Booking** on the left-hand menu. |
Along the top you will see a series of tabs, which are used to configure your Booking Site. We recommend moving along the tabs from left to right to configure your Booking Site and have outlined each of these steps below.
### Specifying which appointment types appear on the Booking Site
The **Appointments** section is where you can make changes to your **Appointment Types**, surface them on the Booking Site and configure how they appear on the Booking Site.
To add an **Appointment Type** to the Booking Site:
| 1 | Click on the **Appointments** tab on the top menu. |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Click **Edit** in the top right hand corner of the Appointment Type you wish to add to the Booking Site. |
| 3 | Scroll down to the **Booking site** section and check the box for **Show this appointment type on the booking site** . |
| 4 | **(Optional)** Enter the **Description** that you want to display on the Booking Site for that Appointment Type. This can let your patients know what to expect from this Appointment Type. For example, you can include details about what will happen during the appointment or indicate if the patient needs to arrive early for check-in. |
| 5 | Select all of the **Providers** who are eligible to be booked for this appointment, even if there is only one provider in your practice. This will list them on the Booking Site for this appointment. Each provider must have their [availability](#availability) configured for the Booking Site to reflect available appointment times. ![]()
|
| 6 | **(Optional)** Add any **Resource Links** you wish for patients to access after booking their appointment online. You can click **+ Add another** to add multiple resources, or click the **X** button to remove them. |
![Edit Appointment Type panel open, showing the Booking site section highlighted with a dashed border. "Show this appointment type on the booking site" checkbox is checked, and three providers are selected: Aisling Glennie Test 2 DO, Carly Miller MD, and Callista Baumgartner MD.]()
[Click here for instructions about creating and managing appointment types](/articles/calendar-and-booking-settings).
To allow a patient to book this type of appointment on the Booking Site, you must add the provider they are booking with to this appointment type, even if there is only one provider in the practice.
### Specifying Provider availability
The **Availability** section is where you can set each provider's Practice Location(s) and availability for the Booking Site. Reference the following guide: [Calendar & Booking Site Guide - Enhanced Provider availability by Practice Location & Appointment Type](/articles/Calendar-Booking-Site-Guide-Enhanced-Provider-availability-by-Practice-Location-Appointment-Type)
Each provider must fill out their own availability otherwise patients will not be able to book with them through the Booking Site.
### Configuring Booking Site settings
The Booking Site section is where you can configure details and preferences about the actual Booking Site itself.
#### Booking Site Controls
| 1 | **Enable your Booking Site** - Click on the toggle to the right of the **Enable Booking site** setting so that it switches from Off (grey) to On (green). Once enabled, you must share the URL with patients for them to book appointments. |
| - | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | **Customize your URL** - If you wish to customize your Booking Site **URL** link so that it is personalized for your practice (i.e. add your practice name to the end of the link), click the **Customize** button. Once you have entered your customized link text, click **Save** to save the new **URL**. |
| 3 | **Share your URL** - Click **Copy** to copy the **URL** link and post it anywhere you like (i.e. on your business website, in a message/letter to your patients, or on a social media site). You can also embed your booking site link on your [Google Business profile](https://support.google.com/business/answer/9798848?hl=en\&ref_topic=4539639). This will make it easier for patients to access your booking site and self-schedule based on your availability. |
| 4 | **Collect payment method upon booking** *(Admin only)* — Toggle this setting On to prompt patients to save a payment method on the booking confirmation page. When enabled, a **Payment method message** field appears below the toggle where you can enter a custom note shown to patients during the payment step. If the field is left blank, patients see the default message: *"A payment method is required to complete your booking. Your card will not be charged at this time."* |
![Frame 2821]()
If the patient logs in to their Passport account during booking (instead of booking as a guest) and we detect they have a payment method saved to their Elation chart then we will not prompt them to enter one again.
* If the payment form fails to load or the patient encounters an error, the appointment is still created — payment collection does not block booking.
This feature requires Patient Payments (Stripe) to be active for your practice.
After customizing your URL, make sure you update any old links that were used publicly (i.e. on your website, in messages, or on social media).
**The practice name displayed at the top of your Booking Site is not editable from Booking Site settings.** It is sourced from your Elation practice record and can only be changed by Elation Support. If your practice name is incorrect on the Booking Site (for example, after a rebrand or practice name change), [contact Elation Support](https://elationhealth.com/contact-support/) to request the update. Updating a [Practice Location](/articles/adding-a-second-practice-location) name will not change the practice name shown on your Booking Site.
Practice Info
* **Site Message**
* Information entered in the **Site Message** box will display at the top of the Booking Site. You can use the **Site Message** box to:
* notify patients of important information regarding your practice
* provide instructions for how to use the Booking Site
* **Email**
* The email address stored in the **Email** field will display at the top of the Booking Site.
* The email address will also be used for booking confirmation emails for your practice if you enable the **Send treating provider and ...... an email after each online booking** Setting under [Preferences](#preferences).
* **Phone**
* The phone number stored in the **Phone** field will display at the top of the Booking Site. This is usually your practice's main phone number.
* **Address**
* The address stored in the **Address** will display at the top of the Booking Site and is used to determine what map will display on your Booking Site.
* **Show this address on booking site header**
* Toggle this setting On (green) if you want the address entered in the **Address** field to appear at the top of your Booking Site.
* **Show maps on booking site**
* Toggle this setting On (green) if you want a map of your practice's location to appear on your Booking Site.
If you do not wish to have your exact location on the map, you can simply enter the city and state. If you do not wish to have any map display on the Booking Site, enter dashes in the **Address** field.
Practice Hours
Update the **Practice Hours** section to display your business hours at the top of your Booking Site. This is like hanging a sign on your door displaying the open hours.
The times listed in **Practice Hours** only display as business hours on your Booking Site. They do not determine what times patients can book appointments. The source of truth for available appointment times is determined by each [provider's availability](#availability).
Preferences
* **The amount of minimum notice required for booking online**
* Enter the amount of\*\* minimum notice required for booking online. For example, if you select 2 days as the minimum notice timeframe, then a patient viewing the Booking Site on a Monday would see the first available appointment on the coming Wednesday.
* **The amount of future availability shown on the booking site**
* Enter the amount of future availability shown on the booking site. For example, if you select 2 weeks, patients will only see up to 2 weeks of appointments in the future and nothing more.
* **Send treating provider and ... an email after each online booking**
* Select whether you wish an email to be sent to the treating provider and your practice's email (the practice's email is designated by the **Email** field of your [Practice Info Settings above](#practice_information)) when a patient books an appointment by toggling this button On (green) or Off (grey).
* **Automatically send patients an email invitation to join Elation Patient Passport after they book online (if they don't already have a Passport account)**
* By default, Elation sends patients an invite to join patient passport after they book an appointment online (if they don't already have a passport account). However, If you would prefer patients do not automatically receive this invitation please toggle this setting from On (green) to Off (grey).
For HIPAA compliant reasons, the patient's full name will not be displayed in this confirmation email. The confirmation email will only list the patient's initials, the type of appointment they booked, the name of the provider they are seeing, and the date and time of that appointment.
Cancellations
Enter a cancellation policy to ensure patients understand your policy in case they ever need to cancel. Please note, Elation does not enforce your practice's cancellation policy, we only display the policy to the patient.
Now that your Booking Site is enabled, you can send patients a direct URL for specific Appointment Types if preferred. For example, you may wish to send a patient a Patient Letter with the link to book an Annual Wellness Exam. To do this: Go to the **Appointments** tab at the top of the [Calendar & Booking Settings page](https://app.elationemr.com/settings/calendar-and-booking/appointments), find the Appointment Type you wish to share with the patient, then click **Copy** to the right of the **Direct URL** that is displayed at the bottom of the Appointment Type details.
Reviewing appointment reminder settings
After you enable your Booking Site, you may also want to review your reminder settings in the **Reminders** section if you wish to send automated appointment reminders to patients with appointments.
Appointment reminder settings will be applied to all appointments, regardless of whether they were booked through your Booking Site or manually in the Elation scheduler.
[Click here for instructions on how to set up your Elation calendar view, schedule appointment reminders for patients and manage the rooms in your practice](/articles/calendar-and-booking-settings).
Associating Patient Forms for appointments booked through the Booking Site
You can speed up your patient intake process by using Elation's Patient Forms feature along with the Booking Site. For more information on setting this up, watch our [video walkthroughs](https://vimeo.com/manage/showcases/6957806) or read [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms).
## Troubleshooting
Patients say they booked but the appointment isn't on your Calendar
If a patient reports they scheduled an appointment but you cannot find it in Elation:
| 1 | **Confirm the patient completed the booking process** - The patient must reach the final **Confirm** step and select the confirmation button. If they navigated away before confirming, the appointment was not created. |
| - | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | **Check for sticky Confirm button behavior** - In some browsers, the **Confirm** button may appear unresponsive. Ask the patient to try a different browser or clear their cache and rebook. |
| 3 | **Verify the patient's contact information** - Confirm the email address or phone number the patient used matches what is on file. Booking confirmations are sent to the contact information entered during scheduling—if there is a mismatch, the patient may not have received confirmation, or the appointment may be under a different patient record. |
No available times showing for patients
If patients report that no appointment times are available on the Booking Site:
| 1 | **Review your Availability configuration** - The Booking Site only displays times you have set as available for online scheduling. Go to Settings → Calendar & Booking → Availability and confirm the correct days, times, and appointment types are enabled for each provider. |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | **Check for Calendar Blocks** - [Calendar Blocks](/articles/how-to-use-elation-calendar#calendar_block_vs_placeholder) hide time slots from the Booking Site. Review your calendar for any blocks during the times patients expect to see availability. |
| 3 | **Check for existing booked appointments** - Booked appointments remove those time slots from the Booking Site. If your schedule is full, no times will display. |
| 4 | **Check the Booking Site interval and availability block start times** - If patients see slots but they land on unexpected minute marks (for example :15 / :35 / :55 instead of :00 / :20 / :40), review **Time block intervals for booking site** under **Settings** → **Calendar & Booking** → **Calendar view**, and confirm each provider's availability block starts on the minute mark you want the first slot to land on. See [Managing the Calendar View](/articles/calendar-and-booking-settings#managing-the-calendar-view) for details. |
[Non-blocking Placeholders](/articles/how-to-use-elation-calendar#placeholder) (such as personal reminders or internal notes) do not hide times from the Booking Site. Only [Calendar Blocks](/articles/how-to-use-elation-calendar#add_events) and booked appointments affect available slots.
## Frequently Asked Questions (FAQs)
### Why are certain appointment types not appearing for my patients?
Appointment types have to be configured in order for them to appear in the Booking Site for each provider. To configure the different types of appointments, follow the steps in the [Appointments](#appointments) section of this article.
### What is the difference between practice hours and physician hours?
The practice hours will be displayed at the top of the Booking Site for patients to reference the regular business hours for the office.
Each provider will also be able to select their own availability under the **Availability** section of the **Calendar & Booking** settings page. The provider’s availability will determine the timeframe patients can select from when booking an appointment. This means that each provider’s availability can fall within or out of normal practice hours if they choose.
* If a provider is already booked for another appointment or other event, the availability for that provider will be automatically updated on the Booking Site to avoid double booking.
### Will we be notified when a patient books an appointment? How will we be notified? Who will get notified?
There is a feature you can turn on if you want an email notification to be sent to providers and staff when a patient books an appointment. This feature is located in the Calendar & Booking → Booking Site → Preferences section.
For HIPAA compliant reasons, the patient’s full name will not be displayed in this email. We will display the patient’s initials, the type of appointment they booked, the name of the provider they are seeing and the date and time of that appointment. This email notification will go to the provider’s Elation email as well as the email listed in the **Email** section of the Booking Site section.
### Can I turn off the staff email notification about booked appointments or changes?
Yes. Go to the **Calendar & Booking** section of the Settings page in Elation, under Booking Site → Preferences, and turn off the **Send treating provider and ... an email after each online booking** setting.
This setting only controls the notification email sent to your practice. It does not affect the confirmation email a patient receives after booking — Elation sends that confirmation automatically, and there is currently no setting to turn it off.
### Do patients need to have a Patient Passport account in order to book an appointment through the Booking Site?
Patients do not need to register for a Passport account in order to book an appointment through the Booking Site. Patients who continue as a **Guest** will be prompted to enter their chart information to allow Elation to try to connect their appointment to their chart.
If the patient has a Passport account, they may log in to connect their appointment to their account or they can continue as a guest to book appointments. We suggest recommending patients sign in to their Passport account when booking an appointment as this ensures the appointment will be tied to their existing Elation chart.
**Guest bookings and duplicate charts:** When a patient books as a Guest without logging in to Passport, Elation attempts to match them to an existing chart. A duplicate chart is only avoided if the patient's **Name**, **Date of Birth**, **Gender**, and **Email** all match the information on their existing chart. If any of these fields do not match, a new chart will be created. If a duplicate chart is created, always merge the duplicate chart into the original chart — see [instructions below](#how-come-a-new-chart-was-created-for-this-patient).
Patients will not be able to book appointments directly through Patient Passport. Patient Passport will direct the patient to your Booking Site if they wish to book an appointment asynchronously. All Booking Site preferences —such as provider availability, appointment types, and time slots— should be managed through the **Booking Site** settings.
### Can people book appointments on behalf of their children, significant other or family member?
People can book appointments on behalf of their children, significant other or family member. There are two options:
| 1 | Log in to that person's Passport account to link the appointment to their chart. |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Book the appointment as a **Guest** for their child, significant other or family member. Enter their information as it is listed in their chart so that Elation can try to map the appointment to their chart. |
### When a patient books an appointment, is the appointment considered fully booked or is the appointment requested and I need to accept it?
Appointments are considered fully booked when a patient books an appointment on the Booking Site. If you would like patients to confirm their appointments prior to the date of the appointment, utilize our appointment reminder feature which offers the patient an option to confirm their appointment.
Appointment reminders can be set in the Settings → Calendar & Booking → Reminders section of Elation. You can select up to 3 reminders to go out for each appointment. The reminders will be sent via the patient's preferred contact method found in the patient's chart under their demographics information. If the patient does not have a preferred contact method selected, the reminders will be sent via the first method listed below according to what information is available in the patient’s chart:
| 1 | Patient Passport Contact Settings (the default setting is email). If they do not have an active Patient Passport account, then: |
| - | ------------------------------------------------------------------------------------------------------------------------------- |
| 2 | SMS Text to the **Mobile** phone number. If they do not have a **Mobile** number, then: |
| 3 | Email notification to the email address. If there is no Email address on file, then: |
| 4 | Phone call to the **Home** or **Main** phone number. |
| 5 | If no phone numbers or email are available then the patient will not receive any appointment reminders. |
### How do appointment reminders work? Can I customize the time range in which patients are reminded? Can I customize how the patient is reminded?
Appointment reminders can be set in the Settings → Calendar & Booking → Reminders section of Elation. You can select up to 3 reminders to go out for each appointment. The reminders will be sent via the patient's preferred contact method found in the patient's chart under their demographics information. If the patient does not have a preferred contact method selected, the reminders will be sent via the first method listed below according to what information is available in the patient’s chart:
| 1 | Patient Passport Contact Settings (the default setting is email). If they do not have an active Patient Passport account, then: |
| - | ------------------------------------------------------------------------------------------------------------------------------- |
| 2 | SMS Text to the **Mobile** phone number. If they do not have a **Mobile** number, then: |
| 3 | Email notification to the email address. If there is no Email address on file, then: |
| 4 | Phone call to the **Home** or **Main** phone number. |
| 5 | If no phone numbers or email are available then the patient will not receive any appointment reminders. |
### Can patients confirm, reschedule or cancel appointments? If so, how and in what time frame?
Patients can confirm, cancel, and reschedule appointments directly from their appointment reminder when the relevant settings are enabled:
* **Confirm:** Always included in email and SMS reminders.
* **Cancel:** Available when **Allow patients to cancel their appointments online** is enabled under **Settings > Calendar & Booking > Reminders**. If the Patient Booking Site is also active, patients see a **Book a new appointment** button after canceling that opens the Booking Site pre-filtered to the original provider.
* **Reschedule:** Available when **Allow patients to cancel their appointments online** is on **and** the Patient Booking Site is active. The patient clicks **Reschedule appointment**, picks a new time from the provider's availability, and the original appointment is automatically canceled when the new booking is confirmed. If they abandon the flow without completing the booking, the original appointment is not canceled.
If a patient needs to reschedule or cancel before they receive a reminder, they will need to call the office.
To turn off patient-initiated cancellations and rescheduling, disable the **Allow patients to cancel their appointments online** setting under **Settings > Calendar & Booking > Reminders**.
### Can I see what the patient sees when they try to book an appointment with me?
Yes, you can see what the patient sees when they try to book an appointment with you by copying the booking site URL and opening it in Google Chrome or Mozilla Firefox. To find the URL, go to Settings → Calendar & Booking → Booking Site. The URL is at the top of this page. You can customize it to your preference by clicking the **Customize** button to the right.
### Why can’t I use the custom URL I want for my booking site?
If you try to save a customized URL and it does not let you save, this means another Elation user is using that URL and you will need to choose a different one.
### How come a new chart was created for this patient? How come this patient’s chart is blank? They have been seen by me multiple times.
When a patient books an appointment as a Guest (without logging in to Passport), Elation tries to match them to an existing chart. A duplicate chart is only avoided if the patient’s **Name**, **Date of Birth**, **Gender**, and **Email** all match the information on their existing chart. If any of these fields differ — for example, the patient uses a different email address or a nickname — a new chart will be created.
If a duplicate chart was created, merge it into the original chart by following these steps:
| 1 | Open the new chart. |
| - | -------------------------------------------------------------------- |
| 2 | Click on the patient’s name to open their Demographics. |
| 3 | Click on the **Merge Chart** button at the bottom right hand corner. |
| 4 | Find the patient’s other chart and then click **Merge Chart** . |
| 5 | Click **Yes, merge chart** when the **Confirm** box pops up. |
To prevent duplicate charts, encourage patients to log in to their Passport account when booking appointments. Logging in guarantees the appointment is tied to their existing chart regardless of the information they enter.
If **Collect payment method upon booking** is enabled and a payment method was collected in a duplicate chart, that card will be deleted when the duplicate chart is merged and will not be available on the merged chart. The patient will need to provide their payment information again after the merge is complete.
### What are resource links?
Resource links are website addresses that you can share with patients when they book an appointment with you. These links will direct a patient to where you want them to go to take a specific actions prior to their appointment. Feel free to utilize resource links to share any web based content with patients.
* Some customers link the patient to an intake form the customer can fill out online. Some customers link the patient to a folder of paperwork they want the patient to fill out and bring to the office.
### Will appointments booked through the booking site appear in my integrated practice management system automatically?
Appointments booked through the booking site will appear in your practice management system if the integration is set up for Elation to push appointment information from the Elation Calendar to the practice management system.
If appointment information is only pushed from the practice management system to the Elation Calendar, then you will need to manually add the patient’s appointment to your practice management system.
### Will patients be able to access the Booking Site on their phone?
Yes, patients will be able to access the Booking Site on their phone. The Booking Site is visible and formatted for all mobile devices of all sizes.
### Is the Booking Settings page only for admin level staff or can everyone at the practice access this Settings page?
The Booking Site Settings page is default accessible to all users. There is a feature on the Settings page that allows you to set the page as **Admin Only**. You will see the option at the top right corner of the **Calendar & Booking** Settings page.
* Once the **Admin Only** option is selected, then only Admin level users will be able to adjust the Calendar and Booking Site settings.
### Are there text limits for the Calendar & Booking Site text boxes?
Yes, the text limit for the different boxes are as follows:
* Site Message = 255 characters
* Address = 255 characters
* Cancellation Policy = 255 characters
* Appointment Type Description = 280 characters
### What time zone will the availability of the Booking Site display in?
The Booking Site will automatically display availability based on the Time Zone of your practice.
### Can I allow more than one patient to book the same time slot?
Each appointment slot can only be booked by one patient. Elation does not allow for double booking the same time slot.
### What happens when a patient cancels an appointment? Does the time slot free up for other patients to book?
When a patient cancels an appointment, the time slot will become available for other patients to book.
### Can patients schedule recurring appointments?
No. Patients cannot schedule recurring appointments through the Booking Site. Only staff can create recurring appointments in Elation.
For instructions on scheduling recurring appointments, see the [Calendar Guide - Scheduling recurring patient appointments](/articles/recurring-patient-appointments) article.
### Can patients join a waitlist online?
No. Elation does not include a built-in online waitlist for patient self-scheduling.
Recommended alternatives:
* Maintain a manual recall list in Elation to track patients who want earlier appointments.
* Instruct patients to call the office if they would like to be added to a cancellation list.
### What do patients see when "Collect payment method upon booking" is enabled?
When this setting is on, the booking confirmation page changes to require a payment method. The page heading reads **"Add a payment method to confirm appointment"** and a card entry form appears below the appointment summary. The **Confirm Appointment** button remains disabled until the patient enters valid card details.
* If the payment form fails to load or the patient encounters a technical error, the button will be enabled and the appointment can still be confirmed without a payment method.
The message shown above the card form is the text you entered in the **Payment method message** field in your Booking Site settings.
Patients who login in to their Passport account during booking and who already have a payment method saved to their Elation chart are not shown the form and can confirm their appointment directly.
If a duplicate chart was created during booking and a payment method was collected on that chart, the card will be deleted when the duplicate is merged into the original. The Elation chart merge dialog will remind you of this before you confirm the merge. The patient will need to provide their payment information again after the merge is complete.
### Can I redirect patients to a page on my own site after they book?
No, the Booking Site doesn't support automatically redirecting patients to a site-based confirmation page after booking. You can add [resource links](#what-are-resource-links) to the confirmation screen for patients to click, but these are not automatic redirects.
### Can I trigger a webhook when a booking completes?
The Booking Site itself doesn't have a setting to trigger a webhook on completion, but a booking still creates or updates an [Appointment](/articles/rest/scheduling-api/appointments/the-appointment-object) record like any other appointment. If you subscribe to the `appointments` event on the [Webhooks API](/articles/rest/overview/webhooks), you'll be notified when that happens.
### Can I embed the Booking Site directly within my own website?
No, Elation doesn't support embedding the booking flow directly within your website. You can add [resource links](#what-are-resource-links) to the confirmation screen to send patients back to your site after they book.
### Can I add Google Tag Manager, GA4 tags, or other custom tracking scripts to the Booking Site?
No, Elation doesn't support adding Google Tag Manager, GA4 tags, or other custom tracking scripts to the Booking Site.
**Next Step**
**Set up your Patient Booking Site today and start seeing the advantages of online booking!**
## Related Articles
* [Calendar Guide- How to set up the provider calendar](/articles/calendar-and-booking-settings)
* [Calendar Guide- Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar)
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Patient Forms Guide](/articles/Patient-Forms-Guide)
# Patient Chart Guide- Annotate and eSign Clinical Reports and Documents
Source: https://help.elationhealth.com/articles/Patient-Chart-Guide-Annotate-and-eSign
This article details how to use the Annotate and eSign feature.
## What is the Annotate and eSign feature?
The Annotate and eSign feature allows users at your practice to annotate and electronically sign clinical reports and documents directly in Elation EHR. Annotations and eSignatures can be added to documents that are filed into patient charts. All users can annotate documents, while Provider Level Users can annotate and electronically sign documents.
You can only annotate faxed or uploaded clinical reports and documents that are PDFs or images. You will not be able to annotate structured electronic results that come in via integrations (ex. electronic lab results, imaging results or hospital results).
## Why is the Annotate and eSign feature valuable?
The Annotate and eSign feature is valuable because it allows you to annotate and electronically sign documents directly in Elation EHR. This feature saves your practice time and streamlines your workflows by enabling you to complete all annotations and electronic signatures directly within Elation. With this feature, you do not have to navigate to another platform, or print the document, to add signatures and complete other necessary markups.
## How to use the Annotate and eSign feature
### Overview
To annotate and/or electronically sign clinical reports or documents, the document must be uploaded to Elation and filed into a patient chart as a Report. These documents can be uploaded from your device into Elation, or faxed to you. There are two ways to upload documents from your device into Elation, either through the Fax Inbox on the Practice Home page or directly into a patient chart. Please reference these guides below for instructions on these workflows:
* [File the Report from the Fax Inbox](/articles/Fax-Inbox-Introduction)
* [Drag and drop the document directly into the patient chart](/articles/filing-documents-to-a-patient-chart)
If the document is faxed to you, you will first need to file the document from the Fax Inbox into a patient chart. Once filed to the chart, the document will be located in the Requiring Actions queue awaiting further action, annotation, and eSignatures as needed.
Once annotations to the document are saved, it will replace the original, un-annotated version of the document. You can continue to add annotations until a Provider Level User clicks the **Sign Off** button. After a document has been signed off by a Provider Level User, no additional annotations or eSigntaures can be added and the annotated version of the document will replace the previous version in the patient chart.
If users at your practice need other users to follow up on the annotated version of the document, they can send an office message directly from the document in the Report Panel or the Requiring Action section of the patient’s chart by clicking the **Actions** dropdown located in the top right of the document and selecting **Office Message**. The **Office Message** button is also available at the bottom of the annotated document in the Report window.
The annotated document can be shared with external entities via a [Referral, Provider Letter](/articles/letter-and-referral-introduction) , or [Patient Letter](/articles/elation-patient-passport-an-introduction) .
All users can annotate documents, but only Provider Level Users can eSign documents.
## How to start an annotation
To annotate a document, please follow the instructions below:
File the document to the patient chart through the Fax Inbox or by dragging and dropping the document into the patient chart.
* [File the Report from the Fax Inbox](/articles/Fax-Inbox-Introduction)
* [Drag and drop the document directly into the patient chart](/articles/filing-documents-to-a-patient-chart)
Locate the document in the Requiring Actions queue of the patient chart and click on the name of the document to open it in the Reports Panel
Begin annotating using one of these 2 options:
* Click **Actions** --> **Annotate**
* Scroll to the bottom of the document in the Reports Panel and click **Annotate**
## How to annotate a document
The annotation options toolbar will list all the annotation options. We will describe each annotation option in more detail in the *‘Annotation Options’* section below. To insert an annotation, click on an annotation option from the toolbar and then click on the spot in the document where you want to place the annotation.
![Annotate Report window showing three labeled toolbars: annotation options (left), page navigation displaying "Page 1 of 2" with First/Previous/Next/Last controls (center), and zoom options (right).]()
Any annotation can be edited, duplicated or deleted prior to saving.
* Move an annotation by clicking and dragging it to a new spot.
* Resize an annotation by clicking the circles on the perimeter of the annotation and then dragging the annotation to the desired size.
* Copy and paste an annotation by clicking on the annotation, pressing **Control/Command** + **C** at the same time on your keyboard (to copy) and then pressing **Control/Command** + **V** at the same time on your keyboard (to paste).
* Delete an annotation by clicking on the annotation and then clicking the **Delete** or **Backspace** button on your keyboard.
* Undo or redo an action by clicking on the **Undo** or **Redo** buttons in the annotations toolbar or pressing **Control/Command** + **Z** (to undo) or ‘Control/Command’ + ‘Y’ (to redo).
### Annotation Options
| Option | Keyboard Shortcut | Description |
| ------------------- | ------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| Signature | S | Provider Level Users can add their eSignature to the document. Staff Level Users cannot e-sign. To update your signature, go to **Settings** → **Account Details** → **Edit Profile** and click your existing signature. |
| Signature with Date | X | Provider Level Users can add their eSignature plus a date. The date defaults to today but can be adjusted. Staff Level Users cannot e-sign. |
| Text | T | Any user can add text to the document. |
| Date | D | Any user can add a date to the document. The date defaults to today. Double-click the date annotation to edit it. |
| Checkmark | C | Any user can add a checkmark to the document. Press **ESC** to stop adding checkmarks. |
| Free Draw | W | Any user can draw freehand directly on the document. Click and drag to draw a stroke — circle items, cross things out, or make any freehand markup. Strokes support undo, redo, and delete like any other annotation. |
| Undo | Ctrl+Z (PC) / Cmd+Z (Mac) | Undo the last action. |
| Redo | Ctrl+Y (PC) / Cmd+Y (Mac) | Redo the last undone action. |
| Select All | Ctrl+A (PC) / Cmd+A (Mac) | Select all annotations on the page. Useful for moving or deleting in bulk. |
| Delete | Delete or Backspace | Delete the selected annotation(s). |
| Copy | Ctrl+C (PC) / Cmd+C (Mac) | Copy the selected annotation(s). |
| Paste | Ctrl+V (PC) / Cmd+V (Mac) | Paste copied annotation(s) onto the page. |
| Exit annotation | ESC | Exit annotation mode or cancel the current annotation selection. |
### Page Navigation Options
Page navigation options will appear at the top of the annotate window if the document has more than one page. You can use these options to navigate between pages.
| Option | Button | Keyboard Shortcut | Description |
| ------------- | ------ | ----------------- | --------------------------------------- |
| First | | N/A | View the first page of the document. |
| Previous page | | Left arrow | View the previous page of the document. |
| Next page | | Right arrow | View the next page of the document. |
| Last | | N/A | View the last page of the document. |
### Zoom Options
Use the zoom options in the top right corner of the annotation window to Zoom in or out of the document page while you are annotating or move to different areas of the page.
| Option | Button | Keyboard Shortcut | Description |
| ----------- | ------ | ----------------- | ---------------------------------------------------------- |
| Zoom to fit | | F | Adjust the size of the image to fit the annotation window. |
| Pan | | P Spacebar | Move to different areas of the image while zoomed in. |
| Zoom in | | = (equal) | Zoom in to the image. |
| Zoom out | | - (dash/minus) | Zoom out of the image. |
## How to save annotations
Once all of your annotations and eSignatures have been added to the document, click the **Save annotation** button at the bottom left of the window to save your work and close the annotation window.
To view an annotated report, click on the report from the Reports window again. You may need to click the **Refresh** button at the top right corner of the Reports window to see your updates.
## Annotation Tips
### Using Free Draw to mark up documents
The Free Draw tool (keyboard shortcut: **W**) lets you draw anything directly on the document — circle a response, cross something out, or add any freehand mark. Click and drag to draw. When you're done with a stroke, release your mouse and start the next one. Press **ESC** to exit Free Draw mode.
![Freedraw]( "Freedraw")
### Exiting an annotation
When you have finished typing text or editing a date in the annotation, press the **ESC** (escape) key on your keyboard to exit the annotation.
### Canceling an annotation selection
If you no longer want to add the annotation you selected from the annotation toolbar, press the **ESC** (escape) key on your keyboard to cancel your selection.
### Inserting text that is all the same size into different areas of the document
Each new text box you create from the **Text** button will be a standard size. If you want to resize the font and re-use that font size for other text annotations in the document, we recommend copying (**CTRL**/’CMD’ + ‘C’ on your keyboard) the first text box you added (the one you resized) and then pasting it (‘CTRL’/’CMD’ + ‘V’ on your keyboard) to the next annotation spot.
### Moving annotations in bulk
To move multiple annotations:
Select the annotations using one of the following methods:
* Click and drag your cursor over all the annotations you want to highlight
* Using your mouse/trackpad and keyboard: click on one of the annotations you want to move, press and hold the **Shift** key on your keyboard, click on the next annotation you want to move, and repeat until all of the annotations are selected
Click on the highlighted annotations and then hold and drag them to the desired location on the page
Let go of your cursor
To move all annotations in bulk:
Press **CTRL**/’CMD’ + **A** on your keyboard
Click on the highlighted annotations and then hold and drag them to the desired location on the document
Let go of your cursor
### Deleting annotations in bulk
To delete multiple annotations in bulk:
Select the annotations using one of the following methods:
* Click and drag your cursor over all the annotations you want to highlight
* Using your mouse/trackpad and keyboard: click on one of the annotations you want to delete, press and hold the **Shift** key on your keyboard, click on the next annotation you want to delete, and repeat until all of the annotations are selected
Press the **Delete** or **Backspace** key on your keyboard
To delete all annotations in bulk:
Press **CTRL**/’CMD’ + **A** on your keyboard
Press the **Delete** or **Backspace** key on your keyboard
Alternatively, click the **Discard** button at the bottom of the annotation window to discard all annotations you made during the edit session
You cannot remove or edit annotations and eSignatures once they have been saved, even if you go to annotate the document again.
## Frequently Asked Questions
### I need to find the original, un-annotated document. How do I do that?
If you need the original, un-annotated document, please click the **I need help** from the Blue Navigation Bar at the top of your page and select **I need help from an Elation Team** member to open a support ticket with Elation's Support Team. Please indicate that you would like the un-annotated version of the document and share the following information with our team:
1. Patient chart ID number (located at the top of the [Demographics Window](/articles/Patient-Demographics-Guide))
2. Date and title of the report
[Click here for more details on how to contact our Support Team](https://help.elationemr.com/s/contactsupport) .
Elation typically provides a first response within 1 business day; Mondays through Fridays, 9am to 5pm Pacific. If you urgently need the un-annotated document and it is blocking patient care, please submit an [Urgent Request.](https://help.elationemr.com/s/contactsupport)
### Can staff annotate documents, or only providers?
Both Provider Level Users and Staff Level Users can annotate documents, but only Provider Level Users can add their electronic signature to documents.
#### I assigned the wrong reviewer for a document. Can someone else annotate it?
Yes, any user can annotate the document from within the patient’s chart. However, Provider Level Users can formally change the reviewer for a document by clicking the **Actions** dropdown located in the top right of the document in the Report Window and selecting **Reassign to Other Provider**. This option is also available directly from the Requiring Action section.
Reports Window
![Hospital report Actions dropdown open in the Reports Panel, with "Reassign to Other Provider" highlighted and indicated by a red arrow.]()
Requiring Action
![Actions dropdown expanded on a Hospital report in the Requiring Action queue, with "Reassign to Other Provider" highlighted and indicated by a red arrow.]()
#### Can I annotate a document that has been signed off?
After a document is signed off, no additional annotations can be added. However, users can use the **Actions** dropdown for the document and select **Remove & Refile Images** from either the Report Window or the Requiring Action section to place the annotated version of the document back in the Fax Inbox and then file the document back to the appropriate patient chart to add additional annotations.
Report Window
![Hospital report Actions dropdown open in the Reports Panel, with "Remove & Refile Images" highlighted and indicated by a red arrow.]()
Requiring Action
![Actions dropdown open on a Hospital report in the Requiring Action queue, with "Remove & Refile Images" highlighted and indicated by a red arrow.]()
#### Can I edit my annotations after they are saved to the document?
No, annotations cannot be edited after they are saved to a document. However, you can add additional annotations to the document before it is signed off by a Provider Level User.
#### Can I edit my annotations after a document has been signed off?
No, annotations cannot be edited after a document is signed off. Please reference [what to do if you need the original, un-annotated version of a document](#i-need-to-find-the-original-un-annotated-document-how-do-i-do-that) if you need to start the annotation process over.
## Related Articles
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
* [Fax Inbox Guide- Managing inbound electronic faxes and uploading documents](/articles/Fax-Inbox-Introduction)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
* [Support Guide- How to get help on Elation](https://help.elationemr.com/s/contactsupport)
Don't see the annotation option you need? Free Draw (**W**) lets you mark up a document any way you like — circle a response, cross something out, underline text, or draw anything else freehand.
# Patient Chart Guide- Audit Logs
Source: https://help.elationhealth.com/articles/Patient-Chart-Guide-Audit-Logs
This guide will describe how users at your practice can access information about actions taken within a patient chart through the Audit Logs feature.
## What is the Audit Logs feature?
The Audit Logs feature within a patient chart is available for Admin Level Users at your practice to track actions taken in a specific chart and track who at your practice has viewed the chart. These logs display the following information for your reference:
* What type of action was taken on what type of chart item
* Shows specific information detailing if items were deleted, edited, and [more](#action-definitions)
* Which user took the action
* Displays the user’s name from your practice
* ## The date & time the action occurred
the Record Date (time and date column) will display in PDT
## Why are Audit Logs useful?
The Audit Logs feature is a useful and valuable tool for your practice to track actions and access within a specific patient chart. Some common actions to track within the chart are deletion/creation of specific items within a record, deletion/creation of records, and access. Reference the
[recommended use cases](#tips-and-recommended-use-cases)
for more information on how to best utilize this feature.
## Using Audit Logs
The Audit Logs feature is available within a patient chart for Admin Level users at your practice. Please follow these steps below to access this feature.
1. Start in a patient chart and click **More** in the top grey navigation bar of the chart
2. Click **Data Exchange**
![Patient chart top navigation with "More" button clicked, showing a dropdown menu with "Data Exchange" highlighted and indicated by a red arrow.]()
3. Click **Audit Logs** from the window that appears
4. A new tab will open on your browser and will bring you to the Audit Log page.
*
This page will automatically show actions taken for the given day you opened the page. You will be able to adjust the date range and filters to customize how the information is displayed for you.
5. Each Audit Log page will show up to 25 actions. If your date range includes more than 25 actions, you can navigate to the other pages by using the **Next>** and **Last>>** buttons, as shown below.
![Audit Log showing 35 results with "Next >" and "Last >>" pagination buttons highlighted by red arrows, used to navigate beyond the first 25 entries.]()
### Audit Log page guide
You can use the various Audit Log filters below to customize your search (match the number to the image below):
1. You can filter the date range here by typing in your preferred date range
*
accepted formats for this field include (YYYY-MM-DD) and (MM/DD/YYYY)
2. You can sort the information by the following categories
* Patient
* Action
* Record Type
* Record ID
* Performed By
* Record Date
3. You can sort the information in either Descending or Ascending order
### Action Definitions
| **Action** | **Description** |
| ------------ | ------------------------------------------------------------------- |
| Add | Information was added |
| Change | Information was changed in a chart item |
| Copy/export | Chart information was exported |
| Delete | Information within a chart item or an entire chart item was deleted |
| Print | Chart item was printed |
| PrintPtInstr | Patient instructions printed |
| Query | Accessing/opening the patient chart |
| Sign | Chart item was signed off |
### Tips and recommended use cases
Below are a few examples of recommended use cases for how your practice can best utilize this feature:
**Scenario 1**
Your practice is looking to track down who deleted a lab order from the chart in the last 3 days. To find this information in Audit Logs, please take the following steps:
1. Access Audit Logs using the steps detailed in the [Using Audit Logs](#using-audit-logs) section
2. Set the date range for the past 3 days
*
the Record Date (time and date column) will display in PDT
3. Sort the information by action and locate the **Delete** logs under the **Action** column
*
You may have to click through multiple pages if there were many actions taken in the chart by using the **Next>** and **Last>>** buttons, as shown below.
![Audit Log page showing 35 total results with "Next >" and "Last >>" pagination buttons highlighted by red arrows, indicating how to navigate beyond the first 25 entries.]()
**Scenario 2**
Your practice wants to see who recorded the vitals on the visit note from today. To find this information in Audit Logs, please take the following steps:
1. Access Audit Logs using the steps detailed in the [Using Audit Logs](#using-audit-logs) section
2. Sort the information by **Record Type** and locate **VitalsCollection** in the **Record Type** column.
Here you can see which users from your practice recorded this information by viewing the names under the **Performed by** column that correspond with the **VitalsCollection** row.
**Scenario 3**
Your practice wants to track which staff members accessed a specific patient chart today. To find this information in Audit Logs, please take the following steps:
1. Access Audit Logs using the steps detailed in the [Using Audit Logs](#using-audit-logs) section
2. Sort the information by Action and locate **Query** under the **Action** column
Here you can see which staff members accessed the patient chart on this day by viewing the names under the **Performed by** column that correspond with the **Query** row.
## Gathering additional details
Need more information regarding a specific action from the Audit Log? Please contact our Support Team using the **I need help** -> **Contact Elation Support** button and include the following information in your request:
1. Description/context for what information you are looking for
2. Patient chart ID (located in the patient’s demographic window)
![Patient Details tab showing the Elation Patient ID field (140802472411137) with a red box and arrow highlighting the Copy button to copy the ID.]()
3. Date of the action and time of the action
4. Record ID
5. Relevant Users involved
## Frequently Asked Questions (FAQ)
**Can I download or export the Audit Log as a file?**
There isn't a way to download or export the Audit Log as a file. Admin Level Users can view it directly in the patient's chart using the steps in the [Using Audit Logs](#using-audit-logs) section above.
**Does the Audit Log show what was in the item that was added, changed, or deleted?**
No. Each entry identifies the Record Type and Record ID of the affected item along with the action, user, and timestamp, but it doesn't display the item's clinical content, such as a medication's name and dose or a lab order's test name. To confirm what a specific Record ID corresponds to, contact Elation Support using the **I need help** -> **Contact Elation Support** button and include the details listed in [Gathering additional details](#gathering-additional-details) above.
## Related Articles
* [Chronological Record Guide- Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
* [Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
# Patient Chart Guide- Creating a new patient chart
Source: https://help.elationhealth.com/articles/Patient-Chart-Guide-Creating-a-new-patient-chart
This article will describe how to create a patient chart in Elation for a new patient.
## What is a patient chart?
All records in the Elation EHR must be tied to specific patient. A
*Patient Chart*
is the feature that stores all of these records in one place. The
*Patient Chart*
can be divided into the following sections:
1. [Patient Demographics](/articles/Patient-Demographics-Guide)
2. [Clinical Profile](/articles/clinical-profile-record-patient-medical-history)
3. [Chart Navigation Bar](/articles/Patient-Chart-Navigation-Bar)
4. [Chronological Record](/articles/store-everything-in-chronological-record)
## Creating a new patient chart
To create a new patient chart:
1. Go to the [Practice Home](https://app.elationemr.com/patients/) page and click on the **New Chart** button in the gray navigation bar.
2. Fill in the patient's demographics details- especially the required fields of **legal first name**, **legal last name**, **date of birth**, **sex at birth** and **Provider assigned in practice**
3. Review the [Patient Demographics Guide](/articles/Patient-Demographics-Guide#Tips) to learn more about the various demographics fields. The Patient Demographics Guide also has a guided video.
4. Click **Create & Open Chart** or **Create Chart** when done.
!["New Chart" button highlighted in the navigation bar with an arrow pointing to the open "Create New Patient Chart" dialog, showing the Patient Details tab with "Legal first name" field outlined in red and marked Required.]()
*
If you are searching for a patient in one of the Patient Search options and you do not see a chart for the patient in the search results, simply click the **Create a new patient chart with this name** button to create a new chart directly from the search.
If you click one of the **Create Chart** options for a new chart that has the same first name, last name, date of birth, and sex at birth as another patient at your practice, you will receive an alert indicating that you could be creating a duplicate chart. You can open a new tab to review the potential duplicate by clicking into the blue text of the name in the alert.
![Duplicate chart warning dialog for Fitzwilliam Darcy (DOB 1/1/1990), showing a link to the existing chart and "Create New Chart" or "Cancel" options.]()
## Frequently Asked Questions (FAQ)
### Can I block certain users from creating charts?
You cannot block certain users from creating charts in Elation. All users can create charts.
### Can I see who created a patient chart?
You can use the Audit Log feature to look up who created a patient chart. However, you must know the approximate date it was created. To use the Audit Log feature:
1. Open the patient's chart
2. Click the **More** button at the top of the patient's chart
3. Click **Data Exchange** >> **Audit Logs**
4. Once the Audit Log window opens, set the **Start date** and **End date** of the timeframe you wish to search
5. Look for the **Action** "add" and the **Record Type** "Patient"
6. Once you find the record, look under the **Performed By** column to see who performed the action.
## Related Articles
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
# Patient Chart Guide - Limiting access to patient charts based on patient criteria (Premium)
Source: https://help.elationhealth.com/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria
This article describes the Patient Cohort feature and how you can use it to segment access to patient records based on patient criteria.
## Overview
### What is the Patient Cohort feature?
The Patient Cohort feature, available with the Premium EHR, allows [Admin Level Users](/articles/administrative-privileges) to group patients based on chart data and restrict access to those cohorts.
Once Patient Cohort restrictions are enabled:
* Assigned users can access charts within their cohorts without restriction.
* The **Provider assigned in practice** (as listed in Patient Demographics) always has full access to their patients’ charts.
* All other users\*\* may either be completely blocked or granted limited access—any limited access is logged in the patient’s chronological record.
When a patient does not belong to any cohort, no access restrictions will appear on their chart for any user.
### What are the benefits of the Patient Cohort feature?
The Patient Cohort feature offers several key benefits:
* Enables targeted privacy controls for specific patient groups—such as behavioral health, employees, or high-profile individuals—while maintaining general chart access for the rest of the practice.
* Allows you to align access permissions with your practice’s privacy standards.
* Logs all limited access attempts for visibility and accountability.
## Setup
### Requesting the feature
The Patient Cohorts feature is for Premium EHR customers only.
* If you are interested in upgrading to the Premium EHR subscription to use this feature, click the **I need help** button to notify Elation and a member of the Elation Team will reach out to assist you.
* If you are already a Premium EHR user and you are interested in using this feature, click the **I need help** button to notify Elation and a member of the Elation Team will turn this feature on for you.
### Specifying Chart Access Settings
An [Admin Level User](/articles/administrative-privileges) can specify the level of access granted to non-assigned users by:
| **1** | Go to **Settings** -> **Security & Privacy** . |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Go to the\*\* Chart Access\*\* -> **Patient cohorts access** section and specify which of the following settings you prefer: **Warning & Optional Bypass** • **Strict Access Control** |
## Workflow Instructions
### Creating new Patient Cohorts and assigning access permissions
Only [Admin Level Users](/articles/administrative-privileges) can manage Patient Cohorts.
| **1** | Click **Reports** -> **Patient Cohorts**. ![Reports menu open in Elation EHR with an arrow pointing to "Patient Cohorts" option, the second item in the dropdown list.]()
|
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Create a Patient Cohort** . |
| **3** | Apply the necessary filters for the cohort. A minimum of one patient criteria must be selected in order to create a cohort. Criteria include: Provider assigned in practice • Patient Passport Status • Sex at Birth • Race • Ethnicity • Preferred Language • Preferred Contact Method • Patient Status • State • Patient Tags • Document Tags |
| **4** | Click **Preview List** to see the patients that meet the selected criteria. |
| **5** | Click **Save as Patient Cohort** once you have verified the list of patients is accurate. ![Create a Patient Cohort dialog showing Provider filter set to "Stuart Price, MD," 6 matching patients listed, with the "Save as Patient Cohort" button highlighted.]()
|
| **6** | Enter a name for your Patient Cohort in the **Patient Cohort Name** field. We recommend using a descriptive name to distinguish multiple cohorts. |
| **7** | Click **+ Add User Group** to select the User Groups that can have access to the patients in this cohort. If no user groups are added, the cohort can still be created, but no access restrictions will be applied. [Click here to learn more about creating User Groups](/articles/user-groups). ![Create Patient Cohort dialog with "Dr. Price's Patients" entered in the name field and "Price Staff" user group added under Access Controls.]()
|
| **8** | Click **Save** to save the new Patient Cohort. |
| **9** | Once a Patient Cohort is created, any patient who meets the criteria will be automatically added. |
New Patient Cohort restrictions take effect the next time users log into Elation. After creating cohorts, ask all users to log out and log back in to apply the updated settings.
The **Provider assigned in practice** always has access, even if not part of the Patient Cohort. Be sure each patient has the correct provider assigned.
### Managing existing Patient Cohorts
#### Viewing Cohort Criteria
To view a cohort’s criteria, click the **Actions** -> **Cohort Criteria** next to the Patient Cohort name. Criteria and User Groups cannot be edited for existing cohorts. To make changes, create a new Patient Cohort with the updated details and delete the outdated one.
![Patient Cohorts page showing the Actions menu open for "Dr. Price's Patients" cohort, with "Cohort Criteria" highlighted and "Delete" listed below it.]()
#### Deleting a Patient Cohort
Removing a Patient Cohort lifts the access restrictions applied to its patients. To delete a Patient Cohort:
| **1** | Click the **Actions** -> **Delete** to the right of the Patient Cohort name. |
| ----- | ---------------------------------------------------------------------------- |
| **2** | Confirm by clicking **Delete** . |
### Accessing patient charts that are part of Patient Cohorts
The **Provider assigned in practice** always has full access to their patients’ charts and assigned users can access charts within their cohorts without restriction.
When any other user attempts to access a restricted chart, they will see one of the following depending on your practice’s [Chart Access Settings](#settings).
* **Warning & Optional Bypass** - An **Access Restricted** warning will appear and the user must select a reason in order to gain access to the restricted chart. If they enter then their name will be recorded in the [Unauthorized Access Log](#logs).
!["Access Restricted" dialog for John Johnson's cohort-restricted chart, showing the "Reason for viewing chart" dropdown expanded with options: Billing, Chart Audit, Clinical Care, Message Triage, Operations Support, Tech Support/Research, Training Purposes, Quality Purposes.]()
!["Access Restricted" dialog for John Johnson's chart with "Reason for viewing chart" set to "Other" and additional details stating "I am covering for Dr. Crusher during her vacation," with "Agree & Continue" and "Cancel" buttons.]()
* **Strict Access Controls** - An **Access Not Authorized** pop-up will appear to block the user from entering the chart. The user will be redirected back to the Practice Home page.
!["Access Not Authorized" dialog blocking chart access for Edna Krabappel under Strict Access Control, with a "Back to Practice Home" button as the only option.]()
### Viewing the Unauthorized Access Log
If the **Warning & Optional Bypass** setting is enabled, Admin Level Users can use the Unauthorized Access Log to track access:
**1**
Click **Reports** -> **Patient Cohorts** .
**2**
Click **Unauthorized Access Log** .
**3**
You can only search for a maximum of 90 days at a time. If the date range you are searching for exceeds 90 days, separate the dates into **90 day** segments and run multiple reports. For example, if you want to look at a report for January 1st to May 31st, you will need to run one report from January 1st to March 31st and then a second report from April 1st to May 31st.
Select the date range you want to view.
**4**
Click **Download CSV** .
**5**
Open the file using a spreadsheet compatible software like Google© Sheets or Excel©.
![Download Unauthorized Access Log dialog with Start date 05/28/2025 and End date 06/27/2025 filled in, and a Download CSV button, opened from the Unauthorized Access Log button on the Patient Cohorts page.]()
## Frequently Asked Questions
### What happens if a patient no longer meets the defined criteria of a Patient Cohort?
When a patient in a Patient Cohort no longer meets the defined criteria, that patient will automatically be removed from the Patient Cohort.
### How do I edit cohort rules or user group access for an existing Patient Cohort?
Patient Cohorts currently cannot be modified after they are created. If cohort criteria or User Groups need to be changed, create a new Patient Cohort with the updated details and delete the outdated one.
### How is the Patient Cohort feature different from the VIP Chart feature?
The Patient Cohort feature limits access based on User Groups defined by an Admin Level User, while the [VIP Chart feature](/articles/vip-chart-feature) restricts access for all users except the **Provider assigned in practice**.
### What happens if I am using both the Patient Cohort feature and the VIP Chart feature?
If you are using both the Patient Cohort feature and the [VIP Chart feature](/articles/vip-chart-feature), rules of both features will be in effect. This means when a user is trying to access an unauthorized chart that is also a VIP patient, they will see both the Unauthorized Access warning as well as the VIP Chart warning.
*© Microsoft 2023© 2023 Google*
## Related Articles
* [User Accounts Guide- Administrative privileges](/articles/administrative-privileges)
* [User Groups Guide- Simplifying office messages & expanded calendar view](/articles/user-groups)
* [Patient Chart Guide - Marking charts as VIP for restricting access (Premium)](/articles/vip-chart-feature)
# Patient Chart Guide- Searching for patient charts
Source: https://help.elationhealth.com/articles/Patient-Chart-Guide-Searching-for-patient-charts
This guide will describe the various ways you can search for patient charts in Elation
## Search Options
There are two options for searching for patient charts in Elation after a
[chart is created](/articles/Patient-Chart-Guide-Creating-a-new-patient-chart)
:
1. The Search box at the top of the [Practice Home](https://app.elationemr.com/patients/)
2. The **Find Chart** button in the blue bar at the top of any page in Elation
### Practice Home Search box
The image below shows you what the Search box at the top of the
[Practice Home](https://app.elationemr.com/patients/)
looks like:
![The "Find patient chart..." search box on the Practice Home page, highlighted with a red border to indicate its location]()
### "Find Chart" button
The image below shows you what the **Find Chart** button looks like in Elation:
![The "Find Chart" button highlighted with a red box in the top navigation bar of Elation EHR.]()
## Tips for searching for patients
There are a few ways to search for patients using one of the two search options listed above:
1. You can use any combination of letters for the patient's legal name or full name and you can type the first and last name in any order
2. You can type in a patient's phone number as stored in their chart (search works for both primary and secondary phone numbers):
3. with or without the area code; however including the area code will yield more accurate results
4. with or without dashes
5. You can type in a patient's Date of Birth in the **MMDDYYYY** format (with or without dashes)
6. You can type in a patient's Elation patient chart ID number
## Frequently Asked Questions (FAQ)
### Can I hide inactive patients from the search results?
Inactive patients will continue to appear in search results. We recommend using the
[Patient Tag feature](/articles/adding-patient-tags)
to apply an **Inactive** tag to inactive patient charts. You will be able to see patient tags in search results and use patient tags to distinguish active patients from inactive patients.
## Related Articles
* [Patient Chart Guide- Creating a new patient chart](/articles/Patient-Chart-Guide-Creating-a-new-patient-chart)
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient Tags Guide- Classifying patients for administrative efficiency](/articles/adding-patient-tags)
# Patient Chart Introduction
Source: https://help.elationhealth.com/articles/Patient-Chart-Introduction
This article provides an overview of the Patient Chart and how to best utilize it.
## What is the Patient Chart?
The patient chart is a page within Elation that is specific to a patient at your practice and stores comprehensive medical information about the patient. There are many care and documentation actions you can take from the patient chart such as documenting visit notes, prescribing medications, sending eFaxes, and more.
## Why is the Patient Chart important?
The patient chart is important because it enables your practice to document patient medical information for all of your patients electronically and store the information per the specific patient.
## Usability of the Patient Chart
The patient chart is designed to display like a paper chart. It has three columns and additional pop up windows so that you can reference various items in the chart without losing your place. The columns and pop up windows ensure that you do not need to leave your single webpage to reference the patient’s data. Each aspect of the patient chart provides opportunity for efficient and specialized documentation.
### Viewing records in the chart
The three columns of the patient chart allow you to view multiple records and care facilitation tools at the same time. You are able to freely move popup windows, like the Prescription Form shown below, around the patient chart so that you can see other aspects of the chart that need to be referenced. If your device has a screen resolution of 1440x900 or higher, you are able to adjust the size of in-progress visit notes and letters to fullscreen or halfscreen. The Clinical Profile will always be displayed.
![Prescription Form dialog open and draggable (move cursor visible), with callouts highlighting the ability to move popup windows and the fullscreen toggle button in the visit note panel.]()
## Navigating the Patient Chart
Below are the various sections of the patient chart:
* [Clinical Profile](#clinical_profile)
* [Patient Demographics](#patient_demographics)
* [Patient Overview](#patient_overview)
* [Chart Navigation Bar](#navigation_bar)
* [Chronological Record](#chronological_record)
* [Chronological Record Search / Timeline](#search_timeline)
* [Requiring Actions](#requiring_action)
* [Outstanding Items](#outstanding_items)
**Overview of patient chart sections:**
![Patient chart with labeled sections: Clinical Profile (left panel), Chart Search and Chronological Record (center), and an open Visit Note with Clinical Reminders (right panel).]()
\*\*Patient chart: \*\*
![Patient chart for Katie Williams showing all three columns simultaneously: Clinical Profile on the left, Chronological Record with Requiring Action and Outstanding Items in the center, and an open Visit Note with care gap alerts on the right.]()
### Clinical Profile
The Clinical Profile is the left-hand panel that appears in every patient's chart. It is home to important patient details including their allergies, problems, history and medications. The Clinical Profile is also used for documenting vaccines, growth charts and storing legal and confidential notes. For more information on the Clinical Profile, please reference the
[Clinical Profile Guide- A snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
.
#### Patient Demographics
The Patient Demographics feature allows you to store all patient identifying information in one place. For more information on how to best utilize the Patient Demographics, please reference the
[Patient Demographics Guide](/articles/Patient-Demographics-Guide)
.
#### Patient Overview
Below the demographics is the part of the Clinical Profile that provides an overview of the patient’s history and a snapshot of other aspects of their health record.
### Chart Navigation Bar
The chart navigation bar is the gray tool bar located at the top of every patient's chart. The chart navigation bar allows you to quickly access all the clinical features and forms you need to care for your patient. You can use the navigation bar to complete a majority of the key clinical, patient workflows without leaving the patient's chart and without jumping into different areas of the patient's chart. For more information on the chart navigation bar, please reference the
[Patient Chart Guide- Chart navigation bar](/articles/Patient-Chart-Navigation-Bar)
.
### Chronological Record
All of the patient's records, such as visit notes, orders, letters, referrals and messages, are stored in one single place - the Chronological Record. The Chronological Record places “To Do's” and reminders at the very top as **Requiring Action** or **Outstanding Items** so that these items are addressed first. Everything else is listed in chronological order with the most recent items at the top of the chart. You can also search through the patient's chart using the Chronological Record Search. For an overview of the Chronological Record, please reference the
[Chronological Record Introduction- A timeline of your patient's records](/articles/store-everything-in-chronological-record)
.
#### Chronological Record Search / Timeline
The Chronological Record Search and Timeline are tools in your patient's chart that allow you to search for specific types of records or records tied to specific clinical data and dates. The Chronological Record contains all of the patient's clinical care history and the search tool allows you to pull up specific records without having to dig through the entire chart. The Timeline allows you to navigate to a certain date of the chart to view records from that time. You can click on the spot on the timeline to navigate to that spot in the Chronological Record. For more information on how to best utilize the Chronological Record Search and Timeline, please reference the
[Chronological Record Guide- Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
.
![Chronological Record Search bar and Timeline highlighted with red outlines, showing date markers from 12/2020 through Today along the timeline.]()
#### Requiring Action
[Requiring Action](/articles/store-everything-in-chronological-record#RequiringAction)
items are open items that are assigned to ‘you’. The most recently dated item will come first. We recommend always addressing Requiring Actions items in a timely manner. If the item no longer requires your attention, you should take the appropriate actions to remove it from Requiring Action.
#### Outstanding Items
Outstanding Items
are open items in the patient's chart that are either assigned to someone else for 'next steps' or if you are using our Post Date feature, the time to address the item has not arrived yet.
## Frequently Asked Questions
### Why are parts of my chart hidden?
Please ensure you are using Elation on a device that has at least a 13 inch screen so that you can see all aspects of the chart and they appear as designed. Using a screen that is less than 13 inches can affect the configuration of the display.
### Why do I only see the Requiring Actions / Outstanding Items section when I search for something in the Chronological Record Search?
If you have multiple items in the Requiring Actions / Outstanding Items sections of a patient’s chart, you will need to minimize those sections or scroll down the Chronological Record to see your search results. You can minimize the Requiring Actions / Outstanding Items sections by clicking the down arrow shown below.
![Requiring Action section expanded showing 2 items, with a red box highlighting the collapse arrow (▼) used to minimize the section.]()
### Why do I not have the option to make my visit note or letter fullscreen or halfscreen?
The option to make your visit note or letter fullscreen or halfscreen only appears when your browser window is covering the entirety of at least a 13 inch screen and your device screen has a resolution of 1440x900 or higher. If your browser window size is less than 13 inches or has a lower resolution than 1440x900, those options will not appear.
## Related Articles
* [Clinical Profile Guide- A snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient Chart Guide- Chart navigation bar](/articles/Patient-Chart-Navigation-Bar)
* [Chronological Record Introduction- A timeline of your patient's records](/articles/store-everything-in-chronological-record)
* [Chronological Record Guide- Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
# Patient Chart Guide- Chart navigation bar
Source: https://help.elationhealth.com/articles/Patient-Chart-Navigation-Bar
This article describes the features of the gray chart navigation bar available at the top of every patient chart.
## What is the chart navigation bar?
The chart navigation bar is the gray tool bar located at the top of every patient's chart. The chart navigation bar gives you access to the following clinical features or forms:
* [Visit Note](/articles/visit-note-categories)
* Notes
* [Office Message](/articles/How-to-use-Office-Messages)
* [Prescription](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Order Forms](/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients)
* [Patient Handouts](/articles/patient-handouts)
* Clinical Reports
* [Referral Form](/articles/letter-and-referral-introduction)
* [Letters to Patients & External Providers](/articles/how-to-send-a-fax)
* [Provider Directory](/articles/Using-the-Provider-Directory)
* [Templates](/articles/templates-settings)
* [C-CDA (CCDA) Exports](/articles/Supported-Elation-CCDA-types)
* [Audit Logs](/articles/Patient-Chart-Guide-Audit-Logs)
![Chart navigation bar at the top of patient Min Jones's chart, showing buttons for Visit Note, Notes, Msg, Rx, Orders, Handouts, Meds Hx, Reports, Referral, Letter, Directory, Templates, and More.]()
## Why is the chart navigation bar useful?
The chart navigation bar allows you to quickly access all the clinical features and forms you need to care for your patient. You can use the navigation bar to complete a majority of the key clinical, patient workflows without leaving the patient's chart and without jumping into different areas of the patient's chart.
## How to utilize the chart navigation bar
Each icon in the gray navigation bar is a button that opens a primary feature or form for you to complete a specific clinical workflow or access clinical information regarding your patient. You can click any icon to access the corresponding feature or form as designated by the icon name. Clicking the **More** icon will give you access to additional secondary features.
**Next Steps**
**Click into the different options in the navigation bar and familiarize yourself with the different features and forms.**
## Related Articles
* [Patient Chart Guide- Creating a new patient chart](/articles/Patient-Chart-Guide-Creating-a-new-patient-chart)
* [Clinical Profile Guide- A snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
* [Chronological Record Introduction- A timeline of your patient's records](/articles/store-everything-in-chronological-record)
* [Requiring Action & Open Items Queues- Managing open action items for your patients](/articles/the-requiring-actions-queue-follow-up-on-action-items)
# Patient Consent Regulations Guide
Source: https://help.elationhealth.com/articles/Patient-Consent-Regulations-Guide
This Help Center Article is written by Elation Health for informational purposes only as a service to our customers. The following article is intended as a summary of relevant regulatory guidance for health care providers to use at their discretion and should not be relied upon to ensure compliance. All users of Elation must follow all applicable laws and rules and are responsible for their own compliance with relevant health care and privacy regulations as reflected in the [Terms of Use](https://www.elationhealth.com/terms-of-use/) of the product.
## Overview
### Consent and Notices of Privacy Practices Under HIPAA
Under the Health Insurance Portability and Accountability Act (HIPAA), providers must present patients with a Notice of Privacy Practices (NPP), which explains how their health information will be used and disclosed, including disclosure to third party providers such as Elation. While HIPAA does not always require explicit consent for routine treatment, payment, and healthcare operations, providers must obtain acknowledgment that the patient has received the NPP. This ensures that patients are aware of their rights regarding their protected health information (PHI) and how it may be shared.
Providers should ensure that patients understand their rights under HIPAA, including their ability to request restrictions on certain disclosures of their health information. If a patient refuses to sign the acknowledgment of receipt, providers must document the attempt to obtain acknowledgment. In situations involving sensitive information, such as psychotherapy notes, HIPAA requires specific patient authorization before disclosure.
## Specially Protected Data
**Substance Use Disorder Data**
Substance use disorder (SUD) data is a specially protected category of protected health information (PHI) that requires heightened privacy protections under HIPAA and 42 CFR Part 2. This regulation mandates that healthcare providers obtain specific patient consent before disclosing SUD-related information, even for treatment, payment, or healthcare operations. Unlike general PHI, SUD records cannot be shared without explicit patient authorization, except in limited circumstances such as medical emergencies, court orders, or specific public health situations.
Given the stigma associated with substance use disorders, providers must implement strict safeguards to protect patient confidentiality. Patients should be clearly informed about their rights regarding SUD data, including the ability to revoke consent for data sharing at any time. Using encryption, access controls, and secure communication channels can help prevent unauthorized disclosures and maintain patient trust while ensuring compliance with legal requirements.
**Reproductive Health Data and New HIPAA Exceptions**
Reproductive health data, including information related to pregnancy, contraception, fertility treatments, and abortion services, is subject to heightened privacy concerns. Under new HIPAA exceptions, healthcare providers are restricted from disclosing reproductive health information in response to legal requests or investigations unless explicitly required by law. These exceptions aim to enhance patient privacy and protect individuals seeking reproductive healthcare.
Providers must ensure patients are aware of these protections and clearly communicate how their reproductive health data will be handled. Secure documentation practices, access controls, and encrypted storage should be utilized to safeguard this sensitive information. Explicit patient authorization should be obtained before sharing reproductive health data with third parties, except in legally mandated situations.
**HIV Data and Mental Health Information**
HIV-related data is another highly sensitive category of PHI, requiring special handling to prevent discrimination and ensure patient confidentiality. Many states have specific laws governing the disclosure of HIV status, often requiring explicit written consent before sharing such information. Healthcare providers must stay informed about both federal and state regulations to ensure compliance and protect patient rights.
Mental health data, including psychotherapy notes, also requires special consideration under HIPAA. Unlike general medical records, psychotherapy notes are given additional protections and cannot be disclosed without patient consent, except under specific circumstances such as threats of harm to self or others. Providers should implement strict privacy measures, such as role-based access controls and secure record-keeping systems, to maintain the confidentiality of mental health information while ensuring necessary care coordination.
**Information Blocking**
Providers are required to exchange electronic health information (EHI) under the 21st Century Cures Act’s Information Blocking Rule. This rule prohibits practices from unreasonably interfering with the access, exchange, or use of EHI. Providers must ensure that they are not engaging in practices that delay or restrict access to patient data unless a permissible exception applies, such as protecting patient privacy or information security.
Ensuring timely and secure data exchange supports continuity of care and empowers patients with greater access to their health information. Providers must implement policies and technologies that facilitate the secure sharing of health data while complying with HIPAA and other applicable laws. By avoiding information blocking, healthcare organizations can improve care coordination, enhance patient outcomes, and meet regulatory compliance requirements.
**State Specific Regulations**
In addition to federal regulations, healthcare providers must comply with state-level privacy and consent laws, which may impose stricter requirements than HIPAA. Many states have enacted specific laws governing patient consent, data sharing, and privacy protections for sensitive health information such as HIV status, mental health treatment, reproductive health, and genetic data. Providers should be aware of their state's unique legal framework to ensure compliance.
**Health Information Exchanges**
State Health Information Exchanges (HIEs) play a critical role in facilitating the secure exchange of patient data between healthcare organizations. These networks enable providers to access comprehensive patient records, improving care coordination and patient outcomes. Participation in an HIE often requires compliance with state-specific consent laws, which may mandate opt-in or opt-out mechanisms for patients to control how their data is shared.
Carequality, a national interoperability framework, allows HIEs and healthcare organizations to exchange data seamlessly across different networks. While HIPAA permits data sharing for treatment, payment, and operations without explicit consent, state laws may impose additional requirements. Providers must understand their state's HIE participation rules and ensure that patients are informed of their rights to consent, revoke access, or opt out of data sharing. Aligning HIE policies with Carequality standards ensures compliance while promoting secure and efficient data exchange for better patient care.
## Data Participants
**Patient**
Under HIPAA, patients have a right to request amendments to their PHI, request withholding of data, and request copies of all their PHI. Requests for data are routed through providers and providers are required to have policies and procedures to receive and respond to such requests as well as to fulfill all PHI requests from patients.
**Provider**
The provider is responsible for ensuring all PHI that they have signed off on is accurate and to preserve the integrity of such PHI. Providers are responsible for following all applicable laws and regulations including aligning their internal policies and procedures to ensure patient data is shared or restricted according to relevant regional laws.
**Elation Health**
Elation Health is the Certified Electronic Health Record Technology (CEHRT) that a provider uses and the provider or practice is responsible for meeting all regulatory obligations. Elation offers multiple product features to enable providers and practices to share or restrict data and collect patient consent in accordance with both patient privacy and information sharing requirements. Elation Health follows all laws and regulations as required for EHR technology and security of PHI.
## Elation Health Patient Consent and Privacy Tools
### Privacy & Security Resources
* [/articles/Features-for-Privacy-Requirements](/articles/Features-for-Privacy-Requirements)
* [/articles/Best-practices-for-keeping-your-Elation-account-secure](/articles/Best-practices-for-keeping-your-Elation-account-secure)
### Elation Health Product Features
| **Elation Health Product Feature** | **Consent Details** | **Data Type Sent/Received** |
| ----------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------- |
| [Carequality](/articles/Carequality-Integration-Introduction) | **Opt-in** Providers must select consent at the beginning of the patient interaction. If the patient does not consent, do not allow data sharing with Carequality. If patients do not consent initially, do not allow patient data sharing. If a patient revokes consent, click the **I need help** -> **Contact Elation Support** button from the patient’s chart and ask our Support Team to remove the patient's consent response from their chart for you. | Sent: CCDA Received: Multiple data types |
| HIE (CCD via SFTP) | HIE integrations are manually set up and if your practice has an HIE integration you should align your Notices of Privacy Practices to reflect how you are sharing data. Consent is for treatment purposes only. | Sent: CCDA |
| [Direct Messaging](/articles/how-to-use-direct-messaging) | Whatever data is sent should correspond to the type of data shared and with whom. For example, a referral sent to an outside specialist with a CCD should be included in the original Notices of Privacy Practices (to share all data for treatment purposes and referrals etc) or as requested depending on practice policies and procedures. These may be a case by case basis for consent depending on the data type and referral based on your own privacy practices. | Sent: Multiple data types (CCDA, Attachments) Received: Multiple data types (CCDA, Attachments) |
| [Summary of Care via fax](/articles/secure-Provider-Portal) | Whatever data is sent should correspond to the type of data shared and with whom. For example, a referral sent to an outside specialist with a CCD should be included in the original Notices of Privacy Practices (to share all data for treatment purposes and referrals etc) or as requested depending on practice policies and procedures. These may be a case by case basis for consent depending on the data type and referral based on your own privacy practices. | Sent: CCDA Received: CCDA |
| [Medication History download via Surescripts](/articles/retrieving-previous-medication-history-for-your-patients) | Clicking **download fills** is an implicit patient consent. Patients may additionally opt out of Surescripts medication history download at any time through the Surescripts network by visiting [https://surescripts.com/opt-out-faq](https://surescripts.com/opt-out-faq). | Received/Sent Medication data |
| [Text messages](/articles/SMS-Text-Message-Opt-In-Guide) | This is captured in the demographics setting of patient charts. This can also be changed by patients directly during text messages or from the patient passport as noted in the Help Center Article describing text message opting in. | Unidirectional (output) |
| [Patient Longitudinal Record](/articles/introducing-elations-patient-longitudinal-record-enterprise-only) | Practices and providers are responsible for ensuring their Notices of Privacy Practices reflect all product functionality and providers and practices that are involved in Patient Longitudinal Records. | Bidirectional access to charts |
| [Lab Integrations](/articles/labs-settings) | These are sent for treatment purposes and should be reflected in your Notices of Privacy Practices. | Sent/Received: Multiple data types sent/received (labs, imaging, transcriptions) |
| FHIR integrations | These are sent for treatment purposes and should be reflected in your Notices of Privacy Practices. | Read Only Can only send information. Can not receive information into the system. |
| API v2 integrations (includes API v2 HIE integrations and Zus) | These are sent for treatment purposes and should be reflected in your Notices of Privacy Practices. | Read and write functionality/bidirectional information exchange. |
The [Patient Forms feature](/articles/Getting-Started-with-Patient-Forms) supports collecting patient consent; however, it remains the provider’s responsibility to obtain and update consent in all required and relevant situations.
## Associated regulatory and industry resources
* [EHRA - Part One: Privacy & Consent Management Landscape and Challenges to Scale](https://ehrablog.org/2024/09/10/part-one-privacy-consent-management-landscape-and-challenges-to-scale/)
* [EHRA - Part Two: Privacy & Consent Management Landscape and Challenges to Scale](https://ehrablog.org/2024/09/10/part-two-privacy-consent-management-landscape-and-challenges-to-scale/)
* [HealthIT.gov - State Consent Laws](https://www.healthit.gov/topic/interoperability/state-consent-laws)
* [HealthIT.gov - HIPAA versus State Laws](https://www.healthit.gov/topic/hipaa-versus-state-laws#:~:text=State%20and%20local%20laws%20also,least%20as%20protective%20as%20HIPAA)
# Patient Demographics Guide
Source: https://help.elationhealth.com/articles/Patient-Demographics-Guide
The patient demographics fields in Elation allow for robust and accurate documentation of your patient's demographic information in the Patient Chart.
The Patient Demographics window in the Patient Chart is one of the most important tools you have at hand to foster a personal relationship with your patient and improve medical billing workflows.
You can hover your move over the video bar to jump ahead to chapters within the video.
## What are Patient Demographics?
The Patient Demographics feature allows you to store all patient identifying information in one place.
With the additional fields and selection options added in 2022 you can now store even more information in specified fields for all of your patients. The upgraded Clinical Profile view will also allow you to see the most critical pieces of information at a glance; without needing to open the full demographics window.
## Why are Patient Demographics valuable?
The Patient Demographics feature allows you to improve healthcare related workflows, enhance communication and streamline your business needs. You can store all of your patients' demographics information in one place to allow you to make crucial healthcare and treatment decisions based off of each patient's information.
Within Elation, various demographics fields also assist you with different workflows and facilitate the use of different features. Please review the [Tips for using various demographics fields](#Tips) section for more details.
## What fields are available in the Patient Demographics window?
All available demographics fields are visible below.
![Patient Details tab selected in Emily Moore's demographics, showing legal name, DOB 10/21/1990, sex at birth Female, gender Woman, Previous Name, and Additional Details fields including SSN, sexual orientation, race, and ethnicity.]()
![Contact Information tab in Emily Moore's demographics, showing empty phone, email, and preferred contact method fields, unchecked appointment reminder opt-out, and address: 44337 Moon Divide Suite 600, New Amber, WA 94478.]()
![Insurance, Payment, & Membership tab selected in Emily Moore's demographics, showing Primary Insurance fields including carrier name, plan name, Group ID, Member ID, copay, deductible, coverage, dates, and policyholder section with "Spouse" selected as patient's relation.]()
![Secondary Insurance section for Emily Moore showing empty fields for carrier name, plan name, Group ID, Member ID, Copay, Deductible, Coverage, Effective Date, and End Date, with Policyholder relation set to "Self"]()
![Patient demographics Pharmacies tab for Emily Moore, showing two saved CVS pharmacies in San Marcos, CA, each with address, phone, fax, and a Remove link.]()
![Provider Information tab in patient demographics for Emily Moore, showing Beverly Crusher, MD selected as the assigned provider, with empty Preferred Location, Referring provider, and Primary care provider fields.]()
![Notes & Chart Management tab in Emily Moore's demographics, showing empty Notes field, Status set to Active, unchecked Mark as VIP, and Merge Chart and Delete Chart buttons.]()
Read the following articles to learn more about managing the following demographics fields:
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Insurance Card Image Upload Guide](/articles/Insurance-Card-Image-Upload-Guide)
* [Patient Chart Guide- Merging duplicate charts](/articles/merging-duplicate-charts)
## How do I delete a patient chart?
If a chart is a duplicate, use **Merge Chart** instead of deleting it — see [Patient Chart Guide- Merging duplicate charts](/articles/merging-duplicate-charts).
To delete a chart that isn't a duplicate (for example, one created in error):
1. Open the patient's chart and click the patient's name to open **Demographics**.
2. Go to the **Notes & Chart Management** tab.
3. Click **Delete Chart**.
**Exception:** Who can see and use the **Delete Chart** button depends on your practice's delete permission tier. See [User Accounts Guide- Configuring delete permissions](/articles/User-Accounts-Guide-Configuring-delete-permissions) for details.
If you delete a chart by mistake, you can restore it — see [Patient Chart Guide- Recovering deleted charts](/articles/patient-chart-guide-recovering-deleted-charts).
## What fields are visible in the Clinical Profile demographics view?
This is what the Clinical Profile view looks like for patient demographics. The patient's preferred full name (ex. Danny Jones) will display at the top of the chart and their legal full name (ex. Donald Jones) will display in the Additional Information section.
![Clinical Profile header for Danny Jones showing preferred name, DOB 01/20/1980, pronouns He/Him/His, gender Man, legal name Donald J. Jones, provider Karly Smith MD, and insurance Aetna.]()
Here is a legend of all of the possible details that will display in the clinical profile if the corresponding fields are filled in and the corresponding icons for those fields.
Hover your mouse cursor over the icons to learn what each icon means.
![Legend of Clinical Profile demographic icons including Legal Full Name, Provider, Insurance, Employer, Sex at Birth, Phone Number, and Membership Plan fields.]()
## Patient Notes icon
**Beta feature:** The feature described in this section is part of a beta release and is only available to a select number of practices.
A patient notes icon can appear in several places so you can see and jump to the **Notes** field from the demographics **Notes & Chart Management** tab without opening demographics manually.
Where the icon appears:
* The patient's Clinical Profile, next to the allergy and risk score badges.
* The appointment creation form on the Calendar, next to the patient name once a patient is selected.
* The appointment or event snapshot popover on the Calendar, next to the patient's date of birth.
How the icon behaves:
* The icon is gray when the patient has no notes and yellow with a filled background when notes are present.
* Hovering the icon shows a preview of the notes content (up to 300 characters), or "No patient notes" if the field is empty.
* Clicking the icon opens Demographics, scrolls to the **Notes & Chart Management** section, and places your cursor in the **Notes** field so you can start typing.
Whether the **Notes** field is shared on provider-facing letters and printouts that include a demographics page is controlled by your practice's **Share demographics notes with providers** setting. See [Security & Privacy Settings Overview — Demographics Notes](/articles/Security-and-Privacy-Settings-Overview#demographics-notes).
## Tips for using various demographics fields
### Legal Name vs. Full Name
* Legal Name= the patient's name as displayed on all government issued documents such as their Social Security Card or Passport
* Full Name= the name the patient wishes to be called that is different from their legal name
**Where each name is used**
When a patient has a Full Name (preferred/actual name) set, Elation uses it on patient-facing surfaces instead of their legal name. Clinical, compliance, payer, lab, and pharmacy workflows continue to use the legal name where required.
**Surfaces that use the Full Name (when set):**
* Patient Passport
* Patient Booking Site, booking confirmation, and booking patient form header
* Appointment confirmation SMS and phone confirmations
* Appointment cancellation emails
* SMS (text message) opt-in page and opt-in request emails
* Patient Forms
* Patient invoice and Membership communications
* Patient profile print view
* MIPS printouts
**Surfaces that continue to use the Legal Name:**
* Insurance claims and eligibility (payer-facing)
* Lab and pharmacy orders (including ePrescribing)
* QRDA-3 submissions to CMS
* Other clinical, compliance-sensitive, or regulatory workflows
### Pronouns
What does the patient want to be referred by when you are not using their name?
* He/Him/His
* She/Her/Hers
* They/Them/Theirs
* Option Not Listed
### Sex at birth
This field is usually used to designate the patient's sex at birth. We recommend storing the patient's legal sex as designated on government issues documents if you bill insurance companies.
* Female
* Male
* Intersex/other
* Unknown
**Gender**
How the patient identifies themselves
* Woman
* Man
* Transgender woman / trans feminine
* for patients who were assigned male at birth but identify with femininity
* Transgender man / trans masculine
* for patients who were assigned female at birth but identify with masculinity
* Non-binary / genderqueer / gender fluid
* for patients who may fluctuate gender expressions over their lifetime or express multiple various gender markers at the same time
* Two spirit
* for patients who identifies as having both a masculine and feminine spirit
* Option not listed
* Prefer not to say
### SSN (Social Security Number)
Once a patient chart is created, demographic's Social Security Number field will be masked until you click the **unhide** button to view it.
![Patient Demographics window showing SSN field masked as dots, with an arrow pointing to the unmasked SSN "888-55-4124" revealed by clicking the eye icon.]()
### Sexual Orientation
Which gender(s) is the patient sexually attracted to?
* Asexual
* Bisexual
* Gay
* Lesbian
* Straight
* Queer
* Option Not Listed
* Prefer Not to Say
**Legal gender marker**
The designation of an individual's sex on a birth record or other government issued document
* (F)= Female
* (M)= Male
* (X)= Nonbinary (a gender that is not exclusively male nor female)
* Unknown
### Patient Contact
The mobile phone and email address stored in this section is used for the following patient engagement features:
* [Automated appointment reminders](/articles/appointment-reminders)
* [Virtual Visit Instructions](/articles/Elation-Telehealth-powered-by-Zoom#VirtualVisitInstructions)
* [Patient Passport notifications](/articles/what-patient-passport-messaging-looks-like-to-a-patient#messagenotifications)
* [Payment updates](/articles/using-elation-to-securely-collect-patient-payments)
### Patient Address
This field is required for prescribing medications, (especially controlled substance medications) and ordering lab tests (especially [electronic lab ordering](/articles/labs-settings) ).
### Insurance
If you bill a patient's insurance company for services rendered, we recommend storing the patient's primary, secondary or tertiary insurance information in the Insurance section of the patient demographics. Learn more about storing insurance information in the [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance) .
### Pharmacies
The preferred pharmacies entered in this section will facilitate sending prescriptions electronically to pharmacies from Elation.
### Provider Information
The *Provider assign in practice* field determines which provider in the practice the patient will be assigned to in the [administrative reports](/articles/lightning-reports) . This field also determines which provider is assigned drafted orders when staff assist with drafting prescriptions, orders and referrals.
## Creating a new patient chart
To create a new patient chart:
1. Go to the [Practice Home](https://app.elationemr.com/patients/) page and click on the **New Chart** button in the gray navigation bar.
2. Fill in the patient's demographics details- especially the required fields of **legal first name**, **legal last name**, **date of birth**, **sex at birth** and **Provider assigned in practice**
:\*\*
3. click **Create & Open Chart** or **Create Chart** when done.
![The New Chart button highlighted in the Practice Home navigation bar, with an arrow pointing to the open Create New Patient Chart dialog showing Patient Details and Contact Information fields, with Legal first name marked as Required.]()
![Find Chart search field showing "emily swan" typed with "No results" displayed and the "Create a new patient chart with this name..." option highlighted below.]()
## Frequently Asked Questions (FAQ)
### Will Patients see their "Full Name" in any communications?
Yes, Patients will see their **Full name** displayed in all of the following Patient facing communications and forums:
* Patient Passport
* Booking Site
* Appointment reminders and confirmations
* Patient Forms
* Patient invoice communications
* Membership communications
* SMS (text message) Opt-In requests
### Can I search for a patient in the EHR using their "Full Name"?
Yes, you can search for a patient using their full name, in addition to their legal name. For example, if the patient’s legal name is “Brian Walter Mills” but their full name is “Bobby Mills”, searching for **Bobby** will return a match for **Brian Walter Mills**.
### Where do I enter a primary caregiver or legal guardian's name for a patient?
Patient Demographics does not have a dedicated field for a primary caregiver or legal guardian's name and relationship to the patient. As a workaround, enter this information in the **Emergency Contact** section, selecting the appropriate relationship (such as Guardian, Caregiver, or Parent). Use the **Notes** field in the demographics window for any additional details about the arrangement.
### Can I store more than one email address for a patient?
No, Elation only stores one active email address per patient chart. That single address is used for Patient Passport invitations and notifications, automated appointment reminders, Patient Forms links, and patient payment requests and receipts. If a patient wants to change which address is used, update the email address in the **Patient Contact** section of their Demographics.
## **Related Articles**
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Insurance Card Image Upload Guide](/articles/Insurance-Card-Image-Upload-Guide)
* [Clinical Profile: A summary snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
# Patient Demographics Guide - Insurance Management
Source: https://help.elationhealth.com/articles/Patient-Demographics-Insurance-Management
This article covers how to maintain a patient's active and historical insurance details.
## Overview
Elation allows you to create and maintain a database of insurance carriers and plans, which can then be used to populate your patients chart with structured insurance details. Entering a patient’s insurance details is a prerequisite to many downstream workflows such as eligibility checks, orders, and fee-for-service billing. Learn how to update these details with the instructions below.
If your practice uses **Elation Billing** , patient insurance information syncs between the EHR and Elation Billing. See [Add or Edit Patient Insurance (Elation Billing)](/articles/add-or-edit-patient-insurance) for Billing-specific insurance workflows.
## Workflow Instructions
If you are using an integrated Practice Management System (PMS) partner with Elation, we recommend reviewing your PMS User Manual for instructions on how to maintain carriers and patient insurance details. The required workflows, supported fields, and syncing behavior for each vendor can differ.
### Managing carriers & plans in Settings
Reference this [Billing Guide- Managing Carriers & Plans in Elation](/articles/Managing-Carriers-and-Plans) article to learn how to create and maintain your practice’s insurance carriers and plans.
As a best practice, carriers should be added to your Settings in advance so that they’re readily accessible when it comes time to update a patient’s insurance details. As needed, new carriers still can be created at any time.
The Insurance settings page can be set to 'Admin Only’ so that only users with Admin privileges can make changes. If you find that you’re unable to add new insurance carriers or plans, you may not have sufficient privileges. Please check with an Admin Level User in your practice for assistance.
### Accessing a patient’s insurance details
![Patient demographics window open to the Insurance, Payment, & Membership tab, highlighted with an orange border, showing empty Primary, Secondary, and Tertiary Insurance sections with Add buttons and a "+ Create new insurance" link.]()
You can access a patient’s insurance details using any of the following workflows:
For a brand new patient:
* Click the **New Chart** button on the homepage. In the demographics window, scroll down to the **Insurance, Payment, & Membership** section.
For an existing patient:
* Open the patient’s chart and click on the patient’s name. In the demographics window, scroll down to the **Insurance, Payment, & Membership** section.
* If the patient has an appointment, click the appointment. In the pop-over, click **Demographics** and scroll down to the **Insurance, Payment, & Membership** section.
* If the patient has an appointment, update the Status to **Checked-in** and the Demographics window will automatically open. Scroll down to the **Insurance, Payment, & Membership** section.
### Entering a new active insurance record
| **1** | Under the Insurance, Payment and Membership Section, click + Create new insurance. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | If you’d like to upload a copy of the patient’s insurance card from your computer, click the **Upload Front** and/or **Upload Back** buttons. Select the file from your computer and optionally crop and rotate the image before clicking **Confirm**. |
| **3** | In the **Carrier name** field, search for the payer’s name and select it from the dropdown menu. The dropdown menu will only display options that have been added to your practice’s Insurance settings page. Refer to this section for more information on how to maintain these carriers. |
| **4** | Fill in the following fields: Plan name • Member ID • Group ID • **Insurance Rank**: choice of Primary, Secondary, Tertiary, Primary (Inactive), Secondary (Inactive), and Tertiary (Inactive) • Coverage Type: choice of Commercial, Medicare, Medicaid, or Worker’s Compensation • Copay • Deductible • Effective Date • End Date • Relation to policyholder: choice of Self, Child, Spouse, or Other |
| **5** | Click **Save** . |
Based on the Insurance Rank selected, a summary of the insurance record will appear under the corresponding heading. If you have real-time eligibility through Elation, you can also run an eligibility check here.
![Insurance, Payment, & Membership section open for Shannon Smith, showing Primary Insurance (Advantage, Member ID R999999999) highlighted with an orange border, with Edit Details and Change Primary Insurance options visible.]()
### Uploading/viewing/updating scanned insurance cards
Insurance cards can be uploaded while you enter insurance information for the patient.
#### To add a scan after insurance details have already been saved
| **1** | Scroll to the insurance record in the Patient Demographics window. |
| ----- | --------------------------------------------------------------------------------------------------------- |
| **2** | Click the **Upload Front** and/or **Upload Back** button. |
| **3** | Select the file from your computer and optionally crop and rotate the image before clicking **Confirm** . |
#### To zoom-in on an uploaded scan
| **1** | Click on the insurance card image. |
| ----- | ------------------------------------------------------------------------------------ |
| **2** | An enlarged version will appear in a pop-up window. Click the **X** button to close. |
#### To crop/rotate an uploaded scan
| **1** | Hover over the insurance card image and click the **pencil** icon. |
| ----- | ------------------------------------------------------------------ |
| **2** | Use the crop and rotate buttons to perform your edits. |
| **3** | Click **Done** . |
#### To change a scan to a different image
| **1** | Hover over the insurance card image and click the **trash can** icon. |
| ----- | --------------------------------------------------------------------- |
| **2** | Click the Upload button to select a new file from your computer. |
If you encounter a repeated error or an error code while uploading an insurance card, [click here for recommended troubleshooting steps](/articles/Insurance-Card-Image-Upload-Guide#Troubleshooting) - including what to include when contacting Support.
### Editing an existing insurance record due to a typo
| **1** | In the bottom righthand corner of the record, click the **Edit Details** link. |
| ----- | ------------------------------------------------------------------------------ |
| **2** | Make the necessary edits. |
| **3** | Click **Save Changes to Insurance** . |
### Editing an existing insurance record due to a change in coverage
| **1** | In the top right corner of the record that is no longer valid, click the **Change … Insurance** button. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | The dropdown menu will show a list of any other insurance details that were once recorded for this patient - both active and historical. If any of these insurances should be selected as the patient’s current coverage, select it from the dropdown menu. • Otherwise, click **+ Create new … Insurance** to enter brand new insurance details. |
| **3** | Complete the fields within the Create window and click **Save** . |
| **4** | Once the new information is saved, the previous insurance record will move to the **Historical Insurance Records** section. |
### Viewing historical insurance records
| **1** | Click the blue **View Historical Insurance Records** link. |
| ----- | ------------------------------------------------------------------------------- |
| **2** | A pop-up window will appear with any historical records. |
| **3** | Towards the right, click the **down arrow** to see full details for the record. |
| **4** | Click **Close** to exit the window. |
**Deleting an existing insurance record**
This workflow should only be used if you want to completely remove this insurance record from the patient’s chart. Alternatively, if you need to change a record from active to historical, use this alternate workflow.
| **1** | In the bottom righthand corner of the record, click the **Edit Details** link. |
| ----- | ------------------------------------------------------------------------------ |
| **2** | At the bottom of the Edit window, click **Delete This Insurance** . |
## Frequently Asked Questions
### Why can’t I edit an insurance record that’s under Historical records?
You will need to move a historical record to an active record first if you need to edit the details.
### What type of files can I upload for the insurance card?
The supported image file types are JPEG (JPG/JPE), PNG and PDF (single page only).
### Is there a way to see when an insurance card image was uploaded?
Not directly. The Demographics **Insurance, Payment & Membership** section only displays the card image itself; there's no "uploaded on" field for active card images. If an older card image was replaced and filed as a report elsewhere in the chart, you may be able to infer the upload date from that report's created date.
### Does running eligibility automatically add insurance to the chart?
No. Real-time eligibility validates existing structured insurance information; it does not automatically create or update insurance records.
**Recommended workflow:**
1. Add or update the patient's insurance record under Demographics (**Carrier name**, **Plan name**, **Member ID**, **Group ID**, and **Insurance Rank**).
2. Run eligibility to confirm coverage.
3. Use the validated record for billing.
**If insurance seems "missing" in billing, check:**
* That **Primary** insurance is present and not marked inactive.
* That the **Carrier** and **Plan** used for billing matches the Carrier and Plan used for eligibility.
### Can I bulk update insurance or payment information for all of my patients at once?
No. Insurance and payment information must be updated individually in each patient's chart — there is no supported workflow to bulk update this information across your patient panel.
### How do I swap which insurance is primary and which is secondary?
There's no dedicated "swap" option. Open the patient's Demographics, go to **Insurance, Payment & Membership**, and update the record you want to be primary directly in the **Primary** slot. Then re-add the other plan in the **Secondary** slot. This doesn't require any special permissions.
## Related Articles
* [Add or Edit Patient Insurance (Elation Billing)](/articles/add-or-edit-patient-insurance)
# Patient Forms Guide - Creating and managing Patient Forms
Source: https://help.elationhealth.com/articles/Patient-Forms-Guide
Learn how to set-up electronic intake forms.
## Overview
### Does Elation have pre-built Patient Forms and questions?
Yes, Elation has the following pre-built Patient Forms templates:
* New Patient Medical History
* Follow-up Medical History
* Demographics
* Insurance Information
* COVID-19 Screening
* Medicare AWV
Each template is associated with a set of pre-built questions. You can customize any of the templates to fit your needs and create your own personalized versions of these forms.
### How do I create my own Patient Forms?
Use the Patient Forms builder to create your own Patient Forms. You can build forms in several ways:
* Use pre-built templates, sections, and questions.
* Create your own questions and sections from scratch.
* Covert a PDF or image of a form into a structured form.
See below for step-by-step instructions.
### Anatomy of a Patient Form
Here are the core components of a Patient Form as it’s being built.
![Patient Form builder showing labeled components: Form Name (A), sign-off checkbox (B), patient-visible Title and Description (C, D), a Demographics section with Section Title (F), Exports to HPI setting (G), Intro Text (I), a Free Text Question with Answer Helper Text (K, L), a Checkbox List Question with settings toggles (O), and Add question (R), Add section (S), Add predefined section (T), and Save changes (U) buttons.]()
| **Letter** | **Name** | **Description** | **Visible to patients?** |
| ---------- | ---------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | --------------------------------------------------------------------------------------------------- |
| A | Form Name | Internal name of the form. | No |
| B | Sign-off permission indicator | Enables Staff Level Users to sign off on patient responses. | No |
| C | Title (What patient sees) | External name of the form. | Yes |
| D | Form Description | Description of the form. | Yes |
| E | Section | Organizes related questions together. Each form can have multiple sections. To move the section to a new location in the form, click and hold the **Grid** icon, drag the section to its new location and then let go of your cursor. | Yes Each section is separated by a horizontal line. |
| F | Section Title | Internal title of the section. | No |
| G | Exports to preference | Defines where responses from this section can be exported to in the patient’s chart. | No |
| H | Section shortcut (delete) | Deletes the section. | No |
| I | Intro Text (What patient sees) | Provides context or explanation for the upcoming question(s). | Yes — while completing the form only. Not shown on the completed form in the chart or its printout. |
| J | Question | The item that asks for specific information or a response from the patient. Each section can have multiple questions. To move the question to a new location in the section, click and hold the **Grid** icon, drag the question to its new location and then let go of your cursor. | Yes |
| K | Question Text | The prompt that you want the patient to answer. | Yes |
| L | Answer Helper Text | Example(s) of what the patient can input as an answer. E.g. If you want the patient to enter their Date of Birth as a two digit month, two digit date and four digit year, enter the **Answer Help Text** as **MM/DD/YYYY**. | Yes |
| M | Question type description | Describes the answer format for the question. | No |
| N | Question shortcuts (copy & delete) | Options to duplicate the question to create a similar question or delete the question. | No |
| O | Question settings | Specify additional preferences for the question format. (Only available for the **Checkbox List Question** format.) | No |
| P | Delete icon | Deletes the answer option. | No |
| Q | Add answer option icon | Adds an answer option. | No |
| R | Add question | Adds a new question to that section. | No |
| S | Add section | Adds a new section. | No |
| T | Add predefined section | Add a predefined section to the form. | No |
| U | Save changes | Save form edits. | No |
| V | Back | Return to the Patient Forms list. | No |
**Intro Text does not appear on the completed form.** Use Intro Text for instructions and context that only need to be seen while the patient is filling out the form. Any language the patient is legally agreeing to — consent terms, financial policy, privacy notices — must go in a **question** (for signature sections, the agreement question), because question text is what appears on the completed form in the chart and on the printout.
A section's question text is what carries through to the completed form and printout, so anything that must be part of the legal record belongs in a question rather than Intro Text. For a worked example of this pattern, see [Patient Forms - Sample Forms and Use Cases](/articles/Patient-Forms-Sample-Forms-and-Use-Cases).
## Setup
### Specifying who can create or edit forms
By default, anyone in the practice can create or edit Patient Forms. If preferred, you can set it so that only [Admin Level Users](/articles/administrative-privileges) can configure patient forms by following these steps:
| **1** | Go to **Settings** -> **Patient Forms** . |
| ----- | ---------------------------------------------------------- |
| **2** | Click the **Admin only** toggle until it turns green (ON). |
Changes to this setting will be applied immediately.
### Specifying who can sign off on completed forms
By default, only Provider Level Users can sign off on forms responses. For each Patient Form, Admin Level Users can enable a setting that allows Staff Level Users to sign off on its form responses. This feature is ideal for forms that generally do not require provider oversight such as forms for demographics or insurance collection.
To allow staff to sign off on a specific patient form, check the box labeled **Allow staff sign-off for this form** when editing that form. This checkbox appears directly under the **Form Name** field in the form editor.
**New forms have this setting turned off by default.** If you create a new form — including a new version of a form you already use — staff sign-off will be disabled until you check this box. If staff can sign off on some of your forms but not others, this setting is the first thing to check on the form that isn't working.
**This setting is per form.** If your practice has two forms with similar or identical names (for example, an original and an updated version), check the box on each form that should allow staff sign-off. Enabling it on one form has no effect on any other form.
**You must be an Admin user to see or change this setting.** If you're editing a form and don't see this checkbox, ask an Admin at your practice to make the change.
If a Staff Level user cannot see a **Sign Off** or **Mark as Reviewed** button on a completed form, see [I don't see a "Sign Off" button – why?](/articles/the-requiring-actions-queue-follow-up-on-action-items#i-dont-see-a-sign-off-button--why) for troubleshooting.
## Workflow Instructions
### Generating a Patient Form draft from a PDF or image
| **1** | Go to **Settings** -> **Patient Forms** . |
| ------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Click **Create from PDF or Image** . |
| **3** | Select the PDF or image of your form from your device and click **Open**. Supported languages are English, German, French, Spanish, Italian and Portuguese. |
| **4** | A new browser tab will open to generate a draft of the form.**Do not close this tab** until the draft is complete, or the form will not be generated. |
| **5** | Once the draft is generated, review the internal **Form Name** in the upper lefthand corner. This name will only be seen by members of your practice. |
| **6** | **(Admin Level User Only)** Specify who can sign off on the completed form by checking or unchecking the **Allow staff sign-off for this form** box. [Click here for information about this setting](#specifying-who-can-sign-off-on-completed-forms). |
| **7** | Review the external **Title** and **Form Description**. These will be visible to your patients while they fill out the form. |
| **8** | Review each section and make adjustments as needed. Adjust the section title as needed. • Adjust where you want the section responses to export to, if allowed. • Add question(s) to the section, see step #9 below. Each section must have at least one question. |
| **9** | Review each question and make adjustments as needed. Add a custom question by clicking **+ Add question**. |
| **10** | Click **Save form** to save any changes. |
| **11** | Click the **back arrow** to return to the main Settings page. |
### Creating a Patient Form from scratch or from a template
| **1** | Go to **Settings** -> **Patient Forms** . |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Choose how you want to build your form: To select a template from the dropdown to use a prebuilt form as a starting point., click **Create from Template**. • To start building from scratch, click **Create a Blank Form**. |
| **3** | Fill out the internal **Form Name** in the upper lefthand corner. This name will only be seen by members of your practice. |
| **4** | **(Admin Level User Only)** Specify who can sign off on the completed form by checking or unchecking the **Allow staff sign-off for this form** box. [Click here for information about this setting](#specifying-who-can-sign-off-on-completed-forms). |
| **5** | Give the form a **Title** and **Form Description**. Both are visible to the patient. |
| **6** | Customize the sections of your form. Templates come with certain predefined sections, predefined export to settings and pre-built questions. • A blank form will start you off with a blank section. • Click **+ Add section** to add a custom section. Customization options include Adjusting the **Section Title** & **Intro Text**. • Selecting where the responses export to in the patient's chart. • Adding questions (see step #7 below). Each section must have at least one question. • Changing the order in which the sections display in the form using the **Grid** icon. |
| **7** | Customize the questions of your form: Templates come with certain predefined sections, predefined export to settings and pre-built questions. • A blank form will start you off with a blank section where you must add at least one question. • Click **+ Add question** to add a custom question to any section. To reorganize questions, click and hold the **Grid** icon, drag the question to its new location in the same section and then let go of your cursor. Questions cannot be moved across sections. |
| **8** | Click **Save form** to save any changes. |
| **9** | Click the **back arrow** to return to the main Settings page. |
### Using pre-defined sections
Each pre-defined section includes a title, default export settings for responses, and one or more pre-set questions. Each predefined section can only be added once to a patient form except for **Other**.
| **1** | Click **Add predefined section** to add a predefined section. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Customize the **Section Title** & **Intro Text** . |
| **3** | When you use the **Other** section, choose where to export the section responses. |
| **4** | Review the pre-built questions that come with the predefined section. Add a custom question by clicking **+ Add question**. • Copy a pre-built question to use it as a starting point for a similar question using the **copy** icon. |
**"Other" is a section, not an export destination.** The **Exports to** dropdown only lists Clinical Profile sections (such as Habits, PMH, Family History, and Social History). There is no "Other" choice in that dropdown, and no dynamic macro adds one. What the **Other** predefined section does is let you *choose* which Clinical Profile section a response exports to—it is the only section whose export destination you can edit. Every other predefined section exports to a fixed destination.
If you are building a form that doesn't belong in the Clinical Profile at all—such as a consent form, terms of service, or financial policy—you don't need to set an export destination. Once the patient submits, the completed form files into their chart as its own report; the **Exports to** setting only matters when you want a response *copied* into a Clinical Profile section.
Other customization options include:
* To delete a predefined section, click the **trash can** icon.
* To move the predefined section to a new location in the form, click and hold the **Grid** icon, drag the section to its new location and then let go of your cursor.
### Using prebuilt questions
Prebuilt questions are designed to collect structured data that fits directly into areas of the chart like Demographics, Clinical Questionnaires, Medication Lists, and Health Maintenance. Each prebuilt question is formatted to suit the type of information being collected. For example, the **Medical History** question uses checkboxes so patients can easily select the conditions they have.
Some prebuilt questions cannot be edited because they are either formatted for the areas they must export to (e.g. **Demographics: Preferred Language**) or they are standard instruments with pre-configured scoring (e.g. **Depression (PHQ-2)**).
Responses to prebuilt questions will be exported to the located defined by the section it is in. You can’t edit the default export destination for prebuilt questions, except for those located in the **Other** predefined section.
### Creating your own questions
Create custom questions to collect information that’s specific to your practice, workflows, or patient population. Responses to custom questions will be exported to the located defined by the section it is in. [Click here to view sample use cases for Patient Forms](/articles/Patient-Forms-Sample-Forms-and-Use-Cases).
The question formats available are:
| **Question Format** | **Use Case** | **Example** |
| ------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------- |
| Short answer | A single-line text field where the patient can type a brief, free-text response. | “What is the name and address of your preferred pharmacy?” |
| Patient signature | Allows patients to provide their electronic signature. | “Please sign below to consent to treatment.” |
| Dropdown Select | A list of options that appears when the patient clicks the dropdown menu. The patient can choose only **one** answer from the list. | “Select your primary language.” |
| Radio Select | A set of visible options displayed as circles. The patient can choose only **one** answer. | “What is your current smoking status?” |
| Checkbox | A list of options with checkboxes. The patient can choose **one or more** answers. You can also specify the following: **Allow free-text input accompanying each option** • **Include a pre-defined \*\* Other** choice\*\* | “Which symptoms are you experiencing?” |
| Free-text list | Allows patients to enter several responses, saved as individual items. | “List any supplements you’re currently taking.” |
| **1** | Add a new question by clicking **+ Add question** . |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Select the question format you want to use. |
| **3** | Customize the question and answer options. Add **Answer Help Text** as guidance for the patient if needed. (e.g. if you want the patient to enter their Date of Birth as a two digit month, two digit date and four digit year, enter the **Answer Help Text** as **MM/DD/YYYY**) • Click **+** to add additional answer options. • Click the **trash can** icon to delete unneeded answer options. |
| **4** | To reorder the questions, click and hold the **Grid** icon, drag the question to its new location and then let go of your cursor. |
| **5** | To copy a question to use it as a starting point for a similar question, click the **copy** icon. |
### Using a Patient Form Template
Templates come with predefined sections and questions to help you quickly create commonly used forms. To use a template simply click on the template name when creating a new form.
For example
* The **Demographics Template** allows you to collect information for certain demographics fields, such as the patient's preferred pronouns or emergency contact information, to maintain the most up to date demographics for each patient.
* Only the sections and questions available in the **Demographics Template** can be exported to a patient's demographics. You cannot create your own questions for exporting to patient demographics fields.
* The **Medicare AWV Template** allows you to send patients a list of typical questions for a Medicare Annual Wellness Visit. This way, you can collect responses before the appointment and reference them in the note, streamlining the visit.
### Managing the Patient Forms List
Newly created forms will appear at the bottom of the **Manage Forms** list on the Patient Forms Settings page. To reorder your forms, click the **Grid** icon and drag and drop the form to a new location.
Each form displays the following details:
* Form title
* Creator and creation date
* Last modified by and last modified date
* Linked Appointment Types, if the form is attached to any
This makes it easy to track form updates and understand how each form is being used in your workflow.
### Editing Patient Forms
When you edit a form, any changes you make will automatically apply moving forward. Patients will see the updated version the next time they load the form.
| **1** | Go to **Settings** -> **Patient Forms** . |
| ----- | ----------------------------------------------------------------- |
| **2** | Click **Edit** next to the form you want to edit. |
| **3** | Make your edits and then click **Save form** to save any changes. |
| **4** | Click the **back arrow** to return to the main Settings page. |
### Deleting Patient Forms
Deleted with caution as deleted forms cannot be restored. Deleting a form will immediately remove it from any linked appointment types. If the form was already sent to a patient, they may no longer be able to complete it—so make sure it’s no longer needed before deleting.
| **1** | Go to **Settings** -> **Patient Forms** . |
| ----- | ----------------------------------------------------- |
| **2** | Click **Delete** next to the form you want to delete. |
| **3** | Click **Delete** again to confirm. |
## Frequently Asked Questions
### Setting Up Forms
#### Can I upload a PDF as my Elation medical history form?
Yes, you can upload the PDF file to the Patient Form builder and have it create a draft form for you to edit and customize. [Click here for more instructions](/articles/Patient-Forms-Guide#generating-a-patient-form-draft-from-a-pdf-or-image).
#### Can patients electronically sign forms?
Yes, patients can electronically sign forms if you use the **Patient Signature** question in your form.
#### Are there any sample forms in the system for us to use?
Our team has added a few form templates that you can further customize. These are found under the **Create new form** button on the Patient Forms settings page.
#### Can we create forms in other languages?
You can modify the question prompt and helper text of our canned and **Other** question to be in another language.
#### Can we create forms with conditional questions (i.e. questions that only appear based on gender or age)?
Questions are not conditional in nature right now. We'd recommend adding phrases like 'if applicable' in the question prompt to indicate that it is not required for all patients.
#### Are any questions on the form mandatory?
Only the **Patient Signature** question has requirements. Other questions cannot be set as mandatory/required. If you'd like your patients to fill in all questions, please include those instructions in the Form Description.
#### Can I add more than one patient signature question to a single Patient Form?
Yes, you can add multiple **Patient Signature** questions to a form. Exception: forms created using **Create from a PDF** support only one **Patient Signature** question. To collect separate sign-off for multiple sections on a form created this way, add one **Patient Signature** question at the end of the form and use a checkbox or radio button question (e.g. "I have read and agree to Section 1 above") for each section that needs individual acknowledgment.
#### Can I duplicate an existing form to create a variant for a different age group or specialty?
Not with a single click. Create a new form for each variant, either starting from one of the built-in templates under **Settings > Patient Forms** or rebuilding the questions manually in the form builder.
#### What is the character limit for the Question Text field?
The character limit for the **Question Text** field is 5,000 characters with the exception of the **Patient Signature** question which has a character limit of 50,000 characters.
#### Can I print a blank version of a Patient Form?
Patient Forms are designed for online completion, so there is not a one-click option to print a fully blank copy from **Settings > Patient Forms**. To create a printable version for office use, recreate the form in Word or Google Docs and upload it as a [Patient Handout](/articles/patient-handouts). To print a copy of a specific patient's form, open the form from their appointment, click **Actions > Copy URL**, paste the link into your browser, and use your browser's print function.
### Filling Out Patient Forms
#### Are the forms mobile friendly?
Yes, medical history forms are mobile friendly and will work on any device with an internet connection.
#### Can I use Elation as a kiosk?
Elation does not currently provide a dedicated kiosk user interface. However, you can use **Patient Forms** on a clinic-owned tablet in your waiting area to collect demographics, questionnaires, and consents from patients upon arrival. Combine this with staff-driven check-in in the **Calendar** and **Patient Payments** for copay collection to create a streamlined intake workflow. For a more robust intake experience with patient self-identification, consider a third-party intake partner such as Updox or IntakeQ. See the [Patient Intake & Check-In Options](/articles/Patient-Intake-Check-In-Options) article for recommended patterns and partner integrations.
#### Besides free-text, can patients answer questions in more structured ways?
Most questions are built as free-text answers. Certain questions will support different types of responses. For example the **Smoking Status** and **Depression (PHQ-9)** questions have a drop down selection, and **Medical History** and **Family History** have checkboxes.
#### Can patients search a database to enter their preferred pharmacy?
Currently, patients can only enter a preferred pharmacy with free text.
#### Can patients save partially completed forms or edit responses that they've already submitted?
Once the form is submitted, the patient cannot go back and edit their responses to that form. If they have not submitted the form yet, they can use the same link that will bring them to a blank version of the form. Partially completed forms will not be saved.
#### A patient sees a "Page Not Found," "Form not found," or "page expired" message when opening their form link. What should I do?
Patient form links are single-use and time-limited, so this means the link has expired or already been used. Resend the patient form request to generate a new link. If the patient's appointment is soon, staff can also open the form on their behalf at check-in.
#### Are patient signatures saved so the patient can re-use them on other forms?
No, a patient will need to individually sign each form where a signature is requested.
#### Can patients add/upload any attachments when they are submitting their forms?
Patients cannot currently add or upload any attachments when submitting a form. We recommend using Patient Passport if a patient needs to send an attachment to the practice.
#### For a screening like PHQ-9, can I view a patient's individual question answers from an older submission, not just the total score?
Not currently. Individual question answers are only viewable for the most recently completed form of that type — older submissions of the same screening only show the total score.
#### Can a staff member or nurse fill out the form on behalf of the patient?
A Provider or Staff member can fill out the form on behalf of the patient by accessing the form from the individual's appointment in the Calendar. Click **Copy URL** and paste it into a new browser tab to open the form.
## Related Articles
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Patient Forms Guide - Sending forms to patients](/articles/Sending-forms-to-patients)
* [Patient Forms Guide - Managing forms responses](/articles/Managing-forms-responses)
* [Patient Forms Guide - Receiving and filling out forms as a patient](/articles/Receiving-and-filling-out-forms-as-a-patient)
* [Patient Forms Guide - Sample Forms and Use Cases](/articles/Patient-Forms-Sample-Forms-and-Use-Cases)
* [How to set up your Patient Booking Site](/articles/Patient-Booking-Site)
* [How to set up Elation Integrated Video](/articles/Elation-Telehealth-powered-by-Zoom)
# Patient Forms Guide - Sample Forms and Use Cases
Source: https://help.elationhealth.com/articles/Patient-Forms-Sample-Forms-and-Use-Cases
Examples of how to create common forms for consent or evaluation.
## Custom Forms
Patient Forms can be customized in many creative ways to collect more than just medical history. With various question formats available, you can adapt the forms to fit your practice’s unique needs. This article outlines several common use cases for Patient Forms and explains how to create forms tailored to each. [Click here for more detailed instructions about creating your own Patient Forms as needed](/articles/Patient-Forms-Guide).
### Consent to Treatment Form
To create a form to collect a patient's signature for Consent to Treatment, follow these steps:
| **1** | Go to **Settings** -> **Patient Forms** . |
| ------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Create New Form** . |
| **3** | Click **Blank** to start building from scratch. |
| **4** | Fill out the internal **Form Name** in the upper lefthand corner. This name will only be seen by members of your practice. E.g. **Consent to Treatment** |
| **5** | **(Admin Level User Only)** Specify who can sign off on the completed form by checking or unchecking the **Allow staff sign-off for this form** box. [Click here for information about this setting](/articles/Patient-Forms-Guide#specifying-who-can-sign-off-on-completed-forms). |
| **6** | Give the form a **Title** and **Form Description**. Both are visible to the patient. An example would be: **Title** =**Consent to Treatment for Horizon Medical** • **Form Description** = *This form explains your treatment options, potential benefits and risks, and your rights as a patient. By signing, you confirm that you understand the information provided and agree to receive the proposed care or procedure.* |
| **7** | Delete the blank section that comes with the blank form by clicking the trash can icon at the right hand corner of the section. |
| **8** | Click **Add predefined section** -> **Patient Signature**. |
| **9** | Add optional **Intro Text** as needed. This typically provides context or instructions for the question. E.g. *Before we begin your care, we want to make sure you understand your treatment options, possible benefits, and any potential risks. Please review the information below carefully, and contact us if you have any questions before signing this form.* |
| **10** | Remove the text **Enter the patient agreement** and then copy and paste or type your consent terms into the **Radio Button Question** box. An example would be: *I voluntarily consent to receive medical care, diagnostic procedures, and treatment from Horizon Medical and its healthcare providers. This may include physical examinations, routine testing, and other treatments deemed necessary for my care.* *I understand that:* *- I have the right to ask questions about any aspect of my treatment.* *- I can refuse any procedure or treatment to the extent permitted by law.* *- My care team will explain the risks, benefits, and alternatives of recommended treatments when appropriate.* *This consent remains valid until I withdraw it in writing.* *By agreeing and signing below, I acknowledge that I have read, understood, and agree to the above.* |
| **11** | Review and adjust the default answer options as needed. |
| **12** | Click **Save form** to save your new form. |
| **13** | Click the **back arrow** to return to the main Settings page. |
### Annual Wellness Questionnaire
To create a series of wellness questionnaires that can be sent to patients prior to annual wellness visits:
| **1** | Go to **Settings** -> **Patient Forms** . |
| ------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Create New Form** . |
| **3** | Click **Blank** to start building from scratch. |
| **4** | Fill out the internal **Form Name** in the upper lefthand corner. This name will only be seen by members of your practice. E.g. **Annual PHQ-9 and GAD-7** |
| **5** | **(Admin Level User Only)** Specify who can sign off on the completed form by checking or unchecking the **Allow staff sign-off for this form** box. [Click here for information about this setting](/articles/Patient-Forms-Guide#specifying-who-can-sign-off-on-completed-forms). |
| **6** | Give the form a **Title** and **Form Description**. Both are visible to the patient. An example would be: **Title** =**Annual Wellness Questionnaire** • **Form Description** = *These questionnaires ask about how you’ve been feeling over the past two weeks. They include questions about mood, interest in activities, energy levels, worry, and tension. Your answers help us understand your mental and emotional well-being so we can provide the best care for you. There are no right or wrong answers—please answer as honestly as you can.* |
| **7** | Delete the blank section that comes with the blank form by clicking the trash can icon at the right hand corner of the section. |
| **8** | Click **Add predefined section** -> **Anxiety (GAD-7)**. |
| **9** | Click **Add predefined section** -> **Depression (PHQ-9)**. |
| **10** | Add optional **Intro Text** as needed. This typically provides context or instructions for the question. |
| **11** | Click **Save form** to save your new form. |
| **12** | Click the **back arrow** to return to the main Settings page. |
### Questionnaires for Screening Tools
Use these steps to create questionnaires from screening tools, such as the STEADI 3 fall-risk assessment:
| **1** | Go to **Settings** -> **Patient Forms** . |
| ------ | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Create New Form** . |
| **3** | Click **Blank** to start building from scratch. |
| **4** | Fill out the internal **Form Name** in the upper lefthand corner. This name will only be seen by members of your practice. E.g. **STEADI 3 Fall Risk**. |
| **5** | **(Admin Level User Only)** Specify who can sign off on the completed form by checking or unchecking the **Allow staff sign-off for this form** box. [Click here for information about this setting](/articles/Patient-Forms-Guide#specifying-who-can-sign-off-on-completed-forms). |
| **6** | Give the form a **Title** and **Form Description**. Both are visible to the patient. An example would be: **Title** =**Fall Risk Screening** • **Form Description** = *The following questions are designed to identify the risk of falling. There are three simple questions about recent falls, balance, and worry about falling. Your answers help us understand your fall risk and recommend ways to keep you safe. Please answer as honestly as you can.* |
| **7** | Update the **Section Title** to something you want to use internally. E.g. 'STEADI 3'. |
| **8** | Specify where you want the responses to export to. E.g. **Functional** |
| **9** | Add optional **Intro Text** as needed. This typically provides context or instructions for the question. |
| **10** | Click **+ Add question** -> **Radio Button List**. |
| **11** | Copy and paste or type the first question of the screening into the **Radio Button Question** box. An example would be: *I have fallen in the past year* |
| **12** | Add the predefined answers for the screening into the answer option boxes. Click **+** to add additional answer boxes if needed. Examples for the first question of the STEADI 3 screening are: *Yes* • *No* |
| **13** | Repeat steps 11 and 12 for each question of the screening. |
| **14** | Click **Save form** to save your new form. |
| **15** | Click the **back arrow** to return to the main Settings page. |
### Next Step
**Create your own Patient Form and share it with your patients!**
## Related Articles
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Patient Forms Guide - Creating and managing Patient Forms](/articles/Patient-Forms-Guide)
* [Patient Forms Guide - Sending forms to patients](/articles/Sending-forms-to-patients)
* [Patient Forms Guide - Managing forms responses](/articles/Managing-forms-responses)
* [Patient Forms Guide - Receiving and filling out forms as a patient](/articles/Receiving-and-filling-out-forms-as-a-patient)
# Patient Intake & Check-In Options
Source: https://help.elationhealth.com/articles/Patient-Intake-Check-In-Options
This article explains how to combine Elation's scheduling, forms, and check-in tools to create an efficient patient intake workflow—and when to consider third-party solutions for a full kiosk experience.
## Overview
### What are patient intake and check-in options?
Patient intake and check-in options refer to the tools and workflows your practice uses to capture patient information and mark their arrival for an appointment. These workflows typically include:
* Collecting demographics, insurance, and clinical history before or at the visit.
* Gathering consent signatures and screening questionnaires.
* Updating appointment status when the patient arrives.
* Collecting copays or other payments.
Elation does not currently provide a dedicated kiosk user interface. However, you can use Elation's built-in features to create streamlined intake and check-in workflows that meet most practice needs.
### Why are intake and check-in workflows valuable?
Efficient intake and check-in workflows help your practice:
* Reduce front-desk workload by collecting information before the patient arrives.
* Improve data accuracy by letting patients enter their own details.
* Streamline patient flow so visits start on time.
* Ensure payment is collected at the point of service.
## Workflow Instructions
You can combine several Elation features to build an intake and check-in workflow tailored to your practice.
### Completing intake with Patient Forms
The **Patient Forms** feature lets you create and customize electronic intake forms that patients can complete at any point in their care journey. Common use cases include:
* First encounter intake - Demographics, insurance information, and clinical history
* Consent forms - Signatures for various services or treatments
* Pre-visit screening - Health questionnaires and history updates before appointments
Patients can fill out forms on their own device or on a clinic-owned tablet in your waiting area. Once a form is completed, Elation automatically tracks it and stores a copy in the patient's chart.
Most practices send forms ahead of a scheduled visit to ensure everything is ready when the patient arrives.
For detailed instructions, see the [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms).
### Sending intake forms when patients book appointments via the Booking Site
The Patient Booking Site is a personalized web page where patients can book from any internet-enabled device, at any time, and appointments appear on your Elation Calendar in real time.
You can link **Patient Forms** to appointment types so that patients automatically receive intake forms when they book.
For detailed instructions, see the [Patient Booking Site Guide](/articles/Patient-Booking-Site).
### Staff-driven check-in with the Calendar
When a patient arrives, staff can update the **Appointment Status** in the Calendar to Checked In. This opens the patient's demographics for verification and triggers actions such as a Medication History Download for walk-in patients.
* Additional statuses—In Room, In Room - Vitals Taken, and With Doctor—let you track the patient's location throughout their visit.
For detailed instructions, see the [Calendar Guide – Checking patients in for their appointment](/articles/Calendar-Guide-Checking-patients-in-for-their-appointment).
### Collecting copays with Patient Payments
Elation **Patient Payments** provides a secure, digital way to collect payments from patients. You can collect payment:
* Before the visit - Popular for practices that charge a set price up front
* During check-in - Popular for insurance-taking practices collecting copays
* After the visit - Popular for direct pay or cash-based practices
You can send a payment request via email or text, charge payment information on file, or enter a card at the point of service.
For detailed instructions, see the [Patient Payments Guide](/articles/using-elation-to-securely-collect-patient-payments).
## Third-Party Intake Partners
If your practice needs a fuller intake experience, consider a third-party intake partner. We recommend reaching out to these partners directly if you'd like to learn more about the options they offer.
### IntakeQ
IntakeQ is an intake forms platform that synchronizes completed forms with Elation and can create or update patient charts using collected demographic information. When a patient submits an intake package via IntakeQ, the forms are automatically uploaded as PDFs to the patient's chart in Elation.
For more information, see the [Elation-IntakeQ Integration Guide](/articles/Elation-IntakeQ-Integration-Guide).
### Updox
Updox is a communications platform that integrates with Elation. It offers features such as electronic fax, secure text/SMS, automated appointment reminders, and patient mass communication. Updox can use Elation's appointment and demographics data to power its patient engagement features.
For more information, see the [Elation-Updox Integration Guide](/articles/Elation-Updox-Integration-Guide).
Zendesk is not a natively supported intake integration with Elation. If your practice wants patient intake information such as demographics, medical history, and medications to flow directly into the EHR, use **Patient Forms** or **Patient Passport** instead. Moving data from Zendesk into Elation would require a custom integration using the [Elation API Reference](https://help.elationhealth.com/api-reference).
## Frequently Asked Questions (FAQ)
### Can I use Elation as a kiosk?
Elation does not currently provide a dedicated kiosk user interface. However, you can simulate the process by doing the following:
* Using Patient Forms on a clinic-owned tablet for intake (demographics, questionnaires, consents).
* Manually updating check-in status in the Calendar.
* Collecting copays with Patient Payments.
For a more robust intake experience with patient self-identification, consider a third-party intake partner such as Updox or IntakeQ.
### Can patients check themselves in remotely before they arrive for their appointment?
At this time, Elation does not have a feature that lets patients check themselves in remotely. Staff will need to check patients in manually upon arrival by updating the **Appointment Status** in the Calendar.
### Can patients complete forms on a tablet in my waiting room?
Yes. Patients can complete **Patient Forms** on any internet-enabled device, including a clinic-owned tablet. Simply open the form link on the tablet and hand it to the patient.
### How do I send forms automatically when a patient books an appointment?
Link your **Patient Forms** to appointment types in your **Calendar & Booking** settings. When a patient books that appointment type, they will automatically receive the linked forms.
## Related Articles
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Calendar Guide – Checking patients in for their appointment](/articles/Calendar-Guide-Checking-patients-in-for-their-appointment)
* [Patient Payments Guide – Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Elation-Updox Integration Guide](/articles/Elation-Updox-Integration-Guide)
* [Elation-IntakeQ Integration Guide](/articles/Elation-IntakeQ-Integration-Guide)
# Patient Payments Guide - Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Patient-Payments-Frequently-Asked-Questions
Answers to common questions we've received from practices about Elation Patient Payments feature.
## General Questions
Please use the **I need help** -> **Contact Elation Support** option from your Elation account or fill out our [Contact Form](https://help.elationemr.com/s/contactsupport).
Elation Patient Payments is powered by Stripe. Stripe is a secure, digital, payment processing platform that is Payment Card Industry (PCI) compliant and utilizes best-in-class security tools to maintain a high level of security. Any information you enter during the payment process is securely encrypted. For more information in regards to Stripe's Security and Privacy Policy, please see:
* Security info: [https://stripe.com/docs/security/stripe](https://stripe.com/docs/security/stripe)
* Privacy Policy: [https://stripe.com/privacy](https://stripe.com/privacy)
## Sending and receiving payment requests
Yes, the minimum allowed charge amount is \$0.50.
Yes, patients can pay with their HSA or FSA cards when paying a balance through Elation Patient Payments. If you are running into issues receiving FSA or HSA payments, follow these steps to verify you have the correct **Industry** selection in your Stripe settings:
1. In your **Patient Payments** settings page in Elation EHR, click on **Go to Stripe account**.
2. Click **Edit** (pencil icon).
3. Update your **Industry** to **Doctors and Physicians**.
Our patient guide on how to complete payment requests is available [here](https://docsend.com/view/ke9fikv3nvga3ykr). Feel free to download and send this to your patients directly!
Take action on any transaction in the Elation Patient Payments Report. Resend or void outstanding requests, refund paid requests, mark any payment as paid via cash/check and more. Click the **...** icon in the **Actions** column within the report to take action on a specific transaction.
Partial refunds are not supported. The recommended workflow is to refund the original payment and send a new payment request to the patient.
After clicking **Resend payment request**, a brief **Request resent** confirmation appears at the top of the screen and disappears after a few seconds. The transaction's status will remain **Payment requested** until the patient pays.
If the patient does not receive the request, confirm their preferred contact method (email or text) in **Demographics**, have them check spam or junk for the email, or use **Copy request link** from the **...** Actions menu to share the payment link another way.
The option to print a receipt is available from the **Patient Payment** payment window after a charge has been completed. The patient will also automatically receive an electronic receipt via text or email depending on their preferred contact method.
Cash and check payments are recorded through a single **Mark as paid by cash/check** action and are not stored as separate payment methods. The emailed receipt shows the method as **Cash** even for check payments. (The printable receipt from the Patient Payments Report shows **Cash/Check**.)
To record that a payment came in as a check, enter the check number in the **Reference / Check #** field when marking the payment — it saves with the transaction and appears in the Patient Payments Report and in Elation Billing.
* **Paid:** The payment request was completed and paid, either via cash/check or credit card and a receipt has been sent to the patient's preferred contact method.
* **Card declined:** The attempt to charge a manually entered card number failed (not a saved card-on-file).
* **Charge pending:** A credit card on file was charged and will be automatically charged within 24hrs. The charge is still in the 24hr window.
* **Payment requested:** A payment request was sent via email or text and has not yet been paid by the patient.
* **Payment declined:** The attempt to charge a card-on-file failed. The specific reason from Stripe (such as "Insufficient funds" or "Card expired") appears in parentheses next to the status — for example, "Payment declined (Insufficient funds)." This helps your team quickly understand what went wrong. Patients are automatically notified and prompted to update their payment information.
* **Refunded:** The payment was refunded to the original payment method.
* **Void:** The payment request was voided, meaning the patient will no longer be able to complete/submit payment for this specific transaction.
Track payment requests and payments through the **Patient Payment Report**. From the blue navigation bar, go to **Reports** -> **Patient Payment Report**. The **Patient Payment Report** will update the status of each transaction in real-time.
When a payment is updated, the update shows up as its own new entry in the report rather than changing an older, existing line. If you're looking at a past transaction expecting it to change, look for the update as a separate, newer entry instead.
For security, Elation only displays the card type, the last four digits, and the expiration date — never the full card number.
Yes. Go to **Reports** -> **Patient Payment Report** and filter by **Payment Type** / **Payment Reason** to separate copay and coinsurance line items from membership fee line items — each payment is tagged with the reason it was collected. To see which specific membership plan a fee came from, cross-reference with the **Membership Report** (**Reports** -> **Membership Report**), which lists every enrolled patient by plan.
**EXCEPTION - MEMBERSHIPS ONLY** Patients can choose to pay for a single membership charge using multiple payment methods. [Click here for more information about this feature](/articles/Membership-Management-How-Patients-Receive-Communications).
The Payment feature currently does not allow for partial payments. The requested amount is the amount that the patient must pay when inputting payment information. You can break up payment requests for a single service by sending multiple payment requests for that service (E.g. Deductible for Date of Service July 1, 2020, payment 1 of 3). Or you can have the patient pay partial payments through your Payment Site, as they are able to choose the amount they pay through the site.
Yes. From the patient's chart, click the **Payment** button to open the payment dialog. You can also initiate a payment from the **Patient Payments Report** by clicking **Send payment request**.
From the Practice Home, click the **Payments** dropdown in the gray navigation bar and select **View Failed Payments**. This takes you directly to the Patient Payment Report filtered to show only failed transactions. If there are any failed payments, a count badge is visible next to the **Payments** button so you can spot them without opening the report first.
There currently isn't a notification or email feature for failed or declined payments. To keep track of failed payments, check the count badge next to the **Payments** button in Practice Home, or periodically review the **Patient Payment Report** (see above).
No. Once a payment has been posted or a payment request has been sent, Elation doesn't support editing the payment's details or category (for example, changing a payment from an outstanding balance to a copay) within Elation Billing or the Patient Payments Report — select the correct payment reason and categorization at the time you enter the payment.
Internal memos can be added when you create a payment request or post a payment, using the **Add internal note** option. These notes are visible only to your practice and appear in the Patient Payments Report. There's currently no supported way to add or edit an internal memo after a payment has already been posted.
Payment methods can't be directly edited in Elation. The recommended workflow is to delete the existing payment method and add a new method.
Navigate to the patient's **Demographics Dialog > Insurance, Payment, & Membership > Payment Information**. To remove a saved card or bank account on file, click the **Delete** option next to the payment method. This only removes the stored payment method — it does not affect any completed or pending transactions.
To add a new payment method, click the **Request payment info** option. This sends the patient a link to enter their new payment information.
A card on file can't be deleted while it's still tied to an active membership. Either unenroll the membership if it's no longer needed, or have the patient add a new payment method first and update the membership to use it, then the old card can be deleted.
Not directly — there isn't a built-in option to print the full report from Elation. Download the report as a CSV, then open it in a spreadsheet application like Excel or Google Sheets to print it or save it as a PDF. If you only need documentation for a single payment, you can reprint that transaction's receipt directly from Elation instead.
## Tips & tricks to increase your collection rate
From the blue navigation bar, go to **Reports** -> **Patient Payment Report**. Within the **Patient Payment Report**, you can take action on any transaction in real-time. Filter the report for outstanding payments where status is 'Payment requested' and choose **Resend request** in the **Actions** column.
This will help guarantee your practice payment, but also make it easier on your patients as they won't have to enter payment details multiple times.
Patients can choose to store a card-on-file for future payments through completing a payment request. They will need to keep the checkbox **Keep this card on file** checked when completing the payment. Once you have charged a card on file, the patient will be notified of the pending charge. The charge will automatically be collected within 24hrs. This gives the patient time to update their card-on-file or contact your office with any questions. Once the charge is completed, the patient will receive a receipt via text or email.
Select one or more **Payment Reasons** in the payment request window before submitting the payment request or charge to your patients. These reasons will be displayed to the patient within the emailed or text request they receive.
## Managing your account
Share a copy of the contents of your email with the [Support Team](https://help.elationemr.com/s/contactsupport) and we will work with Stripe to get your account cleared.
To update the phone number and email displayed on your payment requests, go to your Settings page in Elation and update the information associated with your primary practice location. Navigate to **Settings** -> **Practice Locations**, and click **Edit** next to the location tagged as your **Primary Location**.
Anyone can view & manage the **Patient Payments** Settings section in Elation. To limit access, toggle to **Admin Only** to only allow Admin users. Only a Stripe Team Member (managed in the **Team Member** section in the Stripe account screen) can edit Stripe account information. All changes will be verified by a two-factor authentication text that will be sent to the mobile number the account was activated with.
1. Go to the **Patient Payment** Settings page in Elation.
2. Click **Go to Stripe Account**.
3. Click **Account**.
4. Click **Manage** under Settings.
5. The existing Account Representative will need to enter a 6 digit verification code (sent to their mobile phone on file) into the form and the form will automatically proceed to the next page.
6. Click **+ Add team member**.
7. Enter the team member's email address and click **Invite**.
8. The new team member will go to their email and click the **Accept Invite** button in their invitation email.
9. The new team member enters their mobile number for account verification.
10. The new team member will enter the 6 digit verification code (sent to their mobile phone) into the form and the form will automatically proceed to the next page.
11. A message that says **You have successfully joined your practice's account.** will appear on the Elation Health Stripe Account page for confirmation.
Elation charges a flat rate for each transaction you collect (there is no fee associated with logging a cash/check payment). There are no startup costs, minimums, or termination fees. Elation will not charge you for refunding a transaction. However, the flat rate we charge for processing the transaction will not be refunded.
If you have any questions about your processing rate, use **I need help** → **Contact Elation Support** and our Support Team will be able to assist you.
No. Stripe and card networks do not charge fees beyond Elation's processing fee. Elation's fee covers all payment processing costs.
Elation does not support automatically adding a surcharge or convenience fee to patient payments within the product. Consult your legal counsel if you are considering surcharging practices.
No. Generating invoices through [Patient Invoicing](/articles/patient-invoicing) does not incur processing fees. Elation's percentage-based fee applies only to payments processed via Patient Payments.
Download the Patient Payment Report to see a breakdown of the payments collected and the transaction fees deducted for each collected payment.
1. From the blue navigation bar click **Reports** -> **Patient Payment Report**.
2. Filter the report as needed.
3. Click **Download CSV**.
Stripe issues 1099 tax forms—not Elation. You will automatically receive your 1099 via email by January 31st each year, sent to the email address associated with your Stripe account. If you did not receive a 1099, check your email (including spam/junk folders) or contact Stripe directly. Stripe follows IRS thresholds, so a 1099 may not be issued if your payment volume did not meet the reporting requirement. For detailed instructions, see [Patient Payments Guide - Obtaining a 1099 Tax Form for your Stripe account](/articles/Patient-Payments-Guide-Obtaining-a-1099-Tax-Form-for-your-Stripe-account).
## Related Articles
* [Patient Payments Guide - Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Patient Payments Guide - Obtaining a 1099 Tax Form for your Stripe account](/articles/Patient-Payments-Guide-Obtaining-a-1099-Tax-Form-for-your-Stripe-account)
# Patient Payments Guide - ACH Transactions
Source: https://help.elationhealth.com/articles/Patient-Payments-Guide-ACH-Transactions
Learn how patients can pay their Elation balance through an ACH transaction.
## Overview
### What is an ACH payment?
An ACH payment is a payment transaction made with the patient's bank account. For Elation, the ACH payment option can be selected when the patient completes a Payment Request or fills out payment details for membership plan enrollment.
### What are the benefits of offering this payment method?
* Offers patients flexible payment options
* Can lower the practice's transaction costs compared to credit cards
* Can reduces failed charges since bank accounts don’t expire like credit cards
### What fees are associated with ACH transactions?
Practices will be responsible for paying Elation a 1% + $0.25 (cap of $5) fee per ACH transaction.
## Workflow Instructions
Patients can choose to pay with their bank account when completing a **Patient Payment Request** or paying a **Membership** fee.
If needed, refer to the links below to:
* [Learn how to send a one-time Payment Request to a patient](/articles/using-elation-to-securely-collect-patient-payments#sending_request)
* **NOTE**: To allow the patient to pay with their bank account, leave the **Payment Method** toggled to Credit/Debit and **Payment Option** set to **Send patient a request** when creating a payment request.
* [Learn how to enroll a patient in a membership plan](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans)
* [Learn how patients can self-enroll in a membership plan](/articles/Membership-Management-Patient-Self-Enrollment)
### Selecting ACH as the payment method
| **1** | As the patient, locate the delivered email or text and open the **payment request page** or **enrollment page.** |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Fill out the fields in the **Billing Info** section. |
| **3** | Click the **US bank account** button. In the **search field** , type the name of your bank to search for it. Once found, click on the corresponding **button for your bank** . |
| **4** | In a pop-up window, you'll be shown a message that Elation uses Stripe to facilitate these transactions. Click **Agree and continue** . |
| **5** | Enter your **online banking username and password** to connect to your bank account. For example, if you bank with Wells Fargo, enter the username and password that you'd typically use to log into your account on the Wells Fargo website. |
| **6** | Once the log-in is successful, select the **specific account** that your payment will be withdrawn from. Click **Connect account.** |
| **7** | Once you see the Success screen, click **Back to Elation Health, Inc** . |
| **8** | Confirm that the correct account shows up under the **Bank account** section. |
| **9** | Click the blue **Pay** button. |
If you're unable to find your bank or are unable to complete the log-in workflow above, you can use the **manual entry** method.
With this option, you'll type in your account and routing numbers. Afterwards, you'll receive an email from Stripe with mandatory instructions around micro-deposits. Until you complete the mandatory steps from the email, your payment to your Elation provider **will not** be considered complete.
Because of the extra steps and potential delays involved with the manual workflow, we advise using the main "log-in workflow".
## What practices see during ACH processing
When a membership subscription is charged via ACH, the Membership Report and patient chart badge will reflect the payment state:
| Status | What it means | Action needed? |
| ---------------------------- | ------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------ |
| **ACH Processing** | Payment was initiated and is actively settling. Typically clears in 1–10 business days. | None — status updates to Active automatically once payment settles. |
| **ACH Verification Pending** | Patient connected their bank account via manual entry and has not yet completed Stripe’s microdeposit verification. | Ask the patient to check their email for the Stripe verification message and complete that step. |
| **Past Due** | ACH payment failed or was not resolved within the settlement window (1–10 business days). | Request a new payment method or resend the payment request. |
A membership showing **ACH Processing** is not past due. No action is needed while the payment is settling.
## Frequently Asked Questions
### Can a practice enter the patient's banking information on their behalf?
If the patient brings up the payment page on their device or on a shared device at the office, practice staff can help clarify what steps need to be followed. However, there isn't a way for staff to directly enter a patient's ACH payment details into the EHR.
**Can patients select the ACH payment option on the practice's self-service payment page?**
No, at this time the ACH option isn't available on the self-service payment page.
## Related Articles
* [Patient Payments Guide - Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Membership Management Introduction](/articles/Introduction-to-Membership-Management-with-Elation)
# Patient Payments Guide - Obtaining a 1099 Tax Form for your Stripe account
Source: https://help.elationhealth.com/articles/Patient-Payments-Guide-Obtaining-a-1099-Tax-Form-for-your-Stripe-account
This article describes how customers using the Stripe Patient Payment integration can obtain a 1099 Tax Form for tax reporting.
## Overview
Elation customers using the [Stripe Integration](/articles/using-elation-to-securely-collect-patient-payments) to collect patient payments will automatically receive a 1099 tax form from Stripe via email by January 31st each year for the previous tax year. The 1099 will be sent to the email address associated with the Stripe account. To ensure you receive an accurate 1099, review your Stripe account details by December 15th and update your account details as necessary.
To review Stripe account details:
| **1** | Sign in to your Stripe Dashboard in Elation via **Settings** → **Patient Payments** . |
| ----- | ------------------------------------------------------------------------------------- |
| **2** | Click **Account** → **Business Details** . |
Whenever you update your business details in Stripe, email a copy of the updated W9 to Elation via the Contact Support form so we can update the 1099 filed on your behalf.
### Who issues the 1099?
Stripe issues the 1099 tax form for payments collected through Elation Patient Payments—not Elation. Stripe is the payment processor and is responsible for tax reporting on funds paid out to your practice.
### When will I receive my 1099?
Stripe sends 1099 tax forms via email by January 31st each year for the previous tax year. The 1099 is sent to the email address associated with your Stripe account.
### Where can I find my 1099?
| **1** | Check the email inbox associated with your Stripe account (including junk, spam, and trash folders). |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Access your Stripe Dashboard directly: Go to **Settings** → **Patient Payments** in Elation. • Click **Go to Stripe account**. • Navigate to your tax documents within the Stripe Dashboard. |
### Why might I not receive a 1099?
Stripe follows IRS reporting thresholds for issuing 1099-K forms. If your practice's total payment volume through Stripe did not meet the IRS threshold for the tax year, Stripe may not issue a 1099. Contact Stripe directly to confirm your eligibility and threshold status.
## Frequently Asked Questions
### I did not receive a 1099 tax form from Elation. Why?
Stripe—not Elation—issues 1099 tax forms for Patient Payments. If you did not receive a 1099:
| **1** | **Check your email:** The 1099 is sent to the email address tied to your Stripe account. Check your junk, spam, and trash folders. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | **Verify the threshold:** Stripe follows IRS reporting requirements. If your total payment volume did not meet the IRS threshold for the tax year, a 1099 may not be issued. |
| **3** | **Contact Stripe:** If you believe you should have received a 1099 or need a copy, contact Stripe directly: [Stripe Support Chat](https://support.stripe.com/contact/chat) • [Stripe Support Call](https://support.stripe.com/contact/call) |
### I received a 1099 but it has my name on it instead of my business name. How do I correct this?
The 1099 is tied to the account type you selected when registering for a Stripe account through Elation. If the name on the 1099 is inaccurate, follow the [instructions below](https://docs.google.com/document/d/1ls-BFkipKoPZp-hspTRbC67kt-RAYTjw5Ct7mzYjx4w/edit?tab=t.0#heading=h.msapw7u58usi) to update your Stripe account type.
### How do I update my Stripe account type to a Business or Non-profit entity?
To update your Stripe account type to Business or Non-profit, you must reach out to Stripe using the following instructions:
| **1** | Sign in to your Stripe Dashboard in Elation via **Settings** → **Patient Payments** . |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | In the Dashboard, locate the **?** speech bubble icon in the top right corner and click it. |
| **3** | Select the option to contact Stripe's Support team. Alternatively, you can use the following direct links: |
| **4** | Paste the following message into the chat box: *Hello Stripe Team, I hope you're well. I am writing to request that my Express account be updated to a \_\_\_\_\_\_\_\_\_\_\_ Entity. Please see the details below for your reference:* |
| **5** | Once the update is made (typically within 24 hours), you will receive an email from Stripe confirming that your account has been updated. |
| **6** | After receiving confirmation, log back into your Stripe Dashboard and review your **Business details** to ensure all information is accurate. If necessary, update your EIN or any other relevant details. |
| **7** | Afterwards, contact Elation Support to notify us of your updated account details and send us a copy of your updated W9 and we will file a new 1099 for you. |
| **8** | Afterwards Stripe will email you the updated 1099. |
### I received a 1099 but it has my social security number instead of my EIN. How do I correct this?
The 1099 is tied to the information you entered in your account when registering for a Stripe account through Elation. If any details on the account are inaccurate, follow the instructions below to update your Stripe account details.
| **1** | Sign in to your Stripe Dashboard in Elation via **Settings** → **Patient Payments** . |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Account** → **Business Details** . |
| **3** | Edit any information as needed. |
| **4** | Afterwards, contact Elation Support to notify us of your updated account details and send us a copy of your updated W9 and we will file a new 1099 for you. |
| **5** | Afterwards Stripe will email you the updated 1099. |
### When should I contact Stripe vs. Elation?
| **Question** | **Contact** |
| -------------------------------------------------- | ---------------------------------------------------------------------------- |
| 1099 not received or need a copy | Stripe |
| 1099 has incorrect name, SSN, or EIN | Stripe (to update account type), then notify Elation Support with updated W9 |
| Questions about payment thresholds for 1099 | Stripe |
| Questions about payout amounts or transaction fees | Elation Support |
| Unable to access Stripe Dashboard from Elation | Elation Support |
## Related Articles
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
# Patient Payments – Stripe connection and activation issues
Source: https://help.elationhealth.com/articles/Patient-Payments-Stripe-connection-and-activation-issues
This article helps you identify and resolve common issues with your Stripe connection for Elation Patient Payments.
This article helps you identify and resolve common issues with your Stripe connection for Elation Patient Payments.
## Overview
### When to suspect a Stripe connection issue
You may have a Stripe connection or activation issue if the **Patient Payments** feature is visible in Elation, but you experience any of the following:
* All payment charges fail
* Stripe shows no issues, yet no transactions appear in Elation
* Stripe shows issues (such as verification warnings or payout holds), but your staff are unaware because they have not checked the **Stripe Dashboard**
## Workflow Instructions
Before contacting Elation Support, complete the following checks to identify and resolve common issues.
### Check your Stripe account from Elation
1. **Navigate to Patient Payments** - Go to **Settings** → **Patient Payments**.
2. **Open your Stripe Dashboard** - Click **Go to Stripe account** to open your **Stripe Dashboard**.
![Patient Payments settings page showing "Activation complete" status and the "Go to Stripe account" button used to access the Stripe Dashboard]()
### Review your Stripe account status
![Stripe Dashboard Home page showing 395.87 in recent earnings, 0.00 total balance, next payout scheduled for Feb 16, and recent transactions including Paid and Succeeded statuses]()
Once in the **Stripe Dashboard**, check for the following:
* **Pending verification tasks:** Stripe may require additional identity or business verification before you can process payments. Look for any alerts or banners prompting you to complete verification steps.
* **Payout holds:** Confirm there are no holds on your payouts. Stripe may pause payouts if verification is incomplete or if there are issues with your account.
* **Bank account information:** Verify that your bank account details (account and routing numbers) are correct and match the entity type you selected during setup.
### Verify your Industry setting (for HSA/FSA issues)
If you are having trouble receiving FSA or HSA payments, confirm your **Industry** setting in Stripe:
1. **Open Stripe from Elation** - In your **Patient Payments** settings page in Elation, click **Go to Stripe account**.
2. **Go to Settings** - In the **Stripe Dashboard**, locate and click **Settings**.
3. **Find your details** - Scroll down to **Professional details** or **Business details**.
4. **Open details** - Click **Edit** to view the details.
5. **Edit details** - When the **Additional Information** dialog window opens, click **Edit** to make changes.
6. **Update Industry** - Update your **Industry** to **Doctors and Physicians**.
![Edit Business Details panel in Stripe with the Industry dropdown highlighted, showing "Doctors and Physicians" selected — required for HSA/FSA payment acceptance.]()
## When to contact Elation Support
If you have completed the self-service checks above and are still experiencing issues, contact Elation Support for further assistance.
### How to contact Support
Use the **I need help** → **Contact Elation Support** button at the top of your Elation account.
### Information to provide
To help resolve your issue quickly, include the following details in your support request:
* **Practice name**
* **Patient example:** Patient name (or ID) and the date/time of the attempted charge
* **Stripe charge ID(s):** If available, include any Stripe charge ID(s) from failed transactions
* **Screenshots:** If you are able, any non-PHI screenshots of error messages or examples you can provide
## Related Articles
* [Patient Payments Guide – Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Patient Payments – Frequently Asked Questions](/articles/Patient-Payments-Frequently-Asked-Questions)
* [How to register for Stripe account with Elation](https://docsend.com/view/u5pujrn5mrghwnkj)
* [Patient Payments Guide – Obtaining a 1099 Tax Form for your Stripe account](/articles/Patient-Payments-Guide-Obtaining-a-1099-Tax-Form-for-your-Stripe-account)
# Patient Chart Guide- Patient Status
Source: https://help.elationhealth.com/articles/Patient-Status
The Patient Status feature allows you to mark the status of patients in your practice.
## What is Patient Status?
The Patient Status feature allows you to apply a marker to a patient’s chart to designate their status within your practice. The following statuses are offered:
* Active
* Inactive
* Prospect
* Deceased
## Why is Patient Status useful?
Setting Patient Status allows you to keep an accurate record of your patient panel. The status of a chart is visible at the top of the chart and in the various areas where you search for patients. Insight into the patient’s status allows you to take appropriate actions when a workflow involves a non-active patient.
You can also utilize the Patient Status feature in your [Patient List Report](/articles/find-patients-with-elations-patient-list) to ensure accurate reporting. The reporting will also allow you to send communication to patients based on their status such as inviting prospective patients to schedule an appointment with you once your availability opens up.
The Patient Status is only a marker and does not impact the ability to edit contents in the chart.
## Setting a Patient Status
To set a Patient Status, follow the steps below:
1. Open the chart for a patient who needs their status updated
2. Click on the patient’s name to open their demographics
3. Go to the **Note & Chart Management** section of the demographics
4. Click on the **Status** dropdown to select one of the statuses below. A new notes field will be visible if you choose any status besides “Active”, allowing you to enter additional notes about the status selected
* **Active** - this is the default status for all patients
* **Inactive** - a **Reason** option will appear. You can select one of the following reasons:
* Other
* Patient Left on Bad Terms
* Patient Left on Good Terms
* Practice Ended Relationship
* Unknown
* **Prospect**
* **Deceased** - a new **Date** field will appear allowing you to note the deceased date
5. Click the **Save & Close** or **Print & Close** button at the bottom of the demographics box to save your changes
## Viewing a Patient Status
The Patient Status will be visible in the following areas with the exception of the **Active** status (default)
* at the top of the Clinical Profile as a yellow banner
![Three patient chart headers showing non-active status banners: "Inactive: Patient Left on Good Terms," "Prospect," and "Deceased (8/25/2015)" displayed in yellow above the patient name.]()
* in all patient search features
![Three "Find a Patient Chart" search results for "jerem" showing Jones, Jeremy M with status badges: Inactive (top), Prospect (middle), and Deceased (bottom).]()
* when you are filing documents in the Fax Inbox
!["Assign & File Document into Patient Chart" dialog with "jerem" typed in the Patient field. Search result shows Jones, Jeremy M highlighted with an "Inactive" status badge, DOB 02/25/1959.]()
## Utilizing Patient Status in reporting
The Patient Status is also a filter in the [Patient List Report](/articles/find-patients-with-elations-patient-list). You can include or exclude patients of a specific status in your reports.
![Patient List filter with "Patient Status" checkbox checked and dropdown set to "Deceased," showing options: Active, Inactive, Prospect, and Deceased (selected).]()
You also have the option to update Patient Status in bulk for multiple patients at a time. The **Change Status** button at the top of the Patient List report results will allow you to change the status for all selected patients.
![Change Status panel open with 2 patients selected (Ron Flanders, Johnny B. Goode), Status set to "Inactive" and Reason set to "Patient Left on Good Terms", with Change Status button highlighted.]()
## Frequently Asked Questions (FAQ)
### Can I add additional statuses of my own?
Customers will not be able to add additional statuses of their own. We recommend using the **additional notes regarding patient status** field to enter additional information about the Patient Status selected.
### I previously used Patient Tags to mark different statuses. Should I convert to using the Patient Status feature?
If you need to mark a patient as Inactive, Prospect or Deceased, we recommend using the Patient Status feature instead of the Patient Tags feature due to the broader [visibility](#view_status) of the Patient Status feature.
To easily convert to the Patient Status feature, use the [Patient List Report](/articles/find-patients-with-elations-patient-list) to find all the patients you previously tagged and then use the **Change Status** button at the top of the report to apply the appropriate status to the chart.
### How long will it take to change status in bulk using the Patient List?
Bulk status changes will initiate immediately, but it may take some time to process all the changes, especially if a large number of patients are selected. Confirmation text will appear at the top of the Patient List Report when the update is completed. If you refresh the Patient List Report or navigate away from the page before seeing the confirmation, the bulk status change will still execute.
If you filter for patients in a specific status (ex: Active) and then run a bulk status change for those patients, they will continue to appear in the same status (ex: Active) until you refresh the Patient List Report or re-run the search in the Patient List Report.
### Is there a way to archive a deceased patient's chart?
Elation does not have a separate archive feature. For a deceased patient, we recommend setting their Patient Status to **Deceased** (see above) rather than deleting the chart — this keeps the full chart available for clinical and legal reference while clearly flagging that the patient is no longer active. Deleting a chart removes it from your EMR view, and Elation does not provide a separate archived view for deleted charts.
### Can I filter for more than one status at a time? For example I want my report to include patients marked as Active and Prospect for a marketing campaign.
At this time, you will not be able to filter for more than one status at a time. Elation will notify you if this feature becomes available in the future.
### If I mark a patient Inactive, will that stop messages about them from pharmacies, labs, or other providers?
No. Marking a patient Inactive in Elation doesn't notify external senders like pharmacies, labs, or other providers of the status change, so you may still receive their records and requests. To reduce these messages, notify the sender directly (for example, ask the pharmacy to remove the provider from the patient's records, or let a referring provider know the patient is no longer with your practice).
## Related Articles
* [Patient Chart Guide- Searching for patient charts](/articles/Patient-Chart-Guide-Searching-for-patient-charts)
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient List Report](/articles/find-patients-with-elations-patient-list)
# Pediatric Features Guide
Source: https://help.elationhealth.com/articles/Pediatric-Features
This article lists all the features applicable to practices that see pediatric patients.
## Overview
This article is your guide to navigating the specialized features and considerations designed specifically for pediatric patients within Elation. Caring for children, from infants to adolescents, requires unique workflows, communication protocols, and safety measures. We've developed dedicated tools to ensure accurate record-keeping, age-appropriate clinical management, and enhanced engagement with both the child and their guardians. Read on to learn how to effectively utilize these features, ensuring the highest standard of care for our youngest patients.
## Features
| **Feature** | **Do you need to perform any configurations to start using this feature?** |
| ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **Clinical Questionnaires**
Screen for certain cognitive, functional or psychological conditions in children using structured questionnaires. M-CHAT-R • Vanderbilt - PARENT (NICHQ Vanderbilt - PARENT Informant) • Vanderbilt Follow-up - PARENT (NICHQ Vanderbilt Follow-up - PARENT Informant) • Vanderbilt - PARENT (NICHQ Vanderbilt - TEACHER Informant) • Vanderbilt Follow-up - PARENT (NICHQ Vanderbilt Follow-up - TEACHER Informant) • SWYC (Survey of Well-being of Young Children) | No additional configurations needed. Consults [this Help Center guide](/articles/structured-questionnaires) for instructions on how to use the various Clinical Questionnaires. |
| **Elation Note - Templates for Well Child Visits**
Utilized structured visit note templates in your Elation Notes for routine pediatric encounters. PEDS WCC Newborn • PEDS WCC 2–9 mos • PEDS WCC 12–30 mos • PEDS WCC 3–5 yrs • PEDS WCC 6–11 yrs • PEDS WCC 12–18 yrs | No additional configurations needed. Consult [this Help Center guide](/articles/Elation-Note-Guide-Documenting-an-encounter#template) for instructions on how to use Elation Note Templates. |
| **Growth Charts**
Track height, weight, BMI, and head circumference over time using WHO standards (0–24 months) and CDC standards (2–20 years). Special charts are also available for pre-term infants and patients with Down Syndrome. Vitals entry supports inline auto-conversion between metric and imperial units — type in any unit format (e.g. `170 cm`, `5'10"`, `70 kg`, `14 in`) and Elation converts the value automatically. | No additional configurations needed. Consult [this Help Center guide](/articles/growth-charts-for-pediatric-patients) for detailed instructions, including troubleshooting tips for missing percentiles. |
| **Prescriptions - Weight-based dosage calculation**
Calculate the prescription dosage based on the patient’s weight. | No additional configurations needed. Consult [this Help Center guide](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) for instructions on how to use this feature. |
| **Vaccinations - Immunization Registry Interface**
Send vaccination information to and receive vaccination history and forecast information from your local Immunization Registry. | Yes, refer to [this guide](/articles/Immunization-Registry-Interface-Introduction) to find the setup instructions and user manual for your local Immunization Registry. |
| **Vaccinations - Vaccination Form**
Document vaccination information information. | No additional configurations needed unless you are using an Immunization Registry Interface (see above). Consult [this Help Center guide](/articles/Vaccination-Form-Guide) for instructions on how to use this feature. |
## Frequently Asked Questions
### Is the Ages and Stages Questionnaire (ASQ) available in Elation?
Not currently. If you'd like to administer ASQ digitally in the meantime, use the [Upload PDF feature](/articles/Patient-Forms-Guide#upload_form) to create a Patient Form from your own ASQ materials.
## Related Articles
* [Clinical Profile Guide - Structured Questionnaires](/articles/structured-questionnaires)
* [Clinical Profile Guide - Viewing growth charts for pediatric patients](/articles/growth-charts-for-pediatric-patients)
* [Prescription Form Guide - ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
# Pennsylvania State- PIERS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Pennsylvania-State-PIERS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Pennsylvania Immunization Electronic Registry System [PIERS] directly within Elation as well as query for vaccination history and/or forecast
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Pennsylvania Immunization Electronic Registry System (PIERS), formerly known as PA-SIIS.
## What is the PIERS Immunization Registry Interface?
The PIERS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to PIERS, the Pennsylvania Immunization Electronic Registry System, formerly known as PA-SIIS. Practices can also query PIERS for vaccination history or forecast.
## Why is the PIERS Immunization Registry Interface valuable?
With the PIERS Immunization Registry Interface, practices no longer need to separately log in to PIERS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to PIERS. You can also pull vaccination history for specific patients from PIERS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & PIERS
The Elation Team will assist you with initiating an interface with KSWebIZ. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Name of the Immunization Registry you want to connect to.
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Complete [this request form](/files/immunization-pa-piers-form.docx).
8. Click **Add Attachments** and attach the completed request form.
9. Click **Next**.
10. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to PIERS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to PIERS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using PIERS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
When querying for vaccination history, you may notice results are not returned even though the patient has records in PIERS. This is a known limitation with the PIERS interface that PIERS hopes to improve by the end of 2024. We recommend signing in to PIERS directly to double check for vaccination history if you notice blank results in Elation when querying PIERS.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
### Does Elation have an interface with the Philadelphia Department of Public Health's Immunization Information System (PhilaVax)?
Yes, Elation has an interface with PhilaVax.
[Learn more about the PhilaVax Interface here](/articles/Philadelphia-City-PhilaVax-Immunization-Registry-Interface-Guide)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
* [Philadelphia (PA)- PhilaVax- Immunization Registry Interface Guide](/articles/Philadelphia-City-PhilaVax-Immunization-Registry-Interface-Guide)
# Philadelphia (PA)- PhilaVax- Immunization Registry Interface Guide
Source: https://help.elationhealth.com/articles/Philadelphia-City-PhilaVax-Immunization-Registry-Interface-Guide
This article will describe how you can submit vaccination data to the Philadelphia Department of Public Health's Immunization Information System as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Philadelphia Department of Public Health's Immunization Information System known as PhilaVax.
## What is the PhilaVax Immunization Registry Interface?
The PhilaVax Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to PhilaVax; the Philadelphia Department of Public Health's Immunization Information System. Practices can also query PhilaVax for vaccination history or forecast.
## Why is the PhilaVax Immunization Registry Interface valuable?
With the PhilaVax Immunization Registry Interface, practices no longer need to separately log in to PhilaVax to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to PhilaVax. You can also pull vaccination history for specific patients from PhilaVax to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & PhilaVax
The Elation Team will assist you with initiating an interface with PhilaVax. To notify us of your interest,
1. Click here to fill out our contact form
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Name of the Immunization Registry you want to connect to.
* What type of vaccines does your practice administer?: Child, Adolescent, Adult, Travel, and/or Influenza only
* What is the name and email of a point of contact for this interface?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to PhilaVax using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to PhilaVax. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using USIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide.](/articles/Vaccination-Form-Guide#query_errors)
### Does Elation have an interface with the Pennsylvania Immunization Electronic Registry System (PIERS)?
Yes, Elation has an interface with the Pennsylvania Immunization Electronic Registry System (PIERS), formerly known as PA-SIIS.
[Learn more about the PIERS Interface here](/articles/Pennsylvania-State-PIERS-Immunization-Registry-Interface-User-Guide)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
* [Pennsylvania State- PA-SIIS- Immunization Registry Interface User Guide](/articles/Pennsylvania-State-PIERS-Immunization-Registry-Interface-User-Guide)
# Premium EHR Features Guide
Source: https://help.elationhealth.com/articles/Premium-EHR-Features-Guide
## Overview
### What is Elation’s Premium EHR?
The Premium version of Elation EHR gives customers access to an additional set of features that allow them to:
* Scale and expand their services; especially for customers with multiple locations or provider groups.
* Maximize provider and staff productivity.
* Succeed in value-based payment (VBP) arrangements.
* Care for patient populations with more complex privacy needs.
* Implement more advanced security measures.
The relevance of each feature to your practice depends on your unique needs and workflows. This guide provides instructions on how to activate the features that you are interested in using.
### How do I gain access to Premium EHR features?
If you are interested in Premium EHR features, you will need to upgrade to a Premium EHR subscription. To upgrade, contact Elation using the **I need help** button and a member of our team will reach out to assist you.
## Features
### What are the Premium EHR features and how do I configure them?
Click on any of the following capabilities to see the associated features, their set-up instructions, and common use cases.
* [Define access to certain charts and resources](#scale-workflows-and-meet-compliance-needs-with-advanced-customization-and-controls)
* [Automatically share data across affiliated Elation instances](#automatically-share-patient-data-with-other-elation-instances-to-provide-transparency-and-reduce-redundancy-when-collaborating-on-patient-care)
* [Improve data security](#improve-data-security-by-implementing-additional-user-controls)
* [Delegate key clinical actions](#scale-clinical-workflows-and-maximize-provider-efficiency-by-delegating-key-clinical-actions-to-the-appropriate-staff)
* [Maximize performance in value-based payment contracts](#get-credit-for-performance-in-value-based-payment-contracts-with-automated-coding)
* [Reduce no-shows](#reduce-no-shows-by-ensuring-all-appointment-details-are-properly-shared-with-patients)
* [Utilize additional administrative reports](#stay-informed-about-user-productivity-and-permission-changes-with-additional-reporting-options)
* [Facilitate coding](#utilize-advanced-coding-features-to-optimize-coding-workflows)
If **Yes** is listed under the **After purchasing Premium, do you need to ask Elation to enable this feature first?** column, click **I need help** -> **Contact Elation Suppor** t to submit a request.
#### Scale workflows and meet compliance needs with advanced customization and controls.
**Feature**
**After purchasing Premium, do you need to ask Elation to enable this feature first?**
**Next, do you need to perform any configurations to start using this feature?**
**Common Use Cases**
**Workspaces** Empower staff to perform their duties more effectively by only displaying pertinent resources to them. Your single practice instance can be customized to support different teams and workflows.
No
Yes, refer to [this guide](/articles/workspaces-guide#workflow-instructions) to configure your [Workspaces Settings page](https://app.elationemr.com/settings/workspaces) . Afterwards, consult [this Help Center Guide](/articles/workspaces-guide) for instructions on how to use the feature.
This feature is ideal for: [Click here for examples of how Workspaces can be configured for the uses cases listed above](/articles/Workspaces-Use-Cases) .
* practices with more than one clinical focus or location.
* large networks of clinics (owned by a single entity) with multiple locations.
* practices that have various teams with distinct responsibilities.
**Patient Cohorts** Automatically provision chart access permissions according to present criteria to protect patient privacy and meet compliance needs.
No
Yes, refer to [this guide](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria) on how to create cohorts via the [Patient Cohorts dashboard](https://app.elationemr.com/population/?initialtab=patientcohort) .
This feature is ideal for:
* practices that only want designated providers or staff to access certain patient charts.
* practices that want to audit the unauthorized access of restricted charts.
**VIP Charts** Manually apply chart access restrictions to specific charts to protect patient privacy and meet compliance needs.
No
No additional configurations needed. Consult [this Help Center guide](/articles/vip-chart-feature) for instructions on how to use this feature.
This feature is ideal for:
* practices who have sensitive patient charts that only the Provider-assigned should be able to access (ex. staff members, family members, public figures.
**Block All Chart Access** Prevent specific users from accessing any patient charts.
No
Yes, refer to [this guide](/articles/User-Accounts-Guide-Chart-access-permission-options#using-the-block-all-chart-access-feature) on how to adjust a user’s chart access via the [Manage Accounts Settings page](https://app.elationemr.com/settings/allaccounts/) .
This feature is ideal for:
* practices that have staff who need to access the Elation homepage, reports, and Settings but do not participate in clinical patient care.
#### Automatically share patient data with other Elation instances to provide transparency and reduce redundancy when collaborating on patient care.
**Feature**
**After purchasing Premium, do you need to ask Elation to enable this feature first?**
**Next, do you need to perform any configurations to start using this feature?**
**Common Use Cases**
**Patient Longitudinal Record (PLR)** Aggregate multiple Elation practice instances under a single network configuration to automatically share patient records in real-time.
Yes
No additional configurations needed. Consult [this Help Center](/articles/introducing-elations-patient-longitudinal-record-enterprise-only) guide for instructions on how to use the feature.
PLR requires a formal agreement to be executed among all participating practices. Please consult with Elation to determine if this feature is appropriate for your use case.
This feature is ideal for:
* Separately owned practices who frequently share the same patients, for example:
* Separate practices who belong to the same Enterprise or physician network.
* Separate practices who collaborate closely in a single geographic location.
#### Improve data security by implementing additional user controls.
**Feature**
**After purchasing Premium, do you need to ask Elation to enable this feature first?**
**Next, do you need to perform any configurations to start using this feature?**
**Common Use Cases**
**Single Sign-On (SSO)** Reduce the risk of password-related security breaches by using a centralized authentication point for EHR login.
Yes
No additional configurations needed. Consult [this Help Center guide](/articles/single-sign-on) for instructions on how to use the feature.
This feature is ideal for:
* practices that have existing Identity Providers (IdPs) for Single Sign On (SSO) such as Google, Microsoft/Azure AD, Auth0, Okta, or any other identity provider that supports OIDC or SAML.
**Only allow Providers and administrative staff to delete data from charts** Preserve data integrity by preventing certain staff users from deleting data from patient charts.
Yes
No additional configurations needed. Consult [this Help Center guide](/articles/User-Accounts-Guide-Configuring-delete-permissions) for details about how the feature operates.
This feature is ideal for:
* practices that want to prevent non-administrative staff from deleting documents from patient charts.
**Admin Only Settings** Only permit Admin Level Users to view and/or edit the following settings pages:
* Fax Usage & Settings
* Clinical Care Measures
* Patient Tags
Yes
No additional configuration is needed. Consult the following help center guides on how to use these settings pages:
* [Help Center guide](/articles/fax-usage) for *[Fax Usage & Settings](https://app.elationemr.com/settings/usage/)*
* [Help Center guide](/articles/clinical-reminders-for-clinical-quality-measures#adjusting-clinical-reminders-settings-for-all-staff-level-users-in-the-practice) for *[Clinical Care Measure Settings](https://app.elationemr.com/settings/staff-display/)*
* [Help Center guide](/articles/adding-patient-tags#managing-the-patient-tags-settings-page) for *[Patient Tags](https://app.elationemr.com/settings/patient-tags/)*
This feature is ideal for:
* practices that want to only allow administrative staff to **view and edit** the *[Fax Usage & Settings](https://app.elationemr.com/settings/usage/)* and *[Clinical Care Measure Settings](https://app.elationemr.com/settings/staff-display/)* pages.
* practices that want to only allow administrative staff to **edit** Patient Tags under the [Patient Tags Settings page](https://app.elationemr.com/settings/patient-tags/).
#### Scale clinical workflows and maximize provider efficiency by delegating key clinical actions to the appropriate staff.
**Feature**
**After purchasing Premium, do you need to ask Elation to enable this feature first?**
**Next, do you need to perform any configurations to start using this feature?**
**Common Use Cases**
**Practice-level Delegates** Allow admin-level users to assign staff delegates on behalf of all providers to expedite the configuration of user permissions.
No
Yes, refer to [this guide](/articles/staff-permissions--staff-delegates#practice-level-delegates) on how to assign appropriate Staff User Groups to each delegate permission via the [Admin Managed Delegates Settings page](https://app.elationemr.com/settings/staff-group-delegates/) .
This feature is ideal for:
* practices that have uniform preferences around which Staff Level Users are allowed to execute certain clinical actions on behalf of all Provider Level Users in the practice, including:
* executing prescriptions, orders, or referrals
* editing billing information
* signing office messages
**Allow Staff to send Direct Messages** Promote interoperability and the secure communication of patient data by allowing Staff Level Users to send Direct messages on a Provider’s behalf.
Yes
No additional configurations needed. Consult [this Help Center guide](/articles/how-to-use-direct-messaging) for instructions on how to use the feature.
This feature is ideal for:
* practices who allow Staff Level Users to share patient health information with external collaborating Providers via secure methods like Direct messaging.
**Send Office Messages to User Groups only** Ensure communications and tasks are routed to the appropriate team by sending messages to users according to their function or responsibilities.
Yes
No additional configurations needed. Consult [this Help Center guide](/articles/Office-Message-Feature-Guide#sending-office-messages-to-user-groups-only) for instructions on how to use the feature.
This feature is ideal for:
* practices that want to exercise more control over who receives office messages.
#### Get credit for performance in value-based payment contracts with automated coding.
**Feature**
**After purchasing Premium, do you need to ask Elation to enable this feature first?**
**Next, do you need to perform any configurations to start using this feature?**
**Common Use Cases**
**Premium Coding** Reduce coding burden and improve performance in value-based payment contracts by enabling coding automation for certain clinical workflows.
No
Yes, refer to [this guide](/articles/Automatic-Coding-Guide-Advanced-Coding-Automations) on how to enable the following automations under the **Automatic Coding** section of the [Billing Settings page](https://app.elationemr.com/settings/billing/) .
* BMI Diagnosis Code Ordering
* Blood Pressure - Export Dx Code
* PHQ-9 - Export Dx Code
* Pain Assessment
* Functional Status Assessment
* W Diagnosis Code Ordering
This feature is ideal for:
* practices that participate in value-based contracts.
#### Reduce no-shows by ensuring all appointment details are properly shared with patients.
**Feature**
**After purchasing Premium, do you need to ask Elation to enable this feature first?**
**Next, do you need to perform any configurations to start using this feature?**
**Common Use Cases**
**Require ‘Location’ to be selected in Appointments** Ensure patients attend their appointments at the correct office location by requiring location details be selected when creating appointments.
Yes
No additional configurations needed. Consult [this Help Center guide](/articles/using-multi-location-scheduling) for instructions on how to use the feature.
This feature is ideal for:
* practices who take patients at different office locations.
#### Stay informed about user productivity and permission changes with additional reporting options.
**Feature**
**After purchasing Premium, do you need to ask Elation to enable this feature first?**
**Next, do you need to perform any configurations to start using this feature?**
**Common Use Cases**
**Productivity Reports** Leverage pre-built reports and dashboards to analyze data around appointments and visit notes.
No
No additional configurations needed. Consult [this Help Center guide](/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting) for instructions on how to use the dashboards and reports.
This feature is ideal for:
* practices that want to track the productivity and performance of their practice.
* practices that want to use data to improve clinical and administrative workflows.
**Permission Logs** Track and audit changes to each user’s access and ‘Admin’ permissions.
No
No additional configurations needed. Consult [this Help Center guide](/articles/managing-user-accounts#viewing-permission-audit-logs) for instructions on how to use the feature.
This feature is ideal for:
* practices that have staff who work on an ‘as needed’ basis.
* practices that want better transparency around how user permissions are assigned.
#### Utilize advanced coding features to optimize coding workflows.
**Feature**
**Dx Code Navigator** Use advanced search tools to find diagnosis codes.
#### Quickly access location-specific information.
**Feature**
**Vaccine details** Apply location specific manufacturer, lot # and expiration date details for vaccine supplies.
# Prescription Form Guide - Viewing patient prescription benefits
Source: https://help.elationhealth.com/articles/Prescription-Form-Guide-patient-prescription-benefits
This article describes how to obtain prescription medication coverage, formulary, and cost estimate information in Elation.
## What is coverage, formulary, and cost estimate information and why is it valuable?
The coverage information tells you whether a patient has prescription benefits coverage and which [Pharmacy Benefits Manager (PBM)](#PBM_role) covers the patient. Elation will show all prescription coverages available for the patient.
The formulary information serves as a guide for both healthcare providers and patients, outlining which medications are approved for coverage and the corresponding coverage limits and statuses. The formulary status tells you whether a medication is potentially reimbursable by the patient’s insurance and whether the medication is preferred and/or on- or off-formulary. Preferred medications are generally cheaper than non-preferred medications. Non-formulary medications may require prior authorization or have additional cost considerations compared to on-formulary medications.
The cost estimate information displayed is based on the patient’s prescription coverage benefits, and the medication, quantity, and pharmacy selected. Coverage, formulary and cost estimate information displayed is provided solely by the PBM and is not determined by Elation. Cost estimate information may include the estimated cost of the medication, cost breakdowns, coverage limits, prior authorization needs, and alternative options.
Overall, the medication coverage, formulary, and cost estimate information will tell you how much, and under what conditions the patient’s prescription benefits cover the cost of the medication you are about to prescribe to the selected pharmacy. If the patient has multiple coverages, then you may see coverage, formulary, and cost estimates for all coverages. Based on this information, you can make a well-informed decision regarding which variation of a medication is best suited for you to prescribe to the patient.
## What information in Elation is used to retrieve coverage, formulary, and cost estimate information?
The following chart outlines what information in the patient’s demographics or Prescription Form will be used to retrieve coverage, formulary, and cost estimate information:
| Patient Information | Coverage | Formulary | Cost Estimate |
| ---------------------------------------------------------------------------------------- | -------- | --------- | ------------- |
| Required demographics: Legal First Name • Legal Last Name • Date of birth • Sex at birth | ✔️ | | |
| Additional demographics: Address (full address) • Primary phone number | ✔️ | | |
| Coverage | | ✔️ | ✔️ |
| Medication name | | ✔️ | ✔️ |
| Medication quantity | | | ✔️ |
| Days supply | | | ✔️ |
| Pharmacy | | | ✔️ |
Medical insurance information saved in the patient’s demographics is not used for prescription coverage, formulary, and cost estimate queries.
## Retrieving coverage and formulary information
To retrieve coverage and formulary information:
1. Open the [Prescription Form (Rx/OTC/CS)](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) in the patient’s chart
2. Select a medication
3. Look to the right of the Prescription Form to see the coverage of the medication and formulary information for that medication under **COVERAGE**.
* If the patient has multiple coverages, Elation will display the formulary information for all coverages listed. Use the scroll bar to scroll up and down to see all the coverage and formulary information.
* If coverage or formulary information is unavailable you will see a note about this information being unavailable.
Elation will display all the formulary information that is shared by the Pharmacy Benefit Manager (PBM). Formulary information can include any of the details listed below but not all details are always available from the PBM.
*
Hover your mouse cursor over information badges or details with an asterisk to see additional details as provided by the PBM.
Use the scroll bar to scroll up and down to see all the coverage and formulary information.
![Prescription Form showing Cosentyx coverage panel with a tooltip indicating "Payer includes this drug on formulary, but is not preferred," copay tier 2 out of 5, formulary status "Preferred (On Formulary)," and therapeutic alternatives including Methoxsalen and Acitretin at Preferred Level 1. A second coverage plan shows "Non-Formulary" status.]()
| Formulary Guidance Type | Details |
| ------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Formulary status | Formulary status tells you whether a medication is potentially reimbursable by the patient’s insurance and whether the medication is preferred and/or on- or off-formulary. View the Formulary Status Chart below for more details about the various formulary statuses. Hover your mouse cursor over any status to see its description. |
| Copay tier | The tier coverage is determined by the PBM and is organized from Tier 1 (more preferred) to lower tiers (less preferred). Tier 1 medications will generally be cheaper than Tier 2 medications and so forth. Tier coverage may also differ by pharmacy type (e.g. Retail vs Mail Order). Hover your mouse cursor over the **copay details** to see additional information about the copay tier. |
| Medication type | The formulary may categorize a medication by type (i.e. Prescription or Over-the-Counter) and note whether the medication is brand name or generic. Generic prescriptions are generally cheaper than their brand name counterparts. |
| Coverage factors and limits | Coverage factors and limits disclose the terms and conditions in which the coverage applies. These include: quantity limits • age limits • prior authorization requirements • step medication protocols • drug-specific resource links |
| Therapeutic or payer-specified alternative medications | Any medications in the same drug group, class, and subclass as the medication selected are potentially therapeutic alternative medications. If a PBM provides information about payer-specified alternative medications, then only payer-specified alternative medications and their details will be returned and disclosed under **COVERAGE**, even if other therapeutic alternative medications exist. Therapeutic alternative medications that are at a lower coverage status (less preferred) than the selected medication will never be displayed. • If payer-specified therapeutic alternative medications are not returned, Elation will display information about all therapeutic alternative medications that have an equal or higher coverage status (more preferred) returned by the PBM. Hover your mouse cursor over the name of any alternative therapeutic medication to see summarized copay and formulary status information. You can click on any alternative therapeutic medication to select that medication as a replacement for your script and see full formulary details. |
| **Formulary Status Chart** |
| -------------------------- |
| **Status** |
| Preferred (On Formulary) |
| On Formulary |
| Non-Formulary |
| Non-Reimbursable |
| Formulary status unknown |
## Retrieving cost estimate information
To retrieve cost estimate information:
1. Open the [Prescription Form (Rx/OTC/CS)](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) in the patient’s chart
2. Select a medication and fill out the **Qty**
3. Select the pharmacy destination
4. Look to the right of the Prescription Form to see the cost estimate for that medication and pharmacy under **COST ESTIMATE**. Elation will display all the cost estimate information that is shared by the Pharmacy Benefit Manager (PBM).
*
If the patient has multiple coverages, Elation will by default display the cost estimate information for the first coverage listed. Select a different coverage to see the cost estimate information for that coverage.
By default, the cost estimate information is for a 30 day supply. Enter a different number in the **Days Supply** field if you would like the cost estimate to be for a different **days supply**.
If cost estimate information is unavailable you will see a note about this information being unavailable.
Cost estimate information can include any of the details listed below but not all details are always available from the PBM.
*
Hover your mouse over certain guidance types to see additional information as provided by the PBM.
Use the scroll bar to scroll up and down to see all the cost estimate information.
![Cost Estimate panel showing CeleXA 20 mg with PA and Limits tags, a hover tooltip with OOP and deductible breakdown, and a "Covered with limits" warning noting 30-day supply restriction and total savings.]()
| Cost Estimate Guidance Type | Details |
| -------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| Cost | The cost of the medication as specified by the Payer. |
| Pharmacy Type | The type of pharmacy that can be used to retrieve the medication (e.g. Retail or Mail Order) will be listed if coverage is available for more than one pharmacy type. |
| Coverage Limits | Coverage limits disclose the terms and conditions in which the cost estimate applies. Hover your mouse cursor over the **Limits** tag to see the coverage factors and limits which can include: quantity limits • age limits • usage recommendations & instructions |
| Prior Authorization Requirements | A **PA** tag will tell you whether prior authorization is required for the payer to reimburse the selected medication. The cost estimate you see is the cost estimate of the medication after prior authorization is acquired. Hover your mouse cursor over the **PA** tag to see any additional details that may be provided. |
| Estimate patient pay breakdown | Cost estimates may be broken down by the patient’s out-of-pocket responsibilities. Hover your mouse cursor over the cost to see any of the following details that may be disclosed: Out-of-Pocket (OOP) applied • Out-of-Pocket (OOP) remaining • Deductible applied • Deductible remaining |
| Alternative medication options | The PBM may return specific medications deemed by the PBM to be therapeutic alternatives. If the PBM provides cost estimates for alternative medications then the cost estimate information for all alternatives will also be disclosed under **COST ESTIMATE** in the **Alternatives** section. |
## Retrieving prescription benefits information for discontinued and/or off-the-market medications
When a medication is discontinued by the manufacturer and/or taken off the market, its NDC code will be made obsolete and you will not be able to prescribe the medication or retrieve formulary or coverage information for that medication. Choose another active medication to continue with your prescription. If you'd like to continue prescribing the discontinued or off-the-market medication then you must [create a custom medication](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds#add_med_to_database) and proceed without any prescription benefits information.
*
You may run into this situation when a medication in one of your Prescription Templates is discontinued by the manufacturer and/or taken off the market. Update or delete that template in your [Prescriptions Settings](/articles/create-and-use-custom-rx-templates#managing_templates) to avoid running into this error.
## Frequently Asked Questions
* [Why is prescription coverage information not available for one of my patients?](#no_coverage)
* [Where does the coverage, formulary, and cost estimate information come from?](#source_of_data)
* [Why is the prescription coverage different from the medical insurance coverage saved in the patient chart?](#coverage_vs_insurance)
* [Can staff see prescription benefits information when drafting prescriptions?](#staff_delegates)
* [How does a Pharmacy Benefits Manager (PBM) contribute to the administration of prescription insurance benefits?](#PBM_role)
* [I selected a medication but I do not see any cost estimate information for the medication. Why?](#no_cost_estimate_data)
* [Will prescription insurance benefits be visible in the Elation Go mobile application?](#Elation_Go)
* [Do cost estimates include pricing with cash discount tools such as GoodRx?](#cash_pricing_programs)
* [Does Elation's prescription insurance benefits feature differ from other solutions like CoverMyMeds?](#CoverMyMeds)
### Why is prescription coverage information not available for one of my patients?
Elation will query for patient prescription coverage every time the Prescription Form is opened. These are the most common reasons why prescription coverage may not be available:
* The patient does not have active prescription coverage.
* We could not find a patient match based on the demographics in the patient’s chart. Make sure the following information is in the patient’s demographics and then draft a prescription again or click **Re-check coverage**. Required fields are marked with an asterisk:
* Legal First Name\*
* Legal Last Name\*
* Date of birth\*
* Sex at birth\*
* Address (full address)
* Primary phone number
* The patient’s benefit plan is not part of the network of available information. Elation works with Surescripts, who works with 99% of plans in the United States, and the patient’s plan might be in the 1% that is not part of the Surescripts network.
### Where does the coverage, formulary, and cost estimate information come from?
The formulary and cost information comes directly from the patient’s Pharmacy Benefit Manager (PBM). After you select the medication, quantity, and pharmacy the information is sent along with the patient’s coverage to the patient’s prescriptions benefit plan and then the patient’s out-of-pocket prescription cost and associated details is then returned and displayed on the right side of the Prescription Form along with alternative therapeutic medication options, if available.
### Why is the prescription coverage different from the medical insurance coverage saved in the patient chart?
Formulary and prescription cost estimate information is based on the patient’s prescription coverage and not medical insurance. Elation works with Surescripts to determine coverage and Surescripts works with Pharmacy Benefit Managers (PBMs) to understand formulary and cost estimation information.
### Can staff see prescription benefits information when drafting prescriptions?
Yes, anyone in the practice will be able to see prescription benefits information.
### How does a Pharmacy Benefits Manager (PBM) contribute to the administration of prescription insurance benefits?
A Pharmacy Benefits Manager (PBM) is a third-party administrator that manages prescription drug benefits on behalf of health insurance plans, employers, and government programs. PBMs maintain a list of approved medications, known as a formulary. The formulary is designed to include cost-effective and clinically effective drugs. PBMs negotiate with pharmaceutical manufacturers to include specific drugs on the formulary and secure favorable pricing for medications included in the formulary to reduce overall drug costs for the insurer and patients.
### I selected a medication but I do not see any cost estimate information for the medication. Why?
To see cost estimate information for a medication, the patient’s Legal First Name, Legal Last Name, Date of birth, and Sex at birth must be in their demographics and the medication, quantity, and pharmacy must be selected in the Prescription Form. Enter the quantity and select a pharmacy and then you will see cost estimate information if any is available. [Click here to understand the circumstances in which cost estimate information is not available](#no_coverage).
### Will prescription insurance benefits be visible in the Elation Go mobile application?
Prescription insurance benefits information is not available in the [Elation Go](/articles/elation-go-the-mobile-app-for-practices) mobile application at this time. We will notify you when we support this in the future.
### Do cost estimates include pricing with cash discount tools such as GoodRx?
GoodRx and other cash pricing programs are not currently included in the cost estimate feature. We will notify you when we support this in the future.
### Does Elation's prescription insurance benefits feature differ from other solutions like CoverMyMeds?
Elation's prescription insurance benefits feature and CoverMyMeds are both platforms that offer prescription insurance benefits information and both pull information from Prescription Benefits Managers. For these reasons, the information you see in Elation and CoverMyMeds should be the same.
## Related Articles
* [Prescription Form Guide- ePrescribing and ordering medications using a single prescription form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Prescription (Rx) Templates Guide](/articles/create-and-use-custom-rx-templates)
* [Drug Decision Support Guide- Monitoring drug interactions](/articles/drug-decision-support)
* [EPCS (Electronic Prescribing of Controlled Substances) Introduction](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)
* [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates)
* [Prescriptions Guide- Frequently Asked Questions](/articles/Prescriptions-Guide-Frequently-Asked-Questions)
# Prescription Monitoring Program (PMP/PDMP) Integration- Bamboo Health
Source: https://help.elationhealth.com/articles/Prescription-Monitoring-Program-Integration-Bamboo-Health
**Recommended Reading**: [Prescription Monitoring Program (PMP/PDMP) Integration Introduction](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
## What is the Bamboo Health PMP Integration?
Elation works with Bamboo Health, a third-party healthcare technology solutions company, to provide a seamless EHR to Prescription Monitoring Program (PMP) integration in supported states (see the table below for a full list of the supported states and what features are offered in each state).
Once integrated, two features will be made available to you in the EHR depending on the selected state PMP:
1. Prescription Monitoring Program (PMP) reporting of detailed controlled substance prescription dispense history for patients
2. NarxCare data which can contain the following details based on a patient’s controlled substance prescription dispense history:
* Overdose risk score
* Graphs or charts of the prescription dispense history over time
## Which states can utilize the Bamboo Health PMP Integration?
Bamboo Health supports PMP integrations in the following states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, DC, West Virginia, and Wyoming. See the table below for a full list of the supported states and their offerings.
The Bamboo Health PMP integration is **not available** in Guam, Illinois, Nebraska, New York, or Wisconsin.
PMP data surrounding detailed controlled substance prescription dispensing history for patients may be either a free feature or a paid feature depending on whether or not your state funds your access. Payment will be made directly to Bamboo Health. Find your state in the table below for full details.
NarxCare data for patients may be either a free feature or a paid feature depending on whether or not your state funds your access. Payment will be made directly to Bamboo Health. Find your state in the table below for full details.
| State | Do you need to pay for access to PMP data? | is NarxCare data available or required? | What Narxcare data is available? | Do you need to pay for access to NarxCare data? |
| ------------------- | ------------------------------------------ | --------------------------------------- | -------------------------------- | ----------------------------------------------- |
| Alabama (AL) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Alaska (AK) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Arizona (AZ) | No (state-funded) | Not available | None | N/A |
| Arkansas (AR) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| California (CA) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Colorado (CO) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Connecticut (CT) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Delaware (DE) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Florida (FL) | Yes | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Georgia (GA) | No (state-funded) | Not available | None | N/A |
| Hawaii (HI) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Idaho (ID) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Indiana (IN) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Iowa (IA) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Kansas (KS) | No (state-funded) | Not available | None | N/A |
| Kentucky (KY) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Louisiana (LA) | No (state-funded) | Not available | None | N/A |
| Maine (ME) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Maryland (MD) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Massachusetts (MA) | No (state-funded) | Available and required | NarxCare charts & graphs only | No (state-funded) |
| Michigan (MI) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Minnesota (MN) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Mississippi (MS) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Missouri (MO) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Montana (MT) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Nevada (NV) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| New Hampshire (NH) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| New Jersey (NJ) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| New Mexico (NM) | No (state-funded) | Not available | None | N/A |
| North Carolina (NC) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| North Dakota (ND) | Yes | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Ohio (OH) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Oklahoma (OK) | No (state-funded) | Not available | None | N/A |
| Oregon (OR) | No (state-funded) | Not available | None | N/A |
| Pennsylvania (PA) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Puerto Rico (PR) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Rhode Island (RI) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| South Carolina (SC) | Yes | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| South Dakota (SD) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Tennessee (TN) | No (state-funded) | Not allowed | None | N/A |
| Texas (TX) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded |
| Utah (UT) | Yes | Available and required | NarxCare score, charts, & graphs | Yes |
| Vermont (VT) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Virginia (VA) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Washington (WA) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
| Washington, DC (DC) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| West Virginia (WV) | No (state-funded) | Available and required | NarxCare score, charts, & graphs | No (state-funded) |
| Wyoming (WY) | Yes | Available but not required | NarxCare score, charts, & graphs | Yes |
* The Bamboo Health PMP integration is *not available* in Guam, Illinois, Nebraska, New York, or Wisconsin.
## How much does the integration cost?
The cost of the integration depends on whether or not the PMP data or NarxCare data is funded by your state. If it says **state-funded** in the ***Do you need to pay for access to PMP data?*** or ***Do you need to pay for access to NarxCare data?*** columns above, that means the state pays for your access to that data. For states not funded, the cost can depend on a variety of factors and Bamboo Health will be able to assist you with a cost estimate. [Click here to reach out to Bamboo Health](https://go.bamboohealth.com/ehrrequest.html).
## How do I activate my Bamboo Health integration?
You will work directly with Bamboo Health on creating your Bamboo Health account, contracting, and getting state PMP approval to go live with the integration. Once complete, Bamboo Health will send your organization’s credentials to Elation to activate the integration. Below is the step-by-step breakdown of the entire integration process.
| Step | Task | Owner |
| ---- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------- |
| 1 | Send Bamboo Health a PMP integration request by filling out this form: [https://go.bamboohealth.com/ehrrequest](https://go.bamboohealth.com/ehrrequest) If in Tennessee, use this request form instead: [https://go.bamboohealth.com/tngatewayintegrationrequest](https://go.bamboohealth.com/tngatewayintegrationrequest) • If in Kentucky, Kentucky has a special Bamboo-specific set of credentials that will preclude the practice from having more than one Bamboo PMP connection. | Customer |
| 2 | Click **Create an Account** in the top right-hand corner after filling out the request form. | Customer |
| 3 | Login and follow the on-screen prompts to provide the needed information for your integration request. | Customer |
| 4 | Sign all necessary agreements within the Bamboo Health portal and complete your application. | Customer Bamboo Health |
| 5 | Upon receipt of your completed application, Bamboo Health will submit your request to the state for final approval. | Bamboo Health → State |
| 6 | Upon state approval, Bamboo Health will send credentials to your organization’s primary contact and Elation. This is when Elation will begin working with you to complete your integration. A confirmation email will be sent to your organization’s primary point of contact. | Bamboo Health → Customer & Elation |
| 7 | Elation receives credentials from Bamboo Health. | Bamboo Health → Elation |
| 8 | Elation stores your organization’s credentials from Bamboo Health | Elation |
| 9 | Elation may contact your practice to verify minimum identifiers required for each state such as NPI, DEA and/or state license. Alaska = DEA & License # • Alabama = DEA • California = NPI • Indiana = DEA • Michigan = DEA, NPI & License # • Minnesota = DEA • New Hampshire = DEA • Ohio = DEA & License # • All other states: Not required but need at least one identifier is needed for the integration to work, NPI is acceptable. | Elation → Customer |
| 10 | Elation enables the **Check PMP** button. Once enabled, it will be available in every patient chart. Integration is considered live. | Elation |
| 11 | Once the integration is live, a confirmation email will be sent to your organization’s primary contact. | Elation → Customer |
The Bamboo Health integration will be gradually implemented for interested customers. The length of time it takes to activate the integration will also depend on how many requests are being managed by Bamboo Health and how quickly your state approves the integration.
## Viewing Bamboo Health’s Prescription Monitoring Program (PMP) reporting
To view the Prescription Monitoring Program reporting, connected Providers can click the **Check PMP** button from one of the following 4 (four) locations in the patient’s chart:
* At the bottom of the **Permanent Rx Meds** list in the Clinical Profile
* In the dropdown when you click the **Meds Hx** button at the top of the patient’s chart
* At the top of the Medication History window
* In the Prescription Form next to the **NDC with Packaging** field
![Four highlighted "Check PMP" button locations in a patient chart: in the Permanent Rx Meds section, the Meds Hx dropdown menu, the Medication History panel header, and the Prescription Form.]()
Once the **Check PMP** button is clicked, a query to the PMP is initiated and, if successful, a new browser tab will be opened with the patient’s PMP report. [Reference the data below to see what is available in the PMP report](#PMP_report_data).
A note will be documented in the patient chart after a successful PMP check for reporting purposes. This note can be exported to a visit note or to an office message.
![Chronological Record showing a highlighted PMP check entry dated Mar 26, 2024: "Paul Doctor accessed state prescription monitoring program (PMP) on 03/26/2024 at 08:34 AM — PMP check notification."]()
## What data is available via Bamboo Health’s Prescription Monitoring Program (PMP) reporting?
Bamboo Health’s Prescription Monitoring Program (PMP) reporting displays the patient’s past 2 years of controlled substance refill history broken down into the following:
* A summary of the medication history information broken out by
* Payment type
* Prescribers
* Pharmacies
* Narcotics vs Buprenorphine
* Prescription history detail including the written dates and filled dates
![NarxCare report for test patient showing RX Summary with 5 total prescriptions, 32.50 current MME/day, and State Indicators flagging Overlapping Opioid & Benzodiazepine use, plus a 5-prescription controlled substance history table.]()
## Viewing Bamboo Health’s Narxcare reporting
If you have access to Bamboo Health’s NarxCare data, you will see the **Overdose Risk Score** at the bottom of the Permanent Rx Meds list in the Clinical Profile.
* Place your mouse cursor over the score to see the overall risk level of the score.
![Overdose Risk Score of 250 highlighted in the Permanent Rx Meds section, with a tooltip showing score ranges: 0–199 low risk, 200–499 moderate complexity, 500+ multiple prescribers or overlaps.]()
Narxcare data is made available by Elation Health for informational purposes only and is not an endorsement by Elation: NarxCare is a commercial opioid overdose risk scoring platform proprietary to Bamboo Health. NarxCare has not been clinically validated for use on patients. [Click here for more information](https://academic.oup.com/jamia/article/30/10/1741/7222347) .
## What data is available via Bamboo Health’s NarxCare reporting?
Bamboo Health’s NarxCare data can contain the following details based on a patient’s controlled substance prescription dispense history:
1. Overdose risk score
2. Graphs or charts of the prescription history over time
![NarxCare report for Testpatient Alice showing an overdose risk score of 250 (Below Average), NARX scores of 384 narcotics/231 sedatives/000 stimulants, two state indicators flagged (Overlapping Opioid & Benzodiazepine, Below Prescriber & Dispensary Threshold), and an RX graph showing prescription history by prescriber over a 2-year timeline.]()
![NarxCare dashboard showing MME, LME, and Buprenorphine prescription trend charts over the last 30 days, plus an RX Summary table with narcotic and buprenorphine metrics including current MME/day of 37.50.]()
![PMP report showing Prescriptions section with 5 controlled substances (opioids and Lorazepam), 2 prescribers, and 1 pharmacy (Cremin And Sons), all paid as Private Pay, with KS state PMP designation.]()
## Frequently Asked Questions
### Can Staff Level Users and non-prescribing Provider Level Users use the integration?
Staff Level Users and non-prescribing Provider Level Users cannot use this integration. When Staff Level Users and non-prescribing Provider Level Users who are not set up for the integration click the **Check PMP** button, the state PMP login page will be opened in a new browser tab instead. Anyone can use their state PMP login credentials to log in to the state PMP directly to access PMP data.
### Why is the state’s PMP login page opening when I click the **Check PMP** button?
If your state’s PMP login page is opening instead of directly accessing PMP data through Bamboo Health, this means your account is not set up for the integration. Only prescribing Providers can use the integration at this time. Staff Level Users and non-prescribing Providers cannot use the integration.
If you believe your account should be set up with the integration, contact Elation using the **I need help** -> **Contact Elation Support** button to let Elation know.
### What happens if the patient is not found in the PMP?
If there is no record of the patient in the PMP, a new browser tab will still open with a confirmation that no match was found. This is still considered a successful PMP check and a note will be recorded in the patient record that a PMP check was performed.
### Why is the Bamboo Health integration not available for my state?
Bamboo Health only support PMP integrations in the states of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, DC, West Virginia, and Wyoming.
If you are in the state of Illinois you can consider using the LogiCoy PMP Integration. [Click here to learn more about the LogiCoy PMP integration](/articles/Prescription-Monitoring-Program-Integration-LogiCoy).
If you are in Guam or the states Nebraska, New York, or Wisconsin, you will not be able to use any of Elation’s PMP integrations at this time. We will notify you if a PMP integration becomes available for these states.
## Related Articles
* [Prescription Monitoring Program (PMP/PDMP) Integration Introduction](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
* [Prescription Monitoring Program (PMP/PDMP) Integration- LogiCoy](/articles/Prescription-Monitoring-Program-Integration-LogiCoy)
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
# Prescription Monitoring Program (PMP/PDMP) Integration - LogiCoy
Source: https://help.elationhealth.com/articles/Prescription-Monitoring-Program-Integration-LogiCoy
**Recommended Reading**: [Prescription Monitoring Program (PMP/PDMP) Integration Introduction](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
## What is the LogiCoy PMP Integration?
Elation works with LogiCoy, a third-party healthcare technology solutions company to provide a seamless EHR to Prescription Monitoring Program (PMP) integration for the states of California, Colorado, Illinois, Kentucky, Maryland, Pennsylvania, Utah, and Washington.
## Which states can utilize the LogiCoy PMP Integration?
LogiCoy supports PMP integrations in the states of California, Colorado, Illinois, Kentucky, Maryland, Pennsylvania, Utah, and Washington.
## How much does the integration cost?
Elation is not charging for the setup or maintenance of the LogiCoy PMP integration and states do not generally charge you for the integration. LogiCoy, our integration partner, does charge a yearly per-provider fee to maintain the integration at a special Elation rate. LogiCoy charges each full-time provider \$40 per year and part-time providers \$20 per year.
**Exceptions:**
* **Washington** - The state of Washington requires an agreement with OneHealthPort (OHP), Washington’s HIE, before setting up a PMP integration. Washington charges \$1,100 per year for most practices for full OneHealthPort access and a special \$150 rate for PMP-only services through the HIE for the first year. [Click here for full details about OneHealthPort pricing](https://www.onehealthport.com/hie/contracting).
## How do I activate my LogiCoy integration?
Elation will work with your practice and LogiCoy to make setting up the integration simple.
1. Step 1: Let Elation know you are interested!
* Contact Elation using the **I need help** -> **Contact Elation Support** button to let Elation know you are interested in the LogiCoy integration for your state.
2. Step 2: Elation will submit an integration request
* Elation will submit an integration request to LogiCoy and copy your practice on correspondence. LogiCoy will respond to the email with paperwork for your practice to review and sign, including an End User License Agreement and state-specific agreements.
3. Step 3: Elation will set up the integration
* Elation will work with LogiCoy to set up your integration and will notify your practice when the integration is live.
## Viewing LogiCoy’s Prescription Monitoring Program (PMP) reporting
To view the Prescription Monitoring Program reporting, connected Providers can click the **Check PMP** button from one of the following 4 (four) locations in the patient’s chart:
* At the bottom of the **Permanent Rx Meds** list in the Clinical Profile
* In the dropdown when you click the **Meds Hx** button at the top of the patient’s chart
* At the top of the Medication History window
* In the Prescription Form next to the **NDC with Packaging** field
Once the **Check PMP** button is clicked, the Provider’s identifiers, their practice credentials, and the patient’s demographics will be sent to LogiCoy. If the minimum required information is in the patient’s chart and the integration is live, a new browser tab will be opened with the patient’s PMP report.
![LogiCoy Patient Prescription Analysis report for Sherlock Holmes showing 108 prescriptions, 15 opioids, 13 muscle relaxants, and 0.00 total MEDD for active prescriptions, with a sortable prescription history table below.]()
A note will be documented in the patient chart after a successful PMP check for recording keeping purposes. This note can be exported to a visit note or to an office message.
![Chronological Record showing a highlighted PMP check notification entry dated Nov 16, 2021: "Erin Hawley accessed state prescription monitoring program (PMP) on 11/16/2021 at 10:33 AM."]()
Maryland requires a patient address in the chart for PMP checks.
Kentucky requires the patient’s Social Security Number (SSN) to complete a PMP query. The patient’s SSN should be stored in the patient’s chart for a successful KASPER (KY PMP) check.
## Frequently Asked Questions
### Can Staff Level Users and non-prescribing Provider Level Users use the integration?
Staff Level Users and non-prescribing Provider Level Users cannot use this integration. When Staff Level Users and non-prescribing Provider Level Users who are not set up for the integration click the **Check PMP** button, the state login page will be opened in a new browser tab instead. Anyone can use their state PMP login credentials to log in to the state PMP directly to access PMP data.
### Why is the state’s PMP login page opening when I click the **Check PMP** button?
If your state’s PMP login page is opening in a new browser tab, this means your account is not set up for the integration. Only prescribing Provider Level Users can use the integration at this time. Staff Level Users and non-prescribing Provider Level Users cannot use the integration.
If you believe your account should be set up with the integration, contact Elation using the **I need help** -> **Contact Elation Support** button to let Elation know.
### What happens if the patient is not found in the PMP?
If there is no record of the patient in the PMP, a new browser tab will still open with a confirmation that no match was found. This is still considered a successful PMP check and a note will be recorded in the chronological record that a PMP check was performed.
### Why is the LogiCoy integration not available for my state?
LogiCoy only supports PMP integrations in the states of California, Colorado, Illinois, Kentucky, Maryland, Pennsylvania, Utah, and Washington. If you are in any other state, you can check to see if our other PMP integration partner, Bamboo Health, offers a PMP integration for your state. [Click here to learn more about the Bamboo Health PMP integration](/articles/Prescription-Monitoring-Program-Integration-Bamboo-Health).
If you are in Guam or the states Nebraska, New York, or Wisconsin, you will not be able to use any of Elation’s PMP integrations at this time. We will notify you if a PMP integration becomes available for these states.
## Related Articles
* [Prescription Monitoring Program (PMP/PDMP) Integration Introduction](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
* [Prescription Monitoring Program (PMP/PDMP) Integration- Bamboo Health](/articles/Prescription-Monitoring-Program-Integration-Bamboo-Health)
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
# Prescription Form Guide - ePrescribing and ordering medications
Source: https://help.elationhealth.com/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds
## Overview
### What is the Prescription Form?
The Prescription Form is used to prescribe all medication types: over-the-counter and both non-controlled and controlled substance medications. You can
* Add various medication types to a single form (e,g. 1 non-controlled medication, 1 over-the-counter medication, and 2 controlled substance medications).
* See the packaging and NDC information for each medication to select the appropriate one for your order.
* Designate a pharmacy for each prescription.
* Initiate an [Electronic Prior Authorization](/articles/Managing-electronic-prior-authorizations) request.
* [Monitor for drug interactions.](/articles/drug-decision-support)
* Reference [prescription insurance coverage, formulary and cost estimate](/articles/Prescription-Form-Guide-patient-prescription-benefits) information.
## Setup
### Setting prescribing locations
Review the [Practice Locations Settings](/articles/adding-a-second-practice-location) and make sure each prescribing location is stored. Providers can select which location they are prescribing from at the top of the Prescription Summary window before electronically sending their prescriptions to pharmacies.
For ePrescribing purposes, each Practice Location must have a 10-digit phone number and fax number. Elation will prompt you to update your Practice Location if any of these details are missing.
![Prescription Summary dialog with the Prescriber Location field highlighted, showing "Elation Second Practice Way" selected and its address and phone/fax numbers displayed below.]()
## Workflow Instructions
**CONTROLLED SUBSTANCES ONLY** The ePrescribing workflow is different for controlled substance medications. [Click here for step by step instructions for ePrescribing controlled substance medications](/articles/how-to-e-prescribe-controlled-substances) .
### 1. Starting a new prescription
To start a new prescription, use one of the following options:
* Click **Rx** -> **Prescription Form (Rx/OTC/CS)** at the top of any patient’s chart.
* Click the **Rx/OTC/CS** button in a legacy visit note or non-visit note draft.
* Click on the **Prescription** Standard Block in the [Elation Note](/articles/Elation-Note-Guide-Using-visit-note-blocks).
### 2. Filling out the prescription details
For each prescription, fill out as much detail as needed to effectively prescribe. Required fields have an asterisk
(\*). Here is a list of all the different prescription fields:
Prescription Field
Details
**Medication name and strength**\*
If you are unable to find a prescription or over-the-counter medication you wish to prescribe, you can [manually add it to your database](#add_med_to_database) .
Search for the medication name and strength in Elation’s medication database.
**Sig**\*
Add as much detail as needed for your directions to the patient. You can select a **Sig** from Elation’s database or you can [create your own Custom Rx Sig](#custom_sig) .
**Weight-based Calculator**
**(Only available for patients aged 12 or younger (unless they're over 50kg) OR aged 17 or younger who weigh 50kg or less)** Calculate the dosage based on the patient’s weight. The calculated dosage will be rounded down to the nearest whole number.
1. Enter the **Dosage**, patient’s **Weight** in kilograms, and **Concentration**.
* The patient’s most recently documented weight will be autopopulated if you’ve previously recorded their weight in their chart and will be displayed in the **Juvenile Weight** section of the prescription form.
* The **Concentration** will be autopopulated if you select a medication with a concentration.
* In the case of medications with multiple component ingredients, such as *Amoxicillin-Potassium Clavulanate 400/57 mg/5mL Suspension*, the concentration of the medication will be displayed but the first component ingredient (400mg of Amoxicillin) will be used for calculations.
2. Update the **Frequency** of the dosage as needed. The default is **QD - 1x per day**.
* **Frequency** options can only be one of the following:
* QD (quaque die) - 1x per day
* BID (bis in die) - 2x per day
* TID (ter in die) - 3x per day
* QID (quater in die) - 4x per day
* QHS (quaque hora somni) - at bedtime
* PRN (pro re nata) - as needed
* If the frequency you’d like to prescribe is unavailable, you must manually calculate the dosage.
3. Click **Update Sig…** to update the **Sig** field based on the calculations.
**Qty**\*
Specify how much of a medication you want to give the patient for each order.
**Unit**
Specify the quantity unit.
**Refills**\*
Specify how many refills you allow the pharmacy to dispense to the patient before another order is required.
**Check PMP**
Query the [Prescription Monitoring Program Integration](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP) .
**Days Supply**
Specify how many days supply your order is for. This field is not automatically calculated and does not replace the **Sig** or **Qty** fields. The value entered factors into cost estimate calculations.
**NDC with Packaging**
Verify the packing information as needed. By default, Elation will select the NDC & packaging as defaulted by our database. You can click to select a more appropriate package type as needed.
**Diagnosis (ICD-10)**
Enter all supporting diagnosis for the prescription as needed. Up to two diagnoses can be sent with an ePrescription.
**Instructions to Pharmacy**
Store any instructions to the pharmacy as needed.
**Do not fill before …**
Enter the earliest date a patient can receive the prescription if the prescription is a planned for a future date.
**□ Dispense as Written**
Check this box off if you want the pharmacy to dispense the prescription as specified by your order and to not allow substitutions.
Specify whether this prescription should appear in the Permanent Medication List or Temporary Medication List in the patient’s Medication History. Medications will default to 'Permanent' unless specified as a 'Temporary' medication in the Prescription Form.
**Pharmacy**
If you do not want to send the prescription to the pharmacy or you are not ePrescribing controlled substances, click **Manual printout only** in the pharmacy search to print the prescription.
If you want to the most recently used pharmacy (for each patient) to populate in the Pharmacy field automatically, have an Admin Level User in the practice use the **I need help** -> **Contact Elation Support** button to send a request to our Support Team and a member of the Support Team will turn this feature on for you.
Specify the pharmacy destination if ePrescribing. If the patient has preferred pharmacies, you will see their preferred pharmacies immediately after clicking into the **Pharmacy** field. The pharmacy database is provided by Surescripts and Surescripts has 85% of the pharmacies in the country. To quickly find the desired pharmacy, be sure to type one of the following along with the Pharmacy Name: Elation is unable to add new pharmacies to the pharmacy directory as it is maintained by the Surescripts. You must notify the pharmacy to reach out to Surescripts directly to be part of the Surescripts network.
* City (e.g. 'CVS Short Hills' or 'CVS, Short Hills')
* Street name or Zip code (e.g.. 'CVS 07026' or 'CVS Brooklyn')
* Phone Number
* Store Number
**Save as Rx template**
Click this button if you want to save the **Medication** , **Sig** , **Qty** , **Units** , **Refills** , **Days Supply** , & **Packaging (NDC)** as a [Rx Template](#prescription_templates) for other prescriptions.
**Text patient at ...**
Send a [prescription reminder](/articles/prescription-reminders-for-patients) to the patient.
**Electronic Prior Authorization**
Initiate an [Electronic Prior Authorization](/articles/Managing-electronic-prior-authorizations) request.
**3. Viewing medication coverage, formulary, and cost estimate information**
[Click here for instructions on how to view a patient's medication coverage, formulary and cost estimate information](/articles/Prescription-Form-Guide-patient-prescription-benefits).
**4. Adding another medication to the same prescription order**
If you are prescribing more than one medication, click **+ Add Another Rx** to add as many prescriptions to the form as needed and fill out all necessary [details](#fill_out_details) for each prescription. This feature allows you to:
* add non-controlled medications, over-the-counter medications, AND controlled substance medications to the same form.
* add multiple controlled substance medications to the same form.
ℹ️**CAUTION**
The pharmacy selected for the first prescription in the form will be the default pharmacy selected for all prescriptions that can be sent electronically. Choose a different pharmacy if you need to for specific prescriptions.
**5. Completing the prescription(s)**
Once you are ready to complete the prescription(s), click one of the following buttons as appropriate. Certain options will bring you to a confirmation screen to continue your prescription.
* **Prescribe**
* Sends all prescriptions that have a pharmacy selected to the pharmacy **AND** prints all prescriptions that do not have a pharmacy selected and prescriptions that cannot be sent electronically.
* If a Staff Rx Delegate selects **Prescribe** and controlled substance prescriptions with a pharmacy destination are in the queue, the controlled substance prescriptions and their pharmacy destinations will be saved as a draft.
* **Print All & Close**
* Prints all prescriptions, even if any of the prescriptions in the queue has a selected pharmacy destination, and closes the form.
* **Sign & Clos** e
* Signs all prescriptions and closes the form.
* **Save as Draft & Close**
* Saves all the information entered as a draft in the Requiring Actions section of the patient's chart, including all medications in the form.
* **Discard**
* Discards the selected prescription in the form.
ℹ️**CAUTION**
Delete with caution as discarded prescription drafts cannot be recovered.
**5a. Sending the prescription(s) to the pharmacy**
If you choose to electronically prescribe the prescription, you will see a Prescription Summary that details all the information tied to the script(s) along with each pharmacy destination. Review the details and click **Prescribe** to send all the prescriptions to the pharmacy.
If any of the prescriptions are for controlled substance medications, you will need to enter your EPCS password and security code one time before the prescriptions are sent to the pharmacy.
![Prescription Summary showing two ePrescriptions for Winston Addington: Adderall 5mg Tab sent to CVS Pharmacy #5251, and Cosentyx 150mg/mL sent to Yalaha Pharmacy, with Prescribe and Back buttons at bottom.]()
**5b. Printing prescription(s) for your patient**
If you choose to print certain or all prescriptions for your patient, or if you do not use the electronic prescribing controlled substance ([EPCS](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)) feature and you need to print your controlled substance prescriptions, the Prescription Summary will show which prescriptions will be printed. Click **Prescribe** in the Prescription Summary window to electronically send eligible prescriptions to the pharmacy and then print the prescription that must be printed.
![Prescription Summary showing Rx 1 Cosentyx ePrescribed to Yaha Pharmacy and Rx 1 Adderall 5mg marked "Manual printout only" with a controlled substance tamper-proof paper warning, and a Prescribe button.]()
**Additional Workflow Tips**
### Manually adding a medication to the medication database
If you are unable to find the medication you wish to prescribe, you can manually add it to your database by following these steps:
| **1** | Type the medication name in the **Medication name and strength** field. |
| ----- | -------------------------------------------------------------------------------------------------- |
| **2** | If the correct medication appears in the search list, select it. |
| **3** | If the list does not include the medication you need, click anywhere outside the list to close it. |
| **4** | Click **Add a new med** under the name. |
| **5** | Edit the **Name**, **Strength**, and **Medication Type** as needed. |
| **6** | Click **Create Medication & Continue**. |
Medications that are manually added to the medication database will not be associated with a National Drug Code (NDC). This means Elation will not be able to provide any details around allergy interactions, drug interactions or intolerances, formulary information, or prescription cost estimates.
**Using Custom Rx Sigs**
You can store a custom sig in your sig database for any medication you prescribe. To create a custom sig for any medication:
| **1** | Select a medication in the Prescription Form. |
| ----- | --------------------------------------------- |
| **2** | Type your custom sig in the **Sig** field. |
| **3** | Click **Create a custom sig for this med…**. |
| **4** | Confirm the sig you want to save is accurate. |
| **5** | Click **Save**. |
You can only edit or delete custom sigs from your Prescriptions Settings. To do so:
| **1** | Click on your email at the top of your Elation account. |
| ----- | ------------------------------------------------------- |
| **2** | Click **Settings**. |
| **3** | Go to the **Prescriptions** section. |
| **4** | Go to the **Custom Rx Sigs** section. |
| **5** | Find the custom Rx sig you want to edit or delete. |
| **6** | Click the **Edit** or **Delete** button to proceed. |
**Using Rx (Prescription) Templates**
You can store commonly prescribed medications along with their **Sig**, **Qty**, **Units**, **Refills**, **Days Supply**, & **Packaging (NDC)** as an Rx Template to be used for any patient at any time. [Click here to learn more about Rx Templates](/articles/create-and-use-custom-rx-templates).
**Using Drug Decision Support**
Elation’s Drug Decision Support feature displays drug to drug interactions or drug to allergy interactions directly in the right hand side of the Prescription Form when you are drafting a prescription. [Click here to learn more about the Drug Decision Support features](/articles/drug-decision-support).
**Initiating an Electronic Prior Authorization request**
[Click here for instructions on how to submit an Electronic Prior Authorization request](/articles/Managing-electronic-prior-authorizations).
**Storing preferred pharmacies for your patients**
If patients have one or two preferred pharmacies they commonly use to retrieve medications, you can store their pharmacy preferences in the **Pharmacies** section of their [Patient Demographics](/articles/Patient-Demographics-Guide). When prescribing medications, the patient’s preferred pharmacies will appear first when selecting a pharmacy.
**Refilling a single medication**
If you need to refill a medication for a patient, click **Actions** -> **Refill** next to the medication in the patient’s medication history to begin a new prescription draft with the same details as the last prescription sent for that medication. You can edit the prescription as needed. Any available coverage, formulary, and cost estimate information will be readily visible on the right hand side of the prescription form. The last pharmacy the script was sent will be automatically selected.
**Refilling multiple medications in bulk**
Click **+Bulk Refill** at the bottom of the **Permanent Rx Meds** or **Permanent OTC Meds** sections of the Clinical Profile to begin refilling multiple medications in bulk. All the details from the last prescription sent for each medication will automatically be populated in the Prescription Form. You can edit the prescriptions or specify different pharmacies for different medications as needed. Any available coverage, formulary, and cost estimate information for each prescription will be readily visible on the right hand side of the prescription form. The scripts will default to the pharmacy of the first medication on the list if pharmacy information is available.
![Clinical profile showing "+Bulk Refill" buttons highlighted in orange outlines at the bottom of both the Permanent Rx Meds and Permanent OTC Meds sections.]()
**Prescribing discontinued and/or off-the-market medications**
When a medication is discontinued by the manufacturer and/or taken off the market, its NDC code will be made obsolete and you will not be able to prescribe the medication or retrieve formulary or coverage information for that medication.
If you attempt to prescribe or refill a medication that is discontinued or off-the-market, you will be prompted to choose another active medication. If you'd like to continue prescribing the discontinued or off-the-market medication then you must [create a custom medication](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds#add_med_to_database).
You may run into this situation when a medication in one of your Prescription Templates is discontinued by the manufacturer and/or taken off the market. Update or delete that template in your [Prescriptions Settings](/articles/create-and-use-custom-rx-templates#managing_templates) to avoid running into this error.
!["Medication off-the-market" alert dialog on the Prescription Form for BD U-500 31GX6MM SYN, stating the medication is discontinued and prompting the user to choose another or create a custom medication.]()
**Frequently Asked Questions**
* [If I queue 3 medications and then click **Save as Draft & Close**, will the medications remain in one queue when I open the draft?](#save_as_draft_and_close)
* [Can I default certain medications for certain pharmacies?](#default_pharmacy)
* [Can I enter a relative date (e.g. ‘2 months’) in the Date field of the Prescription Form?](#date_field)
* [I am a Workspaces user. What do I need to know about the Prescription Form?](#workspaces)
* [Will I be able to ePrescribe from the Elation Go mobile application?](#Elation_Go)
* [How do I e-prescribe controlled substances?](#controlled_substance)
* [How do I prescribe custom or compound medications?](#custom_medications)
* [Will I be able to associate an NDC code with custom or compound medications?](#NDC_custom)
* [Can I remove a custom medication I added to my practice's medication database?](#remove_custom_medication)
* [How do I check by Drug-Decision-Support settings?](#drug_decision_support_settings)
* [I am trying to send a prescription to the pharmacy for a patient but the patient does not have an address. What should I do?](#no_address)
* [I am unable to find the unit I want to use to order a medication. What should I do?](#no_unit)
* [How do I fax a prescription or order to another provider?](#fax_prescription_or_order)
* [Can I allow my staff to sign off on prescriptions on my behalf?](#delegate)
* [Where can I find more information about EPCS setup and troubleshooting?](#EPCS_info)
**If I queue 3 medications and then click \*\* Save as Draft & Close**, will the medications remain in one queue when I open the draft?\*\*
If you queue 3 medications and then click **Save as Draft & Close**, opening any medication draft will open all 3 medications in a single queue again.
**Can I default certain medications for certain pharmacies?**
You cannot default certain medications to certain pharmacies. Elation will only default to the last pharmacy used for the last prescription that was sent electronically from the patient's chart.
Optionally, if you want to the most recently used pharmacy (for each patient) to populate in the Pharmacy field automatically, have an Admin Level User in the practice use the **I need help** -> **Contact Elation Support** button to send a request to our Support Team and a member of the Support Team will turn this feature on for you.
**Can I enter a relative date (e.g. **2 months**) in the Date field of the Prescription Form?**
The Prescription Form does not support relative dates in the **Date** field. You must enter an exact date or select a date from the calendar.
**I am a Workspaces user. What do I need to know about the Prescription Form?**
As a [Workspaces](/articles/workspaces-guide) user, you will only see the Practice Locations specific to your Workspace when sending prescriptions to the pharmacy. The first Practice Location listed in the Workspace will always be the default location. Workspace users will not be able to select a default prescribing location for ePrescribing.
**Will I be able to ePrescribe from the Elation Go mobile application?**
Yes, you will be able to [ePrescribe non-controlled substance medications from the Elation Go mobile application](/articles/elation-go-the-mobile-app-for-practices#send_non_controlled_erx). Please note that the following features are currently not available in the Elation Go mobile application:
* Packing (NDC) field
* Days Supply field
* Prescription insurance benefits details
**How do I Prescribe controlled substances?**
To prescribe controlled substance medications, simply select a controlled substance medication in the Prescription Form and then [follow the necessary steps to complete the prescription](#how_to_use).
* If your practicedoes not have the [EPCS (Electronic Prescribing of Controlled Substances)](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs) feature turned on, providers will need to print out the controlled substance prescription on tamper proof paper
* If your practice would be interested in e-Prescribing Controlled Substance (EPCS) please[contact Elation](https://help.elationemr.com/s/contactsupport) to learn more.
**How do I prescribe custom or compound medications?**
You can [follow the instructions about adding a medication to the medication database](#add_med_to_database) to add custom or compound medications to the Prescription Form to prescribe them.
ℹ️**EXCEPTIONS**
Custom or compound controlled substance medications cannot be prescribed electronically via Elation. You will need to prescribe these medications via other means such as printing the prescription or calling them into the pharmacy.
**Will I be able to associate an NDC code with custom or compound medications?** You will not be able to associate an NDC code with custom or compound medications. Custom or compound controlled substance medications cannot be prescribed electronically via Elation. You will need to prescribe these medications via other means such as printing the prescription or calling them into the pharmacy.
**Can I remove a custom medication I added to my practice's medication database?**
You cannot delete a custom medication from your practice's medication database once it has been added. To stop a custom medication from appearing in medication search results, have an Admin Level User in the practice use the **I need help** -> **Contact Elation Support** button to request that the medication be marked obsolete.
\*\*How do I check my Drug-Decision-Support settings?
ℹ️ **Provider Level Users Only**
Drug Decision Support Settings are provider specific. This means only Provider Level Users can adjust their Drug Decision Support settings in their own Elation EHR account.
1. Go to **Settings** -> **Preferences**-> **Drug Decision Support**.
2. Adjust your Drug-to-Drug alerts as needed. You have the following options
* Major alerts only
* Major and Moderate alerts only
* All alerts
3. Turn on or off your Drug-to-Allergy alerts as needed.
4. Changes will be saved automatically on this page.
[Click here to learn more about the Drug-Decision-Support feature](/articles/drug-decision-support).
**I am trying to send a prescription to the pharmacy for a patient but the patient does not have an address. What should I do?**
Patient addresses are now required for both non-controlled and controlled substances. If the patient is experiencing homelessness, store the word **HOMELESS** in the\*\* Address\*\* field and enter the **City**, **State**, and **Zip** for your local area. If the address of the patient is unable to be obtained, store the word **UNKNOWN** in the\*\* Address\*\* field and enter the **City**, **State**, and **Zip** for your local area.
**I am unable to find the unit I want to use to order a medication. What should I do?**
In an effort to provide more accurate and precise quantity and dosing information to pharmacies to dispense medications to patients, the National Council for Prescription Drug Monitoring Programs (NCPDP) has specified which quantity units are acceptable for prescribing. Below is a list of all the accepted prescription units and their recommended alternatives. When **each** is one of the recommended alternatives for a deprecated unit but other recommended alternatives are available, the NCPDP suggests that you choose one of the other more appropriate terms (e.g. choose 'mL' for ampule instead of 'each').
| **Deprecated Unit** | **Recommended Alternative** |
| ---------------------- | ---------------------------- |
| Ampul | mL or each |
| Applicator | grams or mL |
| Bag | grams or mL |
| Bar | each |
| Bead | grams |
| Block | each |
| Bolus | mL |
| Bottle | mL |
| Can | grams, mL, or each |
| Canister | grams or mL |
| Carton | grams, mL, or each |
| Cartridge | mL |
| Case | grams, mL, or each |
| Cassette | grams, mL, or each |
| Container | grams, mL, or each |
| Cylinder | grams, mL, or each |
| Device | each |
| Disk | each |
| Dose pack | grams, mL, or each |
| Dual pack | grams, mL, or each |
| Fluid ounce | mL |
| French | each |
| Gallon | mL |
| Inhalation | grams, mL, or each |
| Inhaler | grams, inhaler, mL, or each |
| Inhaler refill | grams, mL, or each |
| International units | iu |
| Intravenous bag | mL |
| Kilogram | grams |
| Liter | mL |
| Microgram | microgram |
| Milliequivalent | grams or mL |
| Milligram | grams or milligram |
| Nebule | mL or nebule |
| Needle free injection | mL |
| Ocular system | each |
| Ounce | grams |
| Package | grams, mL, or each |
| Paper | each |
| Pint | mL |
| Pouch | grams, mL, or each |
| Pound | grams |
| Pre-filled pen syringe | mL or pre-filled pen syringe |
| Puff | grams or mL |
| Pump | grams or mL |
| Quart | mL |
| Sachet | each |
| Scoopful | grams, mL, or each |
| Spray | grams or mL |
| Syringe | mL, syringe or each |
| Tablespoon | mL |
| Tabminder | each |
| Tampon | each |
| Teaspoon | mL |
| Tray | grams, mL, or each |
| Tube | grams, mL, or each |
| Vial | mL, vial or each |
ℹ️**CAUTION**
The unit **unspecified** should only be used when the correct unit is not available. Inappropriate use of unspecified may trigger an auditing flag by our prescribing partner.
**How do I fax a prescription or order to another provider?**
Prescriptions are typically sent electronically to a pharmacy or printed for your patient. To fax supporting clinical information (such as a signed prescription or visit note) to another provider, use the **Letters & Referrals** feature:
| **1** | Ensure the prescription or visit note is signed. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Open **Letters & Referrals** in the patient chart by clicking **Letter** → **to Provider** or the **Referral** button in the gray navigation bar. |
| **3** | Create a **Provider Letter** or **Referral**. |
| **4** | In the **To** field, enter the recipient's name or fax number. If a search result appears, select an existing contact. If no results are found, press **Tab** to save the fax number to a new contact. Alternatively, you can simply enter the fax number and click out; this will automatically send any attachments (up to 40 pages) and remove the instructions for online viewing from the cover letter. |
| **5** | To send by **Fax**, ensure the recipient has a fax number on file. |
| **6** | Click **Select Chart Items to Attach** and attach the signed visit note, prescription, or other clinical documentation. |
| **7** | Check the box for **Also fax copies of attachments** if you want to include the attached records in the fax. The system will automatically fax the attachments if a fax number is entered in the **To** field, eliminating the checkbox. |
| **8** | Click **Sign & Send** to fax the correspondence. |
| **9** | Monitor the status of your fax in the **Chronological Record** of the patient's chart. Statuses include Fax Pending, Fax Sent, or Fax Failed. |
For more on sending faxes and interpreting statuses, see the [Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax) article.
**Can staff sign off on prescriptions on a provider's behalf?**
Yes, Provider Level Users can allow Staff Level Users to execute prescription orders on their behalf by assigning individuals as Authorized Rx Delegates. Authorized Rx Delegates can perform the duties listed below. Learn more about how to assign Authorized Rx Delegates in the [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates) article.
* Transcribe prescription orders in the EMR and send a new prescription electronically to the pharmacy on provider's behalf.
* Transcribe verbal approval or denial of a prescription refill or change request received from a pharmacy and send that approval or denial electronically to the pharmacy on provider's behalf.
* Transcribe provider's order to discontinue a medication in the EMR for documentation purposes
* Transcribe provider's order to cancel a medication sent to a pharmacy
ℹ️**EXCEPTIONS**
Authorized Rx Delegates **will not** be allowed to ePrescribe controlled substance medications or address controlled substance medication refill requests on a provider's behalf due to DEA regulations.
**Where can I find more information about EPCS setup and troubleshooting?**
For complete information about electronic prescribing of controlled substances, see the following articles:
* [EPCS (Electronic Prescribing of Controlled Substances) Introduction](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)
* [EPCS Guide - ePrescribing controlled substance medications & troubleshooting](/articles/how-to-e-prescribe-controlled-substances)
* [EPCS Guide - Signing up for EPCS](/articles/how-to-complete-the-epcs-sign-up-process)
* [EPCS Guide - Managing EPCS Access Controls](/articles/how-to-set-up-epcs-access-controls)
* [EPCS Guide - Updating your EPCS Token or password](/articles/how-to-update-your-epcs-token)
**Related Articles**
* [Prescription Form Guide- Viewing patient prescription benefits](/articles/Prescription-Form-Guide-patient-prescription-benefits)
* [Prescriptions Guide - Managing electronic prior authorizations](/articles/Managing-electronic-prior-authorizations)
* [Prescriptions Guide - Delivering prescription reminders to patients through RxInform](/articles/prescription-reminders-for-patients)
* [Prescription (Rx) Templates Guide](/articles/create-and-use-custom-rx-templates)
* [Drug Decision Support Guide- Monitoring drug interactions](/articles/drug-decision-support)
* [EPCS (Electronic Prescribing of Controlled Substances) Introduction](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)
* [Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax)
* [Prescription Monitoring Program (PMP/PDMP) Integration Introduction](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
* [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates)
* [Pediatric Features Guide](/articles/Pediatric-Features)
# Prescriptions Guide - Discontinuing medications
Source: https://help.elationhealth.com/articles/Prescriptions-Guide-Discontinuing-medications
## Overview
When patients stop taking a medication, best practice is to discontinue the medication so that the patient's [medication history](/articles/medication-history) is accurate. discontinuing medications in a patient’s chart by consolidating steps and allowing you to specify whether the medication was discontinued by you, another provider, or the patient. Additionally, you can notify the patient’s pharmacy to cancel any active prescriptions from your practice during the discontinuation process.
## Workflow Instructions
### Actions for discontinuing active medications
There are two actions you can take to discontinue any active medication in the patient’s chart. Go to any active medication and click **Actions** then:
* **Discontinue** to discontinue a medication.
* **Document Discontinue** to document that a medication was discontinued by another provider or the patient.
Discontinuing a medication discontinues the entire [medication thread](/articles/medication-history#anatomy-of-a-medication-thread), which includes all medications in that thread. If you later documented a matching record onto an existing prescription, both orders are discontinued together.
![Medication History dialog showing the Actions dropdown for Captopril 25 mg Tab 1 bid, with "Discontinue" and "Document Discontinue" options highlighted in orange.]()
### Discontinuing medications
To discontinue a medication you or your practice prescribed:
1. Locate the medication you want to discontinue in the patient’s [Clinical Profile](/articles/clinical-profile-record-patient-medical-history), [Chronological Record](/articles/store-everything-in-chronological-record), or [Medication List](/articles/medication-history).
2. Click **Actions** next to the medication name.
3. Click **Discontinue**.
4. Select the most appropriate reason for discontinuing the medication from the following list:
* **I want to discontinue this medication**
* **Discontinued by another prescriber**
* **Patient stopped taking medication**
5. Verify the **Discontinued by** field is accurate.
* If **I want to discontinue this medication** was selected, then your name (if you are a Provider Level User) will be in the **Discontinued by** field.
* If you are an [Authorized Rx Delegate](/articles/staff-permissions--staff-delegates) you must select the name of the provider you are discontinuing medications on behalf of. Authorized Rx Delegates cannot discontinue medications for providers they are not delegates for.
6. Verify the **Discontinued date.**
7. (Optional) Enter any details about the discontinuation in the **Additional reason** field.
* The **Additional reason** field is not transmitted to the pharmacy if a cancellation request is sent as part of the discontinuation workflow.
8. (Conditional) If the medication was previously sent electronically from your practice to a pharmacy and that pharmacy accepts electronic cancellations, then you will be able to check a **Send a cancellation request to….** box to send a cancellation request to the pharmacy as part of the medication discontinuation workflow.
9. Click the blue **Discontinue** button to save the change.
* The **Discontinue** button may appear with alternative names depending on the discontinue reason selected and whether the **Send a cancellation request to….** box was checked.
### Documenting medications discontinued by another prescriber or the patient
To document that a medication was discontinued by another prescriber or the patient:
1. Locate the medication you want to discontinue in the patient’s [Clinical Profile](/articles/clinical-profile-record-patient-medical-history), [Chronological Record](/articles/store-everything-in-chronological-record), or [Medication List](/articles/medication-history).
2. Click **Actions** next to the medication name.
3. Click **Discontinue**.
4. Select the most appropriate reason for discontinuing the medication from the following list:
* **I want to discontinue this medication**
* **Discontinued by another prescriber**
* **Patient stopped taking medication**
5. Verify the **Discontinued by** field is accurate.
* (Optional) Enter in the name of the prescriber that discontinued the medication if **Discontinued by another prescriber** was selected.
6. Verify the **Discontinued date.**
7. (Optional) Enter any details about the discontinuation in the **Additional reason** field.
* The **Additional reason** field is not transmitted to the pharmacy if a cancellation request is sent as part of the discontinuation workflow.
8. (Conditional) If the medication was previously sent electronically from your practice to a pharmacy and that pharmacy accepts electronic cancellations, then you will be able to check a **Send a cancellation request to….** box to send a cancellation request to the pharmacy as part of the medication discontinuation workflow.
9. Click the blue **Discontinue** button to save the change.
* The **Discontinue** button may appear with alternative names depending on the discontinue reason selected and whether the **Send a cancellation request to….** box was checked.
## Related Articles
* [Medication List Management Guide - Managing a patient's medication history](/articles/medication-history)
# Prescriptions Guide - Frequently Asked Questions
Source: https://help.elationhealth.com/articles/Prescriptions-Guide-Frequently-Asked-Questions
This article contains all Frequently Asked Questions related to the Prescription Form, ePrescribing and patient medications.
## Documenting medications
| In Elation, what is the difference between “documenting a medication” and **prescribing a medication**? | ‘Documenting a medication’ is when you record a medication that a patient is (or was) taking. In a case like this, you may not be the provider that ordered the medication. **Prescribing a medication** is when you order medication for the patient. |
| ----------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| How do I document a medication a patient is actively taking? | You can use the Document Medication form to document a medication that a patient is taking. Use one of the following methods to access the Document Medication form: Click the \*\*+ Document Med Pt is On \*\* button in the Permanent Rx Meds or Permanent OTC Meds section of the Clinical Profile • Click **Rx** -> **Document Med Pt is On** at the top of the patient’s chart [Click here to learn more about the Document Medication form](/articles/medication-history#document). |
| How do I document a medication that a patient is no longer taking? | You can use the Document Discontinued Med form to document a medication that a patient has discontinued taking. To access this form, click **Rx** -> **Document Discontinued Med** at the top of the patient’s chart. [Click here to learn more about the Document Discontinued Med form](/articles/medication-history#discontinued_not_in_elation). |
| How do I edit a medication that is currently listed in the patient’s Medication List? (ex. change the dose) | To edit a medication that is listed in the patient’s medication list, click **Actions** -> **Document Change** next to the name of the medication. Click one of the **Save** buttons after noting the changes to save the changes to the patient’s medication list. |
| How do I document multiple medications at once? | The Document Medication form has the option for you to document multiple medications, one after another, by clicking the **Save & Add Another** button after documenting a medication. [Click here to learn more about the Document Medication form](/articles/medication-history#document) |
| How do I discontinue a medication that is currently listed in the patient’s Medication List? | To discontinue medication that is in the patient’s medication list, click **Actions** -> **Document Discontinue** if the order to discontinue was made by another provider or click **Actions** -> **Rx: Discontinue** if you are the provider that is discontinuing the medication. |
| Why did documenting a medication also discontinue an earlier order of the same medication? | If the documented medication matches an existing active medication (same name and dosage), Elation adds the new record to that [medication thread](/articles/medication-history#anatomy-of-a-medication-thread). [Discontinuing the medication](/articles/Prescriptions-Guide-Discontinuing-medications) — including during [medication reconciliation](/articles/Reconciling-active-medications) — discontinues the medication thread, which includes all medications in that thread. |
| How do I eliminate duplicate medications from the patient’s Medication List? | To merge duplicate medications Click **Actions** -> **Merge with Other Med**. • Select the medication(s) you want to merge with. • Click **Merge with Selected Med(s)**. While duplicate medications can also be deleted, we recommend using the **Remove Medication** sparingly as deleted records cannot be retrieved. Only delete if it is a true duplicate. |
| Do I need to enter Sig, Qty and Units when documenting existing medications? | While the **Sig**, **Qty** and **Units** fields are not required when documenting medications, we highly recommend including this information when documenting existing medications as this information will expedite the medication refill process. |
| Where can I find the Qty and Units fields when documenting existing medications? | Click the **more…** button at the bottom of the Document Medication form to see additional fields for **Qty**, **Units**, **Rf** and **Indic’n**. |
## Prescribing/ordering medications (general)
How do I refill a medication that’s listed in the patient’s Medication List?
To refill an existing medication in the patient’s chart [Click here to learn more about the Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds).
1. Find the medication in the Clinical Profile or Medication History (under the **Meds Hx** button at the top of the patient’s chart).
2. Click **Actions** -> **Rx: Refill**.
3. Complete the Prescription Form.
How do I refill a medication that’s not listed in the patient’s Medication List?
You can use the Prescription Form to refill medications, even when the medication is not in the patient’s chart yet. [Click here to learn more about the Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds).
1. Use one of the following methods to access the Prescription Form:
* Click **Rx** -> **Prescription Form (Rx/OTC/CS)** at the top of any patient’s chart.
* Click the **Rx/OTC/CS** button in a visit note or non-visit note draft.
2. Click on the **Type** dropdown at the top of the Prescription Form and select **Refill**.
3. Complete the Prescription Form.
How do I refill multiple medications at once?
To refill multiple medications from the medication list at once, click the \*\*+ Bulk Refill \*\* button in the Permanent Rx Meds or Permanent OTC Meds section of the Clinical Profile. All of the medications in the corresponding lists, along with the details from the last documentation/order, will populate in the Prescription Form for you to continue your prescription order(s).
How do I queue multiple medications in a single prescription?
The pharmacy selected for the first medication in the form will become the default pharmacy for subsequent medications that are eligible to be ePrescribed. Optionally change the selection to a different pharmacy if needed.
To queue multiple prescriptions in a single order, click the **+ Add Another Rx** button towards the bottom left of the Prescription Form. You can queue various medication types in a single order; including over-the-counter and both non-controlled and controlled substance medications.
If I queue multiple medications and then click **Save as Draft & Close**, will the medications remain in one queue in the same prescription form when I open the draft?
All queued medications will come back into the same queue in the prescription form. For example, if you queue 3 medications and then click **Save as Draft & Close**, opening any medication draft will open all 3 medications in a single queue again.
Which fields are required for prescription orders?
The following fields are required for prescription orders: If the prescription needs to be sent electronically to a pharmacy then the **Pharmacy** field must also be filled out. [Click here to learn more about the different fields in the Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds#fill_out_details).
* **Medication name and strength**
* **Sig**
* **Qty**
* **Refills**
I cannot find the medication I want to prescribe in Elation’s medication database. Can I add this medication to the database?
Medications that are manually added to the medication database will not be associated with a National Drug Code (NDC). This means Elation will not be able to provide any details around allergy interactions, drug interactions or intolerances, formulary information, or prescription cost estimates
You will not be able to ePrescribe compound controlled substance medications.
If you are unable to find the medication you wish to prescribe, you can manually add it to your database by following these steps:
1. Type the medication name in the **Medication name and strength** field.
2. If the correct medication appears in the search list, select it.
3. If the list does not include the medication you need, click anywhere outside the list to close it.
4. Click **Add a new med** under the name.
5. Edit the **Name**, **Strength**, and **Medication Type** as needed.
6. Click **Create Medication & Continue Rx**.
How do I prescribe a compound medication?
Medications that are manually added to the medication database will not be associated with a National Drug Code (NDC). This means Elation will not be able to provide any details around allergy interactions, drug interactions or intolerances, formulary information, or prescription cost estimates
You will not be able to ePrescribe compound controlled substance medications.
Elation’s medication database has some of the commonly prescribed compound medications. However, you may need to manually add a compound non-controlled substance medication to your database in order to prescribe it. You can manually add it to your database by following these steps:
1. Type the medication name in the **Medication name and strength** field.
2. If the correct medication appears in the search list, select it.
3. If the list does not include the medication you need, click anywhere outside the list to close it.
4. Click **Add a new med** under the name.
5. Edit the **Name**, **Strength**, and **Medication Type** as needed.
6. Click **Create Medication & Continue Rx**.
Can I delete a custom or compound medication I no longer use from my medication database?
Not currently — there isn't a self-service option in the Elation UI to remove a user-created medication from your practice's medication database.
Are electronic prescriptions, including compound medications, uploaded to a shared pharmacy database that other pharmacies or offices can see?
No. Each electronic prescription — including non-controlled compound medications sent electronically — is transmitted through our e-prescribing partner, Surescripts, only to the specific pharmacy you select in the Prescription Form. Elation does not upload prescriptions to a shared database that other pharmacies or offices can browse.
Separately, pharmacies may be required to report controlled substance dispenses to your state’s Prescription Monitoring Program (PMP/PDMP). This is a state-managed database, not an Elation-managed shared pharmacy database. [Click here to learn more about PMP/PDMP integrations](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP).
How do I prescribe to TrumpRx or another discount card/coupon program?
TrumpRx, like GoodRx, is not a pharmacy — it's a coupon program that offers discounted cash pricing at the patient's regular pharmacy. Continue to select the patient's preferred pharmacy in the Prescription Form as you normally would; the patient can then present their TrumpRx or other coupon at that pharmacy to pay with the discounted price instead of using their insurance.
I am unable to find the unit I want to use to order a medication. What should I do?
In an effort to provide more accurate and precise quantity and dosing information to pharmacies to dispense medications to patients, the National Council for Prescription Drug Monitoring Programs (NCPDP) has specified which quantity units are acceptable for prescribing. Below is a list of all the accepted prescription units and their recommended alternatives. When **each** is one of the recommended alternatives for a deprecated unit but other recommended alternatives are available, the NCPDP suggests that you choose one of the other more appropriate terms (e.g. choose 'mL' for ampule instead of 'each').
**Deprecated Unit**
**Recommended Alternative**
Ampul
mL or each
Applicator
grams or mL
Bag
grams or mL
Bar
each
Bead
grams
Block
each
Bolus
mL
Bottle
mL
Can
grams, mL, or each
Canister
grams or mL
Carton
grams, mL, or each
Cartridge
mL
Case
grams, mL, or each
Cassette
grams, mL, or each
Container
grams, mL, or each
Cylinder
grams, mL, or each
Device
each
Disk
each
Dose pack
grams, mL, or each
Dual pack
grams, mL, or each
Fluid ounce
mL
French
each
Gallon
mL
Inhalation
grams, mL, or each
Inhaler
grams, inhaler, mL, or each
Inhaler refill
grams, mL, or each
Internation unit
iu
Intravenous bag
mL
Kilogram
grams
Liter
mL
Microgram
microgram
Milliequivalent
grams or mL
Milligram
grams, milligram
Nebule
mL, nebule
Needle free injection
mL
Ocular system
each
Ounce
grams
Package
grams, mL, or each
Paper
each
Pint
mL
Pouch
grams, mL, or each
Pound
grams
Pre-filled pen syringe
mL, pre-filled pen syringe
Puff
grams or mL
Pump
grams or mL
Quart
mL
Sachet
each
Scoopful
grams, mL, or each
Spray
grams or mL
Syringe
mL, syringe or each
Tablespoon
mL
Tabminder
each
Tampon
each
Teaspoon
mL
Tray
grams, mL, or each
Tube
grams, mL, or each
Vial
mL, vial or each
**Deprecated Unit**
**Recommended Alternative**
Ampul
mL or each
Applicator
grams or mL
Bag
grams or mL
Bar
each
Bead
grams
Block
each
Bolus
mL
Bottle
mL
Can
grams, mL, or each
Canister
grams or mL
Carton
grams, mL, or each
Cartridge
mL
Case
grams, mL, or each
Cassette
grams, mL, or each
Container
grams, mL, or each
Cylinder
grams, mL, or each
Device
each
Disk
each
Dose pack
grams, mL, or each
Dual pack
grams, mL, or each
Fluid ounce
mL
French
each
Gallon
mL
Inhalation
grams, mL, or each
Inhaler
grams, inhaler, mL, or each
Inhaler refill
grams, mL, or each
Internation unit
iu
Intravenous bag
mL
Kilogram
grams
Liter
mL
Microgram
microgram
Milliequivalent
grams or mL
Milligram
grams, milligram
Nebule
mL, nebule
Needle free injection
mL
Ocular system
each
Ounce
grams
Package
grams, mL, or each
Paper
each
Pint
mL
Pouch
grams, mL, or each
Pound
grams
Pre-filled pen syringe
mL, pre-filled pen syringe
Puff
grams or mL
Pump
grams or mL
Quart
mL
Sachet
each
Scoopful
grams, mL, or each
Spray
grams or mL
Syringe
mL, syringe or each
Tablespoon
mL
Tabminder
each
Tampon
each
Teaspoon
mL
Tray
grams, mL, or each
Tube
grams, mL, or each
Vial
mL, vial or each
Do I still need to fill out the Sig or Qty fields if I filled out the Days Supply field?
The **Days Supply** field does not replace the **Sig** or **Qty** fields. The **Sig** and **Qty** fields will always be required for any prescription order.
Will the Days Supply field populate automatically based on the Sig and Qty I entered?
The **Days Supply** field does not populate automatically. You must manually enter a number in the **Days Supply** field if required for the medication you are ordering or if you want to see [prescription cost estimate information](#prescription_insurance_benefits).
Where does the NDC & packing information come from?
The **Packaging (NDC)** information that is selected by default is the default NDC & packaging information that is provided by our medication database provider.
Can I select my own default NDC & packaging for a medication I commonly order?
Yes, you can use the Rx Templates feature to save any **Medication** along with its **Sig**, **Qty**, **Units**, **Refills**, **Days Supply**, & **Packaging (NDC)** information as a template to use for any prescription for any patient. [Click here to learn more about the Rx Templates feature](/articles/create-and-use-custom-rx-templates).
Are diagnosis codes required for prescriptions?
While **Diagnosis (ICD-10)** is not a required field on the Prescription Form, certain insurances may require diagnosis codes for coverage purposes or prior authorizations. You can associate as many diagnosis codes as you want to with a prescription but only the first 2 diagnosis codes will be sent to the pharmacy.
How many diagnosis codes can I send per prescription?
You can associate as many diagnosis codes as you want with a prescription but only the first 2 diagnosis codes will be sent to the pharmacy.
Can I store default pharmacies for specific medications?
You cannot store default pharmacies for specific medications. You can only [store preferred pharmacies at the patient level](#preferred_pharmacies_for_patients).
How do I print a prescription instead of sending it to a pharmacy?
Click the **Manual printout only** option in the pharmacy search to print a prescription instead of sending it to a pharmacy.
How do I fax a prescription to a pharmacy?
To fax a prescription to the pharmacy
1. Print the prescription and use the **Print to PDF** or **Save as PDF** function in the print window to save a PDF copy of the prescription to your computer.
2. [Upload the PDF back to the patient’s chart](/articles/filing-documents-to-a-patient-chart)
3. Attach it to a Letter to Provider to fax it to the pharmacy.
I often enter the same details for certain medications that I order. Can I save this information as a template for all my prescriptions?
Yes, you can use the Rx Templates feature to save any **Medication** along with its **Sig**, **Qty**, **Units**, **Refills**, **Days Supply**, & **Packaging (NDC)** information as a template to use for any prescription for any patient. [Click here to learn more about the Rx Templates feature](/articles/create-and-use-custom-rx-templates).
I am trying to send a prescription to the pharmacy for a patient but the patient does not have an address. What should I do?
Patient addresses are required for both non-controlled and controlled substances.
* If the patient is homeless, store the word **HOMELESS** in the **Address** field and enter the **City**, **State**, and **Zip** for your local area.
* f you are unable to obtain an address for the patient, store the word **UNKNOWN** in the **Address** field and enter the **City**, **State**, and **Zip** for your local area.
I am a Workspaces user. What do I need to know about the Prescription Form?
As a Workspaces user, you will only see the Practice Locations specific to your Workspace when sending prescriptions to the pharmacy. The first Practice Location listed in the Workspace will always be the default location. Workspace users will not be able to select a default prescribing location for ePrescribing.
Will I be notified when a patient picks up a prescription at the pharmacy?
Pharmacies have the option to send fill statuses to Elation. If they do, the information will appear at the bottom of the prescription record within the patient’s chart. [Click here to learn more about fill status notifications](/articles/managing-electronic-prescriptions#fill-status).
I received a message from the pharmacy about a change request. What should I do?
You may see change requests in your **Rx Requests** Practice Home queue if the pharmacy requests changes to a prescription that you sent. Pharmacies most commonly send prescription change requests if the patient requests a generic substitution at the pharmacy, for script clarification, or in the event that the medication is out of stock. Review the change request and then take the appropriate action to respond to the request. [Click here to learn more about prescription change requests](/articles/managing-electronic-prescriptions#rx-change-request).
Can I reassign an item in the Rx Requests queue to a different provider?
You cannot manually reassign a refill or change request in the **Rx Requests** queue to a different provider. Each request stays addressed to the provider the pharmacy sent it to. If someone else needs to act on a non-controlled substance request, the addressed provider can add them as an [Authorized Rx Delegate](/articles/staff-permissions--staff-delegates) instead.
How do I cancel a prescription I sent to the pharmacy?
Pharmacies should respond to cancellation requests within 12 hours, but pharmacies are not obligated to keep to this timeframe. If you do not receive a response from the pharmacy to the cancellation request within 24 hours, we recommend directly contacting the pharmacy.
If you would like to reverse an in-progress cancellation request, you must contact the pharmacy directly to suspend the request.
Deleting a prescription from the chart will not notify the pharmacy to cancel it. Follow the steps above to notify pharmacies of cancellation requests.
To cancel a prescription that was sent to the pharmacy: You will see a message at the bottom of the chart that says ‘This eRx order to…was canceled….” once the pharmacy processes your cancellation request. [Click here to learn more about prescription cancellation requests](/articles/managing-electronic-prescriptions#request-cancel).
1. Locate the prescription in the patient’s chart.
2. Click **Actions** -> **Cancel this eRx order**.
Can I edit a prescription after it's been sent to the pharmacy?
No, a prescription can't be edited once it's been sent to the pharmacy. If it needs to be corrected — for example, the wrong dose or units — cancel or discontinue the existing order and create a new prescription with the correct details. [Click here to learn more about canceling a prescription sent to a pharmacy](/articles/managing-electronic-prescriptions#request-cancel).
Can staff prescribe on a provider's behalf?
An 'Authorized Rx Delegate' is not allowed to ePrescribe controlled substance medications or address controlled substance medication script requests on a provider's behalf due to DEA regulations.
Provider Level Users can assign Staff Level Users as [prescription delegates](/articles/staff-permissions--staff-delegates) which authorizes them to execute non-controlled substance prescription orders on a prescriber's behalf in the EHR. These non-controlled substance prescription orders include:
* Transcribe prescription orders in the EMR and send new non-controlled substance prescriptions electronically to the pharmacy on a provider's behalf.
* Transcribe verbal approval or denial of a non-controlled substance prescription refill or change request received from a pharmacy and send that approval or denial electronically to the pharmacy on provider's behalf.
* Transcribe provider's order to discontinue a non-controlled substance medication in the EHR for documentation purposes.
* Transcribe provider's order to cancel a non-controlled substance medication sent to a pharmacy.
**Prescribing/ordering medications (specific to controlled substance medications & EPCS)**
Can I ePrescribe controlled substance medications?
Yes, you can ePrescribe controlled substance medications after you complete a special registration process.
1. Begin by going to the **Settings** page in Elation and see if you see the **ePrescribing Controlled Substances (EPCS)** settings page. If you do, proceed to Step 2.
* If you do not see the **ePrescribing Controlled Substances (EPCS)** settings page, click **I need help** ->**Contact Elation Support** to request access. A member of the Elation Team will assist you with turning this feature on and if applicable, assist you with understanding any associated costs for using this feature.
2. Complete the [EPCS signup process](/articles/how-to-complete-the-epcs-sign-up-process).
How do I ePrescribe controlled substance medications?
To ePrescribe controlled substance medications after completing the [EPCS signup process](/articles/how-to-complete-the-epcs-sign-up-process): [Click here to learn more about EPCS](/articles/how-to-e-prescribe-controlled-substances).
1. Click the **Rx** -> **Prescription Form (Rx/OTC/CS)**.
2. Complete all necessary fields, especially **Pharmacy**.
3. Click **Prescribe**.
4. Review the details of your prescription and click **Prescribe** again.
5. Enter your EPCS Password and **Security Code** to complete your order.
How do I queue multiple controlled substance medications in a single prescription?
The pharmacy selected for the first medication in the form will become the default pharmacy for subsequent medications that are eligible to be ePrescribed. Optionally change the selection to a different pharmacy if needed.
To queue multiple controlled substance prescriptions in a single order, click the **+ Add Another Rx** button towards the bottom left of the Prescription Form. You can queue various medication types in a single order; including over-the-counter and both non-controlled and controlled substance medications.
If I ePrescribe multiple controlled substance medications in a single order, do I need to enter my EPCS Password and Security Code multiple times?
If you are ePrescribing multiple controlled substance medications in a single order, you only need to enter your EPCS Password and Security Code one time.
Can my staff prescribe controlled substance medications on my behalf?
Staff cannot prescribe controlled substance medications, even if they are an [Authorized Prescription Delegate](/articles/staff-permissions--staff-delegates#provider-rx-delegates). Authorized Prescription Delegates can only prescribe over-the-counter and non-controlled substance medications.
How many diagnosis codes can I send per controlled substance prescription?
You can associate as many diagnosis codes as you want to a prescription but only the first 2 diagnosis codes will be sent to the pharmacy.
Why can't I ePrescribe custom or compound medications that contain controlled substances?
The database of controlled substance medications that are available to e-prescribe through Elation are from the national Medispan medication database. You can add custom or compound medications to this database but you cannot ePrescribe custom or compound controlled substance medications because we currently do not have the option to allow you to associate a custom NDC code to medications you create. To prescribe custom or compound controlled substance medications, [print the controlled prescription on tamper proof paper](/articles/prescribing-a-controlled-substance-med) and hand it to the patient.
Why is my controlled substance prescription failing to be sent to the pharmacy?
If you, the Provider, have completed the EPCS signup process and the Token Password and Security Code you enter when e-Prescribing is accurate, there are a few other factors that may prevent a Controlled Substance prescription from being sent electronically in Elation.
1. Be sure Patient Demographics are filled with no special characters or abbreviations in the following fields:
* Name:
* Entering a patient’s middle name is applicable, but DO NOT include a ‘nickname’ or **goes by** in the **Middle name** field. This information should be added to the **Full name** field. instead.
* Address:
* Spell out abbreviations
* Ave- Avenue, ST- Street, etc.
* PO Box addresses will not be accepted, it is strongly recommended to enter physical addresses.
* City & Zip Code
2. Be sure that all of your credentialing information has been uploaded to Elation:
* NPI
* SPI
* DEA
3. It is important to note that Schedule I & II drugs will not allow for:
* Post-dated prescriptions
* Refill quantity amounts in the order form. The **Refill** field must say **0**.
Why can't I delete a controlled substance prescription from the Chronological Record?
The DEA requires that any prescriptions for controlled substances remain documented within the patient’s health record. This means controlled substance prescriptions can never be deleted from the EHR once the prescription order is signed.
What does the VIP Push button do?
The **VIP Push** button sends a pop up notification to your smartphone and provides you the option to approve or deny the EPCS request rather than opening the app to enter a security code.
## EPCS Registration & Account Management
[Click here for a detailed FAQ about EPCS](/articles/epcs-faq-page).
For complete information about electronic prescribing of controlled substances, see the following articles:
* [EPCS (Electronic Prescribing of Controlled Substances) Introduction](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)– Learn about EPCS requirements and how to get started.
* [EPCS Guide - Signing up for EPCS](/articles/how-to-complete-the-epcs-sign-up-process) – Step-by-step instructions for completing EPCS registration.
* [EPCS Guide - Managing EPCS Access Controls](/articles/how-to-set-up-epcs-access-controls) – How to manage Access Control permissions for EPCS.
* [EPCS Guide - Updating your EPCS Token or password](/articles/how-to-update-your-epcs-token) – How to register a new token, reset your password, and troubleshoot token issues.
* [EPCS Guide - ePrescribing controlled substance medications & troubleshooting](/articles/how-to-e-prescribe-controlled-substances) – End-to-end prescribing workflow and common issue resolution.
## Prescription Templates (Rx Templates) and Custom Rx Sigs
| I often enter the same details for certain medications that I order. Can I save this information as a template for all my prescriptions? | Yes, you can use the Rx Templates feature to save any **Medication** along with its **Sig**, **Qty**, **Units**, **Refills**, **Days Supply**, & **Packaging (NDC)** information as a template to use for any prescription for any patient. [Click here to learn more about the Prescription Templates feature](/articles/create-and-use-custom-rx-templates). |
| ---------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| How do I apply a Rx Template to a prescription order? | To apply a Rx Template to a prescription order: Open the Prescription Form. • Search for the medication that the template is for. • Select the Prescription Template from the search results |
| What is a custom Rx sig? | Elation associates specific sigs with specific medications to expedite the prescribing workflow. If you do not see the sig you want to assign to a prescription, you can enter a customer sig and add it to your **Sig** database to use with other prescription orders. |
| How do I add a custom Rx sig to my Sig database? | To add a custom Rx sig to your Sig database, follow these instructions: Open the Prescription Form |
| How do I edit a custom Rx sig in my Sig database? | To edit a custom Rx sig in your **Sig** database: Click **Settings**. • Click **Prescriptions** under **Practice Settings**. • Go to the **Custom Rx Sigs** section & click **Edit** next to the custom rx sig you want to edit. • Edit the sig as needed. • Click **Save**. |
| How do I delete a custom Rx sig from my Sig database? | To delete a custom Rx sig from your Sig database, follow these instructions: Click **Settings**. • Click **Prescriptions** under **Practice Settings**. • Go to the Custom Rx Sigs section & click **Delete** next to the custom rx sig you want to delete. |
| How do I apply a custom Rx sig to a prescription order? | To apply a custom Rx sig to a prescription order: Open the Prescription Form. • Select the medication you want to order. • Click in the **Sig** field. You will automatically see all available sigs for the medication. Custom rx sigs will be at the top of the list and will have a **User** label to the right of the search results. • Select the custom rx sig you want to use. |
| Who has access to my Rx Templates and custom Rx sigs? | All users in the practice have access to your Rx Templates and custom Rx sigs. |
| Can I save "Instructions to Pharmacy" text as part of an Rx Template? | No, Rx Templates only save the **Medication**, **Sig**, **Qty**, **Units**, **Refills**, **Days Supply**, and **Packaging (NDC)** fields. The **Instructions to Pharmacy** field is not template-able. If the text belongs in the patient-facing directions instead, save it as a **Custom Rx Sig**. Otherwise, consider using a text-expander or keyboard shortcut to enter it consistently. |
| Why doesn't selecting an Rx Template for a controlled substance prompt me for my EPCS Token Password and Security Code? | In the medication search results, controlled substance medications display a **C** indicator next to the medication name. Rx Templates saved for a controlled substance don't carry that indicator, so selecting the Rx Template version won't trigger the EPCS signing prompt. Select the controlled substance entry marked with the **C** indicator instead. [Click here to learn more about ePrescribing controlled substances](/articles/how-to-e-prescribe-controlled-substances). |
## Drug decision support
[Click here for the full drug decision support feature guide](/articles/drug-decision-support).
| What is drug decision support? | Drug decision support is a feature that allows you to see drug-to-drug interactions or drug-to-allergy interactions while you are drafting prescription orders. For optimal use of this feature, you must keep an up to date list of patient’s allergies, drug intolerances and medications in their chart. You must select allergies, drug intolerances and medications from Elation’s database in order for drug decision support to work. |
| ----------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Where does the drug decision support information come from? | The drug decision information is based on the following: Allergies, drug intolerances and medications documented in the patient’s chart • Clinical data from our drug database provider, MediSpan, a Wolters Kluwer© company. |
| What are the different types of interaction alerts? | Drug decisions support alerts are categorized into the following: Minor interactions • Moderate interactions • Major interactions |
| What should I do when I see an interaction alert? | Best practice is to click on the alert to read the full details of the alert. If you choose to proceed to prescribe a medication with a major interaction alert, you will be required to enter a reason for overriding contra-indication. |
| How do I check my drug decision support settings? | Drug decision support Settings are provider specific. This means only Provider Level Users can adjust their drug decision support settings in their own Elation EHR account. Go to **Settings** -> **Preferences** -> **Drug Decision Support**. • Adjust your Drug-to-Drug alerts as needed. You have the following options • Turn on or off your Drug-to-Allergy alerts as needed. • Changes will be saved automatically on this page. [Click here to learn more about the drug decision support feature](/articles/drug-decision-support). |
## Prescription insurance benefits
[Click here for the full prescription insurance benefits guide](/articles/Prescription-Form-Guide-patient-prescription-benefits).
Where can I see prescription insurance benefits for my patient?
The prescription insurance benefits information is displayed at the right hand side of the [Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds).
What prescription insurance benefits information can I see in Elation?
Elation will show the following prescription insurance benefits information as provided by the patient’s Pharmacy Benefits Manager:
* The coverage information tells you whether a patient has prescription benefits coverage and which Pharmacy Benefits Manager (PBM) covers the patient. Elation will show all prescription coverages available for the patient.
* The formulary information serves as a guide for both healthcare providers and patients, outlining which medications are approved for coverage and the corresponding coverage limits and statuses. The formulary status tells you whether a medication is potentially reimbursable by the patient’s insurance and whether the medication is preferred and/or on- or off-formulary. Preferred medications are generally cheaper than non-preferred medications. Non-formulary medications may require prior authorization or have additional cost considerations compared to on-formulary medications.
* The cost estimate information displayed is based on the patient’s prescription coverage benefits, and the medication, quantity, and pharmacy selected. Coverage, formulary and cost estimate information displayed is provided solely by the PBM and is not determined by Elation. Cost estimate information may include the estimated cost of the medication, cost breakdowns, coverage limits, prior authorization needs, and alternative options.
What information in Elation is used to retrieve coverage information?
Medical insurance information saved in the patient’s demographics is not used for prescription coverage, formulary, and cost estimate queries.
The following patient information is used to retrieve coverage information in Elation:
* **Legal First Name**
* **Legal Last Name**
* **Date of birth**
* **Sex at birth**
Am I required to enter a patient’s insurance details in Elation in order to retrieve prescription coverage information?
You do not need to enter a patient’s insurance details in order to retrieve prescription coverage information. However, best practice is to store a patient’s insurance details in Elation, if a patient has insurance, to facilitate other workflows like billing or ordering diagnostic tests.
What details are provided in the coverage information?
Place your mouse cursor over the PBM name to see additional coverage details, if available.
The **COVERAGE** section of the Prescription form tells you whether a patient has prescription benefits coverage and which Pharmacy Benefits Manager (PBM) covers the patient. Elation will show all prescription coverages available for the patient.
*
Place your mouse cursor over the PBM name to see additional coverage details, if available.
What information in Elation is used to retrieve formulary information?
The following information is used to retrieve formulary information in Elation:
* Patient’s coverage information
* Medication name (as selected in the Prescription Form)
What details are provided in the formulary information?
Hover your mouse cursor over information badges or details with an asterisk to see additional details as provided by the PBM.
Use the scroll bar to scroll up and down to see all the coverage and formulary information.
The **COVERAGE** section of the Prescription Form will list all formulary information as provided by the PBM(s). Formulary information can include any of the details listed below but not all details are always available from the PBM:
* Formulary status
* Formulary status tells you whether a medication is potentially reimbursable by the patient’s insurance and whether the medication is preferred and/or on- or off-formulary. [Click here to see a detailed description of each formulary status](/articles/Prescription-Form-Guide-patient-prescription-benefits#coverage_and_formulary).
* Copay tier
* The tier coverage is determined by the PBM and is organized from Tier 1 (more preferred) to lower tiers (less preferred). Tier 1 medications will generally be cheaper than Tier 2 medications and so forth. Tier coverage may also differ by pharmacy type (e.g. Retail vs Mail Order).
* Medication type
* The formulary may categorize a medication by type (i.e. Prescription or Over-the-Counter) and note whether the medication is brand name or generic. Generic prescriptions are generally cheaper than their brand name counterparts.
* Coverage factors and limits
* Coverage factors and limits disclose the terms and conditions in which the coverage applies. These include:
* quantity limits
* age limits
* prior authorization requirements
* step medication protocols
* drug-specific resource links
* Therapeutic or payer-specified alternative medications
* Any medications in the same drug group, class, and subclass as the medication selected are potentially therapeutic alternative medications.
* If a PBM provides information about payer-specified alternative medications, then only payer-specified alternative medications and their details will be returned and disclosed under **COVERAGE**, even if other therapeutic alternative medications exist. Therapeutic alternative medications that are at a lower coverage status (less preferred) than the selected medication will never be displayed.
* If payer-specified therapeutic alternative medications are not returned, Elation will display information about all therapeutic alternative medications that have an equal or higher coverage status (more preferred) returned by the PBM.
What information in Elation is used to retrieve cost estimate information?
The following information is used to retrieve cost estimate information in Elation:
* Patient’s coverage information
* The following details from the Prescription Form:
* Medication name
* Medication quantity
* Days supply
* Pharmacy
Am I required to enter a patient’s insurance details in Elation in order to retrieve cost estimate information?
You do not need to enter a patient’s insurance details in order to retrieve cost estimate information. However, best practice is to store a patient’s insurance details in Elation, if a patient has insurance, to facilitate other workflows like billing or ordering diagnostic tests.
What details are provided in the cost estimate information?
If the patient has multiple coverages, Elation will by default display the cost estimate information for the first coverage listed. Select a different coverage to see the cost estimate information for that coverage.
By default, the cost estimate information is for a 30 day supply. Enter a different number in the **Days Supply** field if you would like the cost estimate to be for a different **days supply**.
If cost estimate information is unavailable you will see a note about this information being unavailable.
The **COST ESTIMATE** section of the Prescription Form will list all cost estimate information as provided by the PBM(s). Cost estimate information can include any of the details listed below but not all details are always available from the PBM.
* Cost
* The cost of the medication as specified by the Payer.
* Pharmacy Type
* The type of pharmacy that can be used to retrieve the medication (e.g. Retail or Mail Order) will be listed if coverage is available for more than one pharmacy type.
* Coverage Limits
* Coverage limits disclose the terms and conditions in which the cost estimate applies. Hover your mouse cursor over the Limits tag to see the coverage factors and limits which can include:
* quantity limits
* age limits
* usage recommendations & instructions
* Prior Authorization Requirements
* A PA tag will tell you whether prior authorization is required for the payer to reimburse the selected medication. The cost estimate you see is the cost estimate of the medication after prior authorization is acquired. Hover your mouse cursor over the PA tag to see any additional details that may be provided.
* Estimate patient pay breakdown
* Cost estimates may be broken down by the patient’s out-of-pocket responsibilities. Hover your mouse cursor over the cost to see any of the following details that may be disclosed:
* Out-of-Pocket (OOP) applied
* Out-of-Pocket (OOP) remaining
* Deductible applied
* Deductible remaining
* Alternative medication options
* The PBM may return specific medications deemed by the PBM to be therapeutic alternatives. If the PBM provides cost estimates for alternative medications then the cost estimate information for all alternatives will also be disclosed under **COST ESTIMATE** in the **Alternatives** section.
I selected a medication but I do not see any cost estimate information for the medication. Why?
To see cost estimate information for a medication, the patient’s **Legal First Name**, **Legal Last Name**, **Date of birth**, and **Sex at birth** must be in their demographics and the medication, quantity, and pharmacy must be selected in the Prescription Form. Enter the quantity and select a pharmacy and then you will see cost estimate information if any is available. [Click here to understand the circumstances in which cost estimate information may not be available for patients without coverage information](#prescription_cost_estimate_unavailable).
Where does the coverage, formulary, and cost estimate information come from?
The formulary and cost information comes directly from the patient’s Pharmacy Benefit Manager (PBM). After you select the medication, quantity, and pharmacy the information is sent along with the patient’s coverage to the patient’s prescriptions benefit plan and then the patient’s out-of-pocket prescription cost and associated details is then returned and displayed on the right side of the Prescription Form along with alternative therapeutic medication options, if available.
Why is the prescription coverage different from the medical insurance coverage saved in the patient chart?
Formulary and prescription cost estimate information is based on the patient’s prescription coverage and not medical insurance. Elation works with Surescripts to determine coverage and Surescripts works with Pharmacy Benefit Managers (PBMs) to understand formulary and cost estimation information.
Why is prescription coverage information not available for one of my patients?
Elation will query for patient prescription coverage every time the Prescription Form is opened. These are the most common reasons why prescription coverage may not be available:
* The patient does not have active prescription coverage.
* We could not find a patient match based on the demographics in the patient’s chart. Make sure the following information is in the patient’s demographics and then draft a prescription again or click **Re-check coverage**. Required fields are marked with an asterisk:
* **Legal First Name**\*
* **Legal Last Name**\*
* **Date of birth**\*
* **Sex at birth**\*
* **Address** (full address)
* **Primary phone number**
* The patient’s benefit plan is not part of the network of available information. Elation works with Surescripts, who works with 99% of plans in the United States, and the patient’s plan might be in the 1% that is not part of the Surescripts network.
How does a Pharmacy Benefits Manager (PBM) contribute to the administration of prescription insurance benefits?
A Pharmacy Benefits Manager (PBM) is a third-party administrator that manages prescription drug benefits on behalf of health insurance plans, employers, and government programs. PBMs maintain a list of approved medications, known as a formulary. The formulary is designed to include cost-effective and clinically effective drugs. PBMs negotiate with pharmaceutical manufacturers to include specific drugs in the formulary and secure favorable pricing for medications included in the formulary to reduce overall drug costs for the insurer and patients.
Is prescription insurance benefits information available in the Elation Go mobile application?
Prescription insurance benefits information is not available in the [Elation Go](/articles/elation-go-the-mobile-app-for-practices) mobile application at this time. We will notify you when we support this in the future.
Do cost estimates include pricing with cash discount tools such as GoodRx?
GoodRx and other cash pricing programs are not currently included in the cost estimate feature. We will notify you when we support this in the future.
Does Elation's prescription insurance benefits feature differ from other solutions like CoverMyMeds?
Elation's prescription insurance benefits feature and CoverMyMeds are both platforms that offer prescription insurance benefits information and both pull information from Prescription Benefits Managers. For these reasons, the information you see in Elation and CoverMyMeds should be the same.
## Medication history & medication fill history download
| What is the Medication History feature in Elation? | Medication History is the list of all medications ever documented or recorded in the patient’s chart, categorized into 3 categories (permanent, temporary or discontinued), and sorted by the date the medication was started. |
| ---------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Where can I see a patient’s medication history? | You can see the active permanent medications in **Permanent Rx Meds** and **Permanent OTC Meds** sections of the Clinical Profile. To see the full medication history, which includes temporary and discontinued medications, click **Meds Hx** in the gray navigation bar and then click **Medication History**. |
| What’s the difference between the **Medication History** feature and the Medication Lists in the patient’s Clinical Profile? | The **Medication History**(which can be found by clicking the **Meds Hx** button in the gray navigation bar at the top of the patient’s chart) is the patient’s full medication history as documented in Elation, including permanent, temporary and discontinued medications. The Medication Lists in the Clinical Profile only displays the permanent medications as documented in Elation. |
| What’s the difference between the Permanent Medication lists and the Scripts Since Last 6 Visits list? | The **Permanent Medications List** is a record of all of the medications marked as **Permanent** for a patient throughout their entire lifecycle as a patient in your practice. The **Scripts Since Last 6 Visits** lists any prescriptions that were ordered by your practice within the last 6 documented encounters and may only be a subset of the patient’s entire medication history. |
| What do the alerts for **# fills received** under the Outstanding Items section mean? | The alerts for **# fills received** under the **Outstanding Items** section is a report of the medication fill history download performed on the patient. The report displays the patient’s last 6 months of prescription fills as reported by the patient’s Pharmacy Benefits Managers (PBM). [Click here for additional details about the medication fill history download feature](/articles/retrieving-previous-medication-history-for-your-patients). |
| What do I do with the **# fills received** notification in the Outstanding items section? | Providers should review the **# fills received** information and use the information to reconcile the patient’s Medication History as needed. To help you visualize the medication fill history, you will see the downloaded fills highlighted in yellow in the patient’s Medication List in the Clinical Profile as well as in the Medication History. The fill history is not a permanent part of your patient’s medication history until the fill is signed off by a provider. [Click here for step by step instructions on how to reconcile downloaded medication fill history](/articles/mergingreconciling-downloaded-meds-with-existing-meds). |
| Why are some of the patient’s medications highlighted in yellow? | Downloaded medication fill history is highlighted in yellow to help you visualize the medication fill history against medications in the patient chart. The fill history is not a permanent part of your patient’s medication history until the fill is signed off by a provider. [Click here for step by step instructions on how to reconcile downloaded medication fill history](/articles/mergingreconciling-downloaded-meds-with-existing-meds). |
| Can I download medication fill history for a patient? | Yes, Elation does have a feature for downloading medication fill history. Elation partners with Surescripts, an information technology company that supports electronic transmission of medical records, to retrieve prescription data from the patient’s Pharmacy Benefits Managers (PBM) - specifically data related to the patient’s last 6 months of prescription fills. This medication fill history includes medications that were prescribed by any of the patient’s providers. In order use the medication fill history download feature, the following requirements must be met: The **Provider assigned in practice** must have sent 5 prescriptions electronically through Elation • Patient charts must have the information in the patient demographics |
| How do I download medication fill history? | There are two methods for downloading medication fill history: Automatic download • Manual download |
| What does downloaded medication fill history look like? | Downloaded medication fill history will appear as a report in the **Outstanding Items** section of the patient’s chart. The report is titled **... medication fills received**. You can click on the title of the report to open the full report • in the Clinical Profile as medications with a yellow background. This indicates that updates regarding a medication have been found but the details are not a permanent part of your chart yet (ie the details are **view only**). You must sign off and import the medication history in order for the data to be a permanent part of your patient’s chart. |
| What's the success rate of medication fill history downloads? | Only 60-70% of patients in a regular fee-for-service patient panel will have medications available for download. See the [‘Why is medication fill history retrieval unsuccessful for some patients?’](#med_fill_download_unsuccessful_reasons) question for common reasons why medication fill history retrieval is unsuccessful. |
| Why is medical fill history retrieval unsuccessful for some patients? | These are the common reasons why medication fill history retrieval is unsuccessful for some patients: Surescripts does not have enough information about the patient, resulting in multiple patients that could match the criteria Elation sent to Surescripts. To avoid HIPAA violations, Surescripts defaults to not sending us information if there is ambiguity around whether we are referencing the same patient. • A patient just changed insurance plans (even if it is a different plan with the same insurer). All of this information depends on what information is stored by the patient's insurance plan's pharmacy benefits management system. If there is a change in insurer or pharmacy benefits manager (this is determined by the insurer or self-insured employer), the pharmacy benefits manager will not have the patient's medication refill history because they just started managing that patient's medication usage. • The patient has decided to pay for their prescriptions with cash instead of using their insurance to cover the bill. This results in the insurance company not having data about dispensed prescriptions. • The patient's insurer is using a Pharmacy Benefits Manager (PBM) that is out of network with Surescripts. Approximately 99% of the PBMs in the USA participate in the [Surescripts network.](https://surescripts.com/network-connections/eprescribing-payers-and-pbms) |
| How often can medication fill history be downloaded? | [Automatic medication fill history](#download_medication_fill_history) is downloaded every 90 days per patient if they are scheduled in the Calendar. You can perform a [manual download](#download_medication_fill_history) at any time for the most up to date medication fill history. |
| Why is the medication fill history download creating duplicate medications in the Medication List? | By default, downloaded medication fills are grouped together by the National Drug Code (NDC) code that may be supplied to us from the Pharmacy Benefits Manager (PBM) during the download. If the PBM did not share certain NDC codes with us then downloaded medications without NDC codes will not be grouped together. [Click here to learn more about merging duplicate medications](/articles/medication-history#How%20do%20I%20merge%20and%20un-merge%20medications?). |
| Who can sign off on medication fill hisotry downloads? | Only Provider Level Users or their [prescription (Rx) delegates](/articles/staff-permissions--staff-delegates) can sign off on downloaded medication fills. |
| Can I delete medication fill history download reports? | Medication history download reports cannot be deleted. |
| Which insurers or insurance plans are supported for medication fill history retrieval? | Since insurers can change pharmacy benefits managers or use multiple pharmacy benefits managers depending on the plan, Surescripts avoided making this system dependent on participating insurers. 99% of the pharmacy benefits management companies participate in the [Surescripts network](https://surescripts.com/network-connections/eprescribing-payers-and-pbms). |
| Can the Medication Fill History Download feature be turned off? | The Medication Fill History Download feature cannot be turned off. We recommend clicking the **Sign off & Do Not Add to Med List** option to store each download as a report. This option will keep the downloaded fill history separate from the medication list you have maintained. |
| Can patients opt-out of medication fill history download? | Yes, patients can opt-out of medication fill history download by emailing Surescripts at [privacyofficer@surescripts.com](mailto:privacyofficer@surescripts.com). Once opted out at the Surescripts level, the patient’s medication history will not be shared with Elation or any other vendor using Surescripts for medication history. |
## In-house medications and injections
| How do I document oral medications that were administered in the practice? | You can use the **Instructions to pharmacy** field in the Prescription Form as a note field to indicate that an oral medication was administered to the patient in the practice. After filling out the medication details, click **Sign & Close** to save the medication to the patient’s Medication History. |
| --------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| How do I document a medication that was administered to a patient through a needle and syringe (injectables)? | There are 3 options for documenting a medication that was administered to a patient through a syringe: Using the **Instructions to pharmacy** field as a note field in the Prescription Form. • Using the Vaccine Form. • Using a Visit Note Template. [Click here to learn more about these 3 workflows](/articles/Administering-Injectables). |
| Does Elation integrate with any inventory management softwares for me to track medications I dispense in house? | Yes, Elation integrates with the following two inventory management softwares: MDScripts • FlexScan For more information about how these integrations work and the cost of these integrations, please contact our Support Team using **I need help** -> **Contact Elation Support**. |
## Prescription monitoring for controlled substance prescriptions
[Click here for the full Prescription Monitoring Program guide](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP).
| Does Elation connect with any prescription monitoring programs (PMP/PDMP)? | Elation has an integration with the Prescription Monitoring Programs (PMP/PDMP) of California, Illinois, Kentucky, Maryland, Utah, and Washington through LogiCoy, a Global Information Technology and Services integration partner. |
| ----------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Do I need to pay extra to connect with my state’s prescription monitoring program (PMP/PDMP)? | Elation will not charge customers for the setup or maintenance of the PMP/PDMP integration and states do not generally charge for the integration either. LogiCoy, our integration partner, does charge a yearly per-provider fee to maintain the integration at a special Elation rate. LogiCoy charges each full-time provider $40 per year and part-time providers $20 per year. Exceptions: Illinois - The state of Illinois is covering LogiCoy fees and Illinois providers will not be charged by LogiCoy or the state for the integration. • Washington - Washington requires an agreement with OneHealthPort (OHP), Washington’s HIE, before setting up a PMP integration. |
| Are PMP/PDMP integrations required? | Most providers are not currently required by their state to have a PMP/PDMP integration. The following states are exceptions: . Illinois- Providers based in Illinois are required to have a PMP integration as of January 1, 2022. • Washington- Practices with ten or more prescribers in Washington are required to have a PMP integration as of January 1, 2022. |
| Can I enable a PMP integration for multiple states? | Yes, PMP integrations can be set up with multiple states as long as [Elation an integration with those states](#PMP). Elation will query the correct PMP, if multiple PMP integrations are set up, based on the patient’s address. |
| Why is a PMP/PDMP integration not available for the state I practice in? | Elation is working on the capability to integrate with prescription monitoring programs (PMP/PDMP) in other states. You will be notified if and when a PMP/PDMP integration becomes available for the state you practice in. |
| How do I initiate a PMP/PDMP integration for one of the available states? | Follow the **Setting up a PMP integration** instructions in [this article](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP#pmp-setup) to initiate an integration. |
| How do I use the PMP/PDMP integration to view controlled substances that have been dispensed for a patient? | You can click the **Check PMP** button from one of the following places in a patient’s chart to see dispensed controlled substance prescription data from the PMP/PDMP integration: Under the **Permanent Rx Meds** section of the clinical Profile. • Click **Meds Hx** in the gray navigation bar at the top of the patient’s chart. • At the top of the Medication History window. A note will be left in the patient’s chronological record after a successful PMP check for documentation purposes. You can export this note to a visit note or to an office message for reference as needed. |
| Can staff use the PMP/PDMP integration? | At this time, Staff Level Users and Non-prescribing Provider Level Users cannot use the PMP/PDMP integration. |
| What happens if the PMP/PDMP check could not find the patient? | If there is no record of the patient in the PMP, a browser tab will still open in a new tab with a confirmation that no match was found. This is still a successful PMP check and a note will be recorded in the chronological record that a PMP check was performed. |
*© 2023 Wolters Kluwer N.V. and/or its subsidiaries. All rights reserved.*
## Related Articles
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [EPCS Guide- ePrescribing controlled substance medications & troubleshooting](/articles/how-to-e-prescribe-controlled-substances)
* [Prescription (Rx) Templates Guide](/articles/create-and-use-custom-rx-templates)
* [Prescription Form Guide- Viewing patient prescription benefits](/articles/Prescription-Form-Guide-patient-prescription-benefits)
* [EPCS (Electronic Prescribing of Controlled Substances) Introduction](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)
* [EPCS Guide - Signing up for EPCS](/articles/how-to-complete-the-epcs-sign-up-process)
* [Drug Decision Support Guide- Monitoring drug interactions](/articles/drug-decision-support)
* [Medication List Management Guide- Documenting, discontinuing or merging medications](/articles/medication-history)
* [Medication History Download Introduction](/articles/retrieving-previous-medication-history-for-your-patients)
* [State Prescription Monitoring Program (PMP/PDMP)](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
# Product Updates - April 2025
Source: https://help.elationhealth.com/articles/Product-Updates-April-2025
This article will describe all of the new features introduced in Elation in April 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR Updates](#EHR)
* [Streamlined Workflow for Discontinuing Medications](#discontinue_meds)
* [Enhanced Lab Ordering](#lab_ordering)
* [New Bidirectional Lab Integrations](#bidi_labs)
* [Auto-Created Chart Reporting Capabilities](#reporting)
* [Medication Lookups Display Medication Routes](#medication_routes)
* [Billing Home Navigation Change](#Billing_Home)
* [Interim Approach for Depression Quality Measures](#depression_CQMs)
* [Developer Platform Updates](#Developer_Platform)
* [Attach Chart Elements to Letters](#letters_API)
* [Stay updated](#Updates)
## Elation EHR Updates
### Streamlined Workflow for Discontinuing Medications
Our updated workflow for discontinuing medications combines multiple pathways - Discontinue, Document Discontinue, and Cancel eRx - into one clear, efficient process. The unified workflow makes it easier to discontinue meds, document medication changes, and send electronic cancel requests to pharmacies. Safer, smoother medication management for your entire care team is now available! Check out the [Help Center Guide](/articles/Prescriptions-Guide-Discontinuing-medications) for more details.
### Enhanced Lab Ordering
We’ve made several enhancements to lab ordering:
* You can now easily sign and hold lab orders until specimens are collected. The new workflow is fast, smooth, and efficient. Refer to the [Help Center Guide](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection) for more details.
* You can now associate lab tests with **specific** diagnoses, improving billing accuracy, clinical documentation, and overall patient care. Refer to the [Help Center Guide](/articles/Order-Forms-Guide-Specifying-diagnosis-codes-at-the-test-level) for more details.
### New Bidirectional Lab Integrations
The following bidirectional lab integrations are now available:
* [East Side Clinical Lab](https://www.eastsidelab.com/) - offering clinical laboratory services to customers throughout Rhode Island, Massachusetts and Connecticut.
* [HealthTrackRx](https://www.healthtrackrx.com/) - a nationwide molecular diagnostic lab specializing in PCR-based infectious disease testing. They offer fast, next-morning results to healthcare providers across the U.S.
* [Medical Diagnostics Laboratory](https://www.mdlab.com/) - a national laboratory offering molecular and genetic testing, pathology, pharmacogenomics and BRCA to customers.
* [Precision Diagnostics](https://www.precisiondxlab.com/) - a clinical laboratory specializing in toxicology and pharmacogenetics testing in the Dartmouth, Massachusetts area, with services designed to support healthcare providers in making informed decisions for patient care.
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. Refer to our [Bidirectional Lab Interface guide](/articles/Bidirectional-Lab-Interface-Guide) for more information.
### Auto-Created Chart Reporting Capabilities
We’ve added a new filter for system-generated charts - such as those created from the Booking Site or third-party integrations - to the **Patient List** report. Practices can now quickly generate a list of **Auto-Created Charts**, making it easier to identify and manage these records. Providers and staff can also include or exclude these records from other searches and reports. Refer to the [Patient List](/articles/find-patients-with-elations-patient-list) guide for more details.
### Medication Lookups Display Medication Routes
We’ve enhanced your prescribing experience with improved visibility for the medication route—sourced directly from Medi-Span, our trusted provider of comprehensive drug data. The medication route now appears when searching for medications in the Prescription Form and when creating Prescription Templates, making it easier to identify and select the correct medication.
### Billing Home Navigation Change
We’ve removed the Billing button from the Practice Home action bar to streamline navigation for EHR-only users/accounts. To access Billing Home, use the navigation button located under the **Reports** tab in the main navigation menu, which ensures a more consistent and intuitive experience.
### Interim Approach for Depression Quality Measures
At the end of 2024, Elation released **standard reporting** for the following electronic Clinical Quality Measures (eCQMs):
* [Screening for Depression and Follow-Up Plan](/articles/CMS2v14)
* [Depression Remission at Twelve Months](/articles/CMS159v13)
Elation has developed an interim approach to ensure patients are appropriately included or excluded in measure reporting, which is outlined in detail in the guides linked above. **If you are planning to report on these measures in 2025, please review the guides and follow the instructions outlined.** When automated reminders are available for these measures later this year, we will provide additional updates and guidance.
Refer to our MIPS [2025 Overview](/articles/MIPS-2025-Overview) or [Quality Category](/articles/MIPS-2025-Quality-Category) guides for more information on the program and Elation’s reporting capabilities.
## Developer Platform Updates
### Attach Chart Elements to Letters
Integrators can now attach elements of the patient chart directly to letters when creating them via the API. This new capability streamlines workflows, making it easier to include relevant clinical data in your communications.
Check out our [API documentation](https://help.elationhealth.com/articles/rest/patient-document-api/referrals/the-letter-object) for implementation details, and start leveraging this functionality today!
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates — April 2026
Source: https://help.elationhealth.com/articles/Product-Updates-April-2026
New features and improvements released across Elation EHR, Elation Billing, Elation Note, and the Developer Platform in April 2026.
## What's new
Elation Health is excited to announce our latest updates designed to enhance your experience with Elation EHR, Elation Billing, Elation Note, and the Developer Platform. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency.
## Elation EHR
### PREVENT™ Calculator Now Available in Clinical Insights
Prebuilt for practices, the PREVENT™ calculator makes cardiovascular risk tracking easier to perform and consistent across your team — right where you already work in Clinical Insights. The guideline-based calculator integrates the American Heart Association (AHA) PREVENT™ cardiovascular risk equations directly into Elation, eliminating the need to use external tools. Using chart data, it calculates 10-year and 30-year risk estimates for total cardiovascular disease (CVD), atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF). Learn more in the [PREVENT™ Cardiovascular Risk Calculator Guide](/articles/prevent-calculator).
### Enhanced Document Vaccination Form
Enjoy faster, more accurate vaccination documentation, now with barcode scanning. The updated Document Vaccination form replaces the legacy experience and supports 2D barcode scanning to auto-populate vaccine fields. We've also added a new **VIS (Vaccine Information Sheet) Given Date** field that defaults to the administered date to comply with VFC (Vaccines for Children) documentation requirements.
### Automatic EDD Calculation in Prenatal Flowsheets
We've eliminated the manual step of calculating due dates during prenatal visits. Entering or updating the **LMP** (last menstrual period) field within Prenatal flowsheets now automatically calculates and populates the **EDD** (expected delivery date) field within the flowsheet. Note that manual updates to the EDD do not update the **LMP** field. Learn more in the [Prenatal Flowsheets Guide](/articles/prenatal-flowsheets).
### Self-Service MFA Reset
MFA (multi-factor authentication) lockouts no longer need an admin or support ticket. Self-service resets now get providers and staff back on track in minutes. Locked-out users can reset their MFA factors independently by navigating to a dedicated reset page. The new reset workflow uses Stripe Identity for verification, sending a limited-time reset link to verified users along with an administrative email notification. Learn more in the [**Multi-Factor Authentication - Resetting authentication factors Guide**](https://help.elationhealth.com/articles/Resetting-authentication-factors-for-MFA#option-2-reset-your-own-factors-with-self-service-mfa-reset)**.**
### Easily Address Chart Management Issues
Get back to patient care faster without waiting on a support ticket for chart management issues. Practice administrators and staff can now restore accidentally deleted or merged patient charts directly in Elation via an updated self-service option. To find the new option, select **I need help → Restore a deleted chart**. Learn more in [Recovering Deleted Charts](/articles/patient-chart-guide-recovering-deleted-charts).
### View More CPT Code Descriptions
Save billers time and reduce errors by eliminating the need to look up unfamiliar CPT codes in a separate browser tab. Clinicians and billers can now hover over any CPT code in a bill to see a popup description. Previously, only CPT codes that a practice had manually configured in **Settings** showed descriptions. Now, hovering over any CPT code displays a short description — no configuration required.
### Bulk Bill Management in Billing Home
Give billers more direct control over pending claims. In Billing Home, users can now multi-select bills and take bulk action across them, including transmission to Elation Billing or another PMS, regardless of bill status.
### Enhanced Document Deletion Controls — Premium EHR
Prevent accidental or unauthorized deletions with a new, optional [Premium EHR](https://help.elationhealth.com/articles/Premium-EHR-Features-Guide) setting that restricts non-admin providers and non-admin staff to deleting only unsigned documents they personally created. The new setting also prevents these non-admin users from deleting patient charts entirely. Contact Elation to have this feature enabled for your practice.
## Elation Billing
### Automated Quality Coding for MIPS
Eliminate manual work with additional automated coding in [AI Billing](https://help.elationhealth.com/articles/AI-Billing-Introduction). AI Billing coding automations now add MIPS quality codes for several measures. A new setting in AI Billing — enabled by default — automates quality coding for Medicare Annual Wellness Visits. Users can choose **HCPCS** vs. **CPT II** coding and specify the payers to which the coding applies.
### Better Patient Statement Tracking
Gain more visibility into outstanding patient AR. Statement history now shows how many text and email statements were sent per batch, making it easier to see which individual patients received statements. The update includes a high-level summary and an easy drill-down to the individual patient level.
## Elation Note
The following Elation Note features are currently in beta.
### Automatic Conversion of Select Vital Signs
Reduce mental math and cognitive burden when documenting vitals, especially for young children. Height, weight, and head circumference fields in the **Vitals & Observations** block now accept input in any common unit and automatically convert to the correct unit. The updated block converts feet, inches, centimeters (cm), kilograms (kg), pounds (lb), European decimal commas, compound inputs (for example, `5'10"`), and fractions. Invalid inputs automatically revert to the last valid value.
### Copy-Paste Enhancements
Save clicks, typing, and time. Formatted text (bold, italics, underlines, hyperlinks, and tables) copied from outside Elation Note now pastes with formatting preserved.
### Full Appointment Automation
Experience a smoother, more consistent visit documentation workflow. Elation Note now syncs the full set of appointment automation data — appointment time, chief complaint, billing notes, and copay — to the note and its associated bill.
## Developer Platform
### Consolidated Documentation
All API and Hosted Database documentation is now consolidated within the Help Center, making it easier for practices to find the information they need. See the [API Reference](https://help.elationhealth.com/api-reference) and [Hosted Database](https://help.elationhealth.com/hosted-database) documentation.
## Stay Updated
To stay informed of all the latest updates to our Developer Platform services, bookmark the individual changelogs and monitor them regularly:
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog)
* [Hosted Database changelog](https://help.elationhealth.com/articles/hdb/hdb-snowflake)
# Product Updates - August 2025
Source: https://help.elationhealth.com/articles/Product-Updates-August-2025
This article will describe all of the new features introduced in Elation in August 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR Updates](#EHR)
* [A Central Place for Product Updates](#resource_center)
* [Standard EHR: A Smarter, More Flexible Way to Chart](#Elation_Note)
* [Patient Forms: Collect More Accurate Patient Information](#updated_forms)
* [Patient Forms: Annual Wellness Visit From Templates](#AWV_forms_template)
* [Quickly Identify AWV-Eligible Patients in Your Patient List](#AWV_Patient_List)
* [Medication Reconciliation](#medication_reconciliation)
* [Draft Letters in Seconds—Meet Wordsmith](#Wordsmith)
* [Dx Code Navigator for Premium EHR](#Dx_Code_Navigator)
* [Calendar Blocker](#calendar_blocker)
* [Note Assist](#Note_Assist)
* [Create Care Plans in your Patient’s Preferred Language](#care_plan_language)
* [Added Retry Button](#retry_button)
* [Developer Platform Updates](#developer_platform)
* [Explore Your Hosted Data with AI, Instantly](#Elation_Analyst)
* [Stay Updated](#changelog)
## Elation EHR Updates
### A Central Place for Product Updates
You can find all the latest Elation product updates in one easy-to-access location—right inside your workflow. We know in-app messages and pop-ups don’t always come at the right time. That’s why we’ve added a permanent **Resource Center**, where you can catch up on new features and enhancements whenever it works for you. This means fewer interruptions and more control—so you can stay informed, adopt new tools at your own pace, and get the most out of Elation.
### A Smarter, More Flexible Way to Chart
Elation Note is our new block-based charting experience—designed to give you more control, speed, and flexibility when documenting patient visits. It introduces dynamic, drag-and-drop blocks, reusable templates, and support for structured data entry—making it easier to tailor notes to your workflow.
The note includes familiar sections like HPI, Assessment and Plan, as well as custom blocks your practice can create. Custom blocks support structured fields such as checklists, dropdowns, and conditional inputs—ideal for capturing standardized, reportable data across your team. Elation Note also supports actionable clinical reminders, enabling providers to complete key interventions during the visit.
You’ll spend less time navigating rigid forms and more time focused on care. Elation Note also simplifies how practices manage templates, customize layouts, and track quality measures—giving you a faster, more adaptable way to document.
* Drag, drop, and reorder sections—including standard and custom content
* Use rich text formatting to highlight, organize, and clarify your notes
* Undo recent changes as you chart—no need to start over
* Create and customize visit templates—and remove sections you don’t need
* Chart faster with custom blocks using checkboxes, dropdowns, and other structured fields
[Click here for more information about the Elation Note](/articles/Elation-Note).
### Patient Forms: Collect More Accurate Patient Information
With the updated form builder, create and customize your patient intake forms to ensure a smoother check-in. Capture structured, accurate information from the start to save time and reduce errors.
What’s New:
* Add multiple-choice, checkboxes, dropdowns, free-text, signature fields, and more
* Customize sections, reorder or duplicate questions, and delete fields as needed
[Click here for more information about Patient Forms](/articles/Getting-Started-with-Patient-Forms).
### Patient Forms: Annual Wellness Visit From Templates
You can now use Elation’s new Annual Wellness Visit (AWV) forms template to collect and store patient information in advance, streamlining pre-visit workflows. This enhancement lets you capture data in a structured format and export it directly to the note’s Functional, Cognitive, and HPI sections—reducing manual work and helping you focus your encounters on the patient, not the paperwork. [Click here for more information about Patient Forms](/articles/Getting-Started-with-Patient-Forms).
### Quickly Identify AWV-Eligible Patients in Your Patient List
You can now use **Quick Views** in the Patient List to instantly see which patients are eligible for Annual Wellness Visits (both initial and subsequent). These views use age and past billing codes to help you surface eligible patients faster—no manual tracking needed. With **Quick Views**, you can proactively reach out, schedule visits, and ensure your practice captures eligible AWV revenue. [Click here for more information about the Patient List Report](/articles/find-patients-with-elations-patient-list).
### Medication Reconciliation
You can now reconcile medications more efficiently with Medication Reconciliation. This AI-powered tool pulls your patient's actual medication history directly from their EHR. It then highlights any medications that may need to be stopped, based on factors like missed refills, unusual doses, or a questionable need for the drug. Each flag comes with a clear explanation to support your decision-making. You can mark meds as **taking** or **not taking,** and discontinue directly from a single, streamlined view—no more toggling between screens. [Click here for more information about the Medication Reconciliation feature](/articles/Reconciling-active-medications).
### Auto-draft Letters in Seconds—Meet Wordsmith
Drafting referral orders, provider letters, and patient letters just got easier. With AI-powered **Wordsmith**, you can simply describe what you want to communicate, and instantly receive a polished draft—ready to edit or send. This optional tool helps reduce time spent on routine documentation, improves consistency, and speeds up communication—giving you more time to focus on patient care. [Click here for more information about this feature](/articles/Auto-drafting-letters-and-referrals-with-Wordsmith).
### Dx Code Navigator for Premium EHR
Previously, providers had to manually search for specific diagnosis (dx) codes for patients, or rely on their memories. Now, they can use the **Dx Code Navigator** to quickly and easily find the correct diagnosis code to reflect their patient’s condition. This workflow enables accurate coding to the highest specificity, allowing physicians to think clinically but get the right code. We are currently evaluating the most appropriate pricing and packaging for the **Dx Code Navigator** feature. You can request to have this feature turned on for your practice by submitting a **I need help** ticket. [Click here to learn more about this feature](/articles/Dx-Code-Navigator).
### Calendar Blocker
You can now use a new ‘Other Event’ type that indicates preference —like “New Patients Only” during morning slots—without blocking your availability. This means scheduling preferences can be reflected on the calendar without limiting appointment booking. It’s especially helpful managing appointments, ensuring availability remains accurate while giving practices more flexibility and control. This improvement also supports better performance of features like online booking and Quick Reschedule, which rely on up-to-date availability.
### Note Assist
#### Create Care Plans in your Patient’s Preferred Language
You now have the option to personalize Care Plans with Note Assist by automatically generating them in your patient’s preferred language. This helps ensure patients fully understand and can follow through on their care—an essential part of delivering high-quality, empathetic care.
#### Added Retry Button
Occasionally, Note Assist may miss parts of a visit or fail to generate a note due to latency or system outages, leaving you with an incomplete chart and extra manual work—or needing to contact support for recovery. To make this easier, we've added a Retry button that lets you re-process the full transcript and regenerate the visit note instantly, without reaching out to support.
## Developer Platform Updates
**Explore Your Hosted Data with AI, Instantly**
If you have a Hosted Database, you can now explore your data with **Elation Analyst**—an AI-powered chat tool that lets you ask questions in plain language and get instant answers, no SQL required. Elation Analyst helps you uncover insights, validate ideas, and run queries—without needing to hire an analyst or write complex code. For more information on Elation Analyst, look through our [Hosted Database Guide](/articles/Elation-Analyst).
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates - December 2024
Source: https://help.elationhealth.com/articles/Product-Updates-December-2024
This article describes the new features that were introduced for Elation EHR in November 2024.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR Updates](#EHR)
* [New Bidirectional Lab Integration](#bidilab)
* [Enhanced Quality Reporting](#cqms)
* [Annual Compliance Updates](#compliance)
* [New Document Tag for Clinical Quality Measure Exclusions](#doctag)
* [Lab Order Form Optimizations](#lab)
## Elation EHR Updates
### New Bidirectional Lab Integrations
The following bidirectional lab integrations are now available:
* [American Esoteric Laboratories (AEL)](https://www.ael.com/) - providing esoteric and clinical laboratory services to healthcare providers in Alabama, Arkansas, Mississippi, Missouri, and Tennessee.
* [Primex Laboratories](https://primexlab.com/) - providing clinical diagnostic testing services to clients throughout central and southern California, Nevada, and American Samoa.
The bidirectional interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. Refer to our [Bidirectional Lab Interface guide](/articles/Bidirectional-Lab-Interface-Guide) for more information.
### Enhanced Quality Reporting
Elation now provides standard reporting for two Clinical Quality Measures (CQMs) related to depression:
* Screening for Depression and Follow-Up Plan
* Depression Remission at Twelve Months
Reporting on these measures will help you stay compliant with value-based reporting requirements for ACOs as well as participate in MIPS and other payer programs.
### Annual Compliance Updates
* We’ve implemented changes to the V24/V28 blended HCC risk scoring model, and have recalculated patient risk scores in the EHR for improved care planning and documentation.
* Elation’s MIPS reporting capabilities have been updated to meet the latest standards, ensuring you can confidently fulfill reporting requirements with reduced administrative effort.
### Document Tag for Clinical Quality Measure Exclusions
Ensure accurate quality reporting and compliance while accounting for the unique circumstances of nursing home residents. The new **EXCLUSION: Living Long Term in a Nursing Home** Document Tag has been introduced to allow practices to document that a patient is excluded from specific clinical quality measures due to their status of living long-term in a nursing home. When appropriate, this exclusion reason can be used for the following measures: CMS122 (Diabetes: Glycemic Status Assessment Greater Than 9%), CMS125 (Breast Cancer Screening), CMS130 (Colorectal Cancer Screening), CMS131 (Diabetes Eye Exam), and CMS165 (Controlling High Blood Pressure). By using this feature, practices can appropriately exclude patients from these measures.
### Lab Order Form Optimizations
Experience streamlined ordering! The Lab Requisition Form has been updated to improve usability and efficiency. New search functionality has been added to the **Lab** selection fields, allowing users to quickly find the desired option. Additionally, for delegate users, new search functionality has been added to the **Ordering Provider** field and that field now also sorts providers by last name, making it easier to locate and select the correct provider.
# Product Updates - December 2025
Source: https://help.elationhealth.com/articles/Product-Updates-December-2025
This article will describe all of the new features introduced in Elation in December 2025.
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR](#EHR)
* [Discover the Latest Platform Updates](#platform_updates)
* [Pediatric Tools Available Now!](#pediatrics)
* [Clinical Insights Enhancements](#Clinical_Insights)
* [Streamline Your Documentation Printing](#note_printing)
* [Note Assist](#Note_Assist)
* [Hosted Database](#Hosted_Database)
* [Manage Employer Contracts](#employer_contracts)
* [Stay Updated](#stay_updated)
## Elation EHR
### Discover the Latest Platform Updates
The new Product Updates feed centralizes recent enhancements in a single, durable location accessible via the notification bell. An orange beacon will now alert you to new content, ensuring you never miss critical information like today’s new articles on Wordsmith and Clinical Insights.
![Elation EHR navigation bar showing the notification bell icon location in the top-right, used to access the Product Updates feed.]()
### Pediatric Tools Available Now!
Our pediatric toolkit is designed for safety, accuracy, and engagement, empowering you to nurture every child’s health journey. You can check out the [Pediatrics Guide](/articles/Pediatric-Features) for more details.
#### Visualize Pediatric Growth Milestones
\*\*The new pediatric growth chart for head circumference allows clinicians to track and visualize development for patients older than 24 months. This clinical-first enhancement ensures patient growth remains on track by comparing measurements against expected developmental standards directly within the platform. Check out the [Clinical Profile Guide](/articles/growth-charts-for-pediatric-patients) to learn more about utilizing these expanded pediatric charting tools.
\*\*
#### Track Pediatric Developmental Milestones
The Survey of Well-being of Young Children (SWYC) developmental questionnaires are now available to help clinicians monitor growth and development during critical child milestones. These comprehensive screening tools can be accessed within the Functional section of the Clinical Profile or embedded directly into patient forms to streamline data collection. Read through the [Structured Questionnaires guide](/articles/structured-questionnaires) for more information.
![SWYC 2-month questionnaire with completed Developmental Milestones responses, scoring 8 points, and BPSC scoring 12 points flagged as "Needs further evaluation or investigation."]()
### Clinical Insights Enhancements
#### Chat with Clinical Insights
Clinical Insights is now more conversational, letting you ask follow-up questions to refine insights without restarting. Context is preserved to reduce repetitive prompting and keep workflows moving. Learn more in the Help Center. Visit the [Chronological Records Guide](/articles/using-the-search-tool-in-your-patient-chart) for more details.
#### Instant Insights
Custom Clinical Insights buttons are now one click away on the toolbar, making frequent queries easier to find and faster to access.
#### Reference Recent Patient Communications
Clinical Insights now incorporates the three most recent non-visit notes, including phone, email, and other non-visit documentation, into every patient search. The platform automatically indexes newly signed non-visit notes to ensure clinicians have a comprehensive, up-to-date view of all patient interactions during the decision-making process.
![Notes toolbar dropdown expanded showing Phone Note, Non-Visit Note, Email Note (highlighted), and Point-of-Care Labs options, with the Chronological Record below displaying recent non-visit notes.]()
### Streamline Your Documentation Printing
The new Elation Note print experience offers a simplified and flexible workflow with intuitive preset modes. Clinicians can now generate high-quality printouts for clinical records, patient summaries, or billing needs directly from both draft and signed notes while viewing a live preview of the final document. Please visit the Help Center to learn more about customizing your note selections and using the new print modes.
## Note Assist
We’ve made thoughtful updates to Note Assist to help you create more accurate notes with a smoother, more intuitive experience.
### Improved note processing quality
As of January 1, 2026, Note Assist will generate the note contents at the end of the visit so that content is conclusive of any edits you've made along the way.
### An easier way to share feedback
You can now share feedback through a consistent in-workflow icon available throughout documentation. This gives you a simple way to contribute insights when it’s most relevant, without interrupting your note-writing flow.
![The feedback icon (thumbs up/down) highlighted in the Scribe panel header, with tooltip reading "Give feedback on generated note"]()
### Merge AI content into your note with confidence
The new Merge button in Elation Note lets you add AI-generated summaries directly into the patient chart. It intelligently blends content with your existing text, preserving your edits and helping prevent duplicate entries.
![Merge Note Contents button highlighted in the Note Assist transcript panel, with Start Recording and Close buttons visible below.]()
## Hosted Database
### Manage Employer Contracts
Elation Analyst users can now ask questions about Patient Tags to better manage employer contracts and track utilization metrics. This update allows direct primary care practices to demonstrate return on investment by analyzing data across every patient touchpoint. Please visit the [Hosted Database Guide](/articles/Elation-Analyst) for more information regarding this feature.
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
# Product Updates - February 2025
Source: https://help.elationhealth.com/articles/Product-Updates-February-2025
This article will describe all of the new features introduced in Elation in February 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing, Note Assist, and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR Updates](#EHR)
* [New Bidirectional Lab Integrations](#bidi-labs)
* [Edit Profile Confirmation](#edit-profile)
* [Developer Platform Updates](#developer-platform)
* [API V2 Updates](#api-V2)
* [Patient Demographics Endpoint](#patient-demographics)
* [How to stay updated](#stay-updated)
## Elation EHR Updates
### New Bidirectional Lab Integrations
The following bidirectional lab integrations are now available:
* [Core Diagnostic Laboratories](https://corediagnosticlabs.com/) - offers diagnostic testing to practices in the Birmingham, Alabama region
* [Sunrise Medical Laboratories and Sunrise Mid-Atlantic](https://www.sunriselab.com/) - offer a broad spectrum of clinical laboratory testing to practices in the New York, Maryland, D.C., West Virginia, Connecticut, and Virginia regions. Both Sunrise Medical and Sunrise Mid-Atlantic are part of the [Sonic Healthcare Group](https://www.sonichealthcare.com/).
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. Refer to our [Bidirectional Lab Interface guide](/articles/Bidirectional-Lab-Interface-Guide) for more information.
### Edit Profile Confirmation
When editing a user’s name or NPI number on the **Edit Profile** screen in **Account Details** > **User Settings**, a new confirmation pop-up will display before the changes can be saved. Changes made to names and NPI numbers will update **all previously signed** documentation. By proceeding, administrators will confirm that the updates are being made to the identifying details of the same individual ensuring accuracy and compliance across records.
## Developer Platform Updates
### API V2 Updates
Elation’s API v2 was updated on February 16, 2025 to improve JSON response formatting. The changes are available in Production. For details, please refer to the most recent [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16).
### Patient Demographics Endpoint
The preferred contact method for patients is now available in API V2 under **PatientDemographics** > **preferred\_contact**, allowing seamless integration of patient communication preferences and ensuring more effective and personalized outreach. Supported options include SMS, email, phone, and Passport. Refer to our [API V2 documentation](https://help.elationhealth.com/articles/rest/overview/introduction) for more details.
### How to stay updated
To stay informed of all the latest updates for both the API and Hosted Database, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates - February 2026
Source: https://help.elationhealth.com/articles/Product-Updates-February-2026
This article will describe all of the new features introduced in Elation in February 2026.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing, Note Assist, and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR](#EHR)
* [Choose Which In-App Messages You Receive](#in_app_messages_preference)
* [Sign Reports Directly from the Home Screen](#sign_reports)
* [Fewer Electronic Prior Authorization Delays](#ePA)
* [Customize Membership Payment Labels](#custom_payment_reason)
* [Store Multiple Patient Payment Methods](#store_multiple_payment_methods)
* [Split Membership Payments Across Multiple Cards](#split_membership_payments)
* [Note Assist](#Note_Assist)
* [Customize AI-Generated Notes to Fit Your Style](#customize_Note_Assist)
* [Elation Billing](#Elation_Billing)
* [Route Payments to the Correct Practice Entity](#payments_per_entity)
* [Manage Billing Settings in One Place](#billing_settings)
* [Safeguards for Multi-Entity Billing](#multi_entity_billing)
## Elation EHR
### Choose Which In-App Messages You Receive
Practices can now opt out of non-urgent promotional messages while continuing to receive important system alerts. This gives your team more control over your workspace and helps clinicians stay focused on patient care. To update your preferences, click **I need help** -> **Contact Elation Support**.
### Sign Reports Directly from the Home Screen
Clinicians can now review and sign reports directly from Practice Home without opening each patient chart. This streamlined workflow reduces clicks and helps you clear their inbox faster. Please visit our [Requiring Action Guide](/articles/check-for-your-offices-daily-to-do-list) for more information on using the enhanced report inbox.
### Fewer Electronic Prior Authorization Delays
Patient demographics will now automatically align with prescription eligibility records before submitting electronic prior authorizations. This helps prevent matching errors—especially for patients with hyphenated or multiple last names—so medications are approved with fewer delays. Please visit our [Prescriptions Guide](/articles/Managing-electronic-prior-authorizations) for more information on our prescribing workflows.
### Customize Membership Payment Labels
Practices can now replace the default “payment reason” text for Membership Plans with their own custom wording. This helps ensure receipts and payment pages match your practice’s contracts, compliance requirements, and patient communication style. Please visit our [Membership Management Guide](/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments#add) for more information on updating your membership plan settings.
![Edit Membership Plan dialog showing a "Payment reason" field filled with custom text "Whatever I Want to Show Up," which will appear on patient receipts and payment pages.]()
### Store Multiple Patient Payment Methods
Practices can now save multiple payment methods per patient—including credit cards and ACH bank accounts—and set a default option. Staff can quickly switch to another saved method if a payment fails, helping prevent billing interruptions.disruptions from failed transactions by allowing staff to quickly select an alternative saved method. Please visit our Help Center for more information on managing patient demographics and payments.
![Insurance, Payment, & Membership tab open for test patient2, showing two saved Visa cards (ending in 2323 marked Primary, and 3444), with options to delete each or request a new payment method.]()
### Split Membership Payments Across Multiple Cards
Patients can now automatically split recurring membership payments across multiple payment methods—such as an HSA/FSA card and a secondary credit card. This eliminates the need for staff to process separate charges and helps patients make full use of their health savings benefits while keeping membership billing automatic and reliable. See this [Membership Management Guide](/articles/Membership-Management-How-Patients-Receive-Communications#charge) for more information.
## Note Assist
### Customize AI-Generated Notes to Fit Your Style
Clinicians can now set custom instructions for Note Assist to control how AI-generated notes are structured and written. Tailor sections like HPI and A\&P to match your documentation style, reducing editing time and helping you finish charts faster. This feature is available to all Note Assist customers, including both paid and freemium plans. Please visit our [Note Assist Guide](/articles/Note-Assist-Guide-Preparation#setting-up-custom-instructions) for more information on configuring custom instructions in Note Assist.
![Note Assist settings showing HPI Format set to "Bullets" and a Custom Instructions text field, with expandable section-specific instructions for Allergies, HPI, A&P, Medications, and other note sections.]()
## Elation Billing
### Route Payments to the Correct Practice Entity
Administrators can now link patient payments to specific legal entities, ensuring funds are only applied to claims with the matching tax ID. This provides greater accuracy and control for practices managing multiple entities. Read through this [Help Center article](https://help.billing.elationemr.com/en/articles/6882487-practice-settings-setup-and-overview) for more information on managing multi-entity billing structures.
![Pediatrics practice entity settings showing Associations tab with two linked providers and Patient Payments section with Payment Processor dropdown open, displaying "Elation Stripe Payments" and "External Payments" options.]()
### Manage Billing Settings in One Place
Billing settings and legal entity configurations are now combined into a single interface. This simplified setup reduces redundancy and makes it easier for administrators to manage financial workflows. Check out the [Practice Settings article](https://help.billing.elationemr.com/en/articles/6882487-practice-settings-setup-and-overview) for more information on the updated billing settings.
### Safeguards for Multi-Entity Billing
If a patient statement includes balances tied to a non-default legal entity, patients will now be prompted to contact your practice before paying online. This helps prevent payments from being deposited into the wrong Stripe account and protects financial accuracy. Please visit our [Help Center article](https://help.billing.elationemr.com/en/articles/6882487-practice-settings-setup-and-overview) for more information on multi-TIN billing workflows.
# Product Updates - January 2025
Source: https://help.elationhealth.com/articles/Product-Updates-January-2025
This article describes the new features that were introduced for Elation EHR in January 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing and Developer Platform. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new from January 2025:
* [Elation EHR Updates](#EHR)
* [New Bidirectional Lab Integration](#bidi_labs)
* [Increase to Outbound Fax Page Limit](#fax_limit)
* [Elation Billing Updates](#Elation_Billing)
* [Manual Control Over Claim Assignment](#claim_assignment)
* [Improved Claim Visibility on the Worklist](#claim_visibility)
* [Developer Platform](#developer_platform)
* [Hosted Database Upgrade](#hosted_database)
## Elation EHR Updates
### New Bidirectional Lab Integration
The following bidirectional lab integration is now available:
* Northwell Health Labs - a full-service clinical laboratory that provides a wide range of diagnostic testing services including blood work, pathology, microbiology, molecular diagnostics, and specialized testing. It is part of Northwell Health and serves the Manhattan, Queens, Staten Island and Long Island (Nassau and Suffolk counties) regions.
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. Refer to our [Bidirectional Lab Interface guide](/articles/Bidirectional-Lab-Interface-Guide) for more information.
### Increase to Outbound Fax Page Limit
Experience less manual work and a smoother workflow when sending large faxes. We have increased the outbound faxing page limit from 20 pages to 40 pages, allowing you to more easily send larger faxes. Seamless functionality to send larger documents allows you to spend less time managing faxes and more time focusing on your patients. Please note, recipients of outbound faxes that are 40 pages or more will receive a two-page document: a cover page and instructions for retrieving the full document online via their Elation Connect account. This functionality is similar to what happened previously for faxes that were 20 pages or more.
## Elation Billing Updates
### Manual Control Over Claim Assignment
Elation Billing now gives practices more control over how they handle insurance claims. With our latest update, clinicians can manually override assignment on claims—offering greater flexibility, especially for practices managing out-of-network billing.
Previously, Elation defaulted to **Accept Assignment** on all claims, meaning practices had to agree to insurance-approved rates. Now, users have the option to decline assignment on a **claim-by-claim** basis, allowing practices to:
* Bill patients directly for services when preferred.
* Navigate out-of-network claims with more autonomy.
* Avoid administrative burdens tied to lower reimbursement rates.
### Improved Claim Visibility on the Worklist
We've added two new columns to the Elation Billing Worklist to provide clearer, more efficient claim management:
* Secondary Insurance – Now displayed directly from the patient’s insurance record, making it easier to track coverage at a glance.
* Balance – Shows the outstanding balance for each claim, helping practices prioritize follow-ups and payments.
These updates streamline billing workflows, reducing the need to navigate between screens and ensuring key claim details are always within reach.
## Developer Platform
### Hosted Database Upgrade
The Hosted Database was upgraded to version 1.8 on January 15, 2025. The updates are now available in Production, and include enhancements that improve overall data quality, facilitate more accurate analytics, and ensure streamlined and efficient access to information.
* Review the [updated schema](https://dbdocs.io/hosteddb_support/hosted_database_snowflake)
* Review the most recent [changelog](/articles/hdb/hdb-snowflake)
# Product Updates - January 2026
Source: https://help.elationhealth.com/articles/Product-Updates-January-2026
This article will describe all of the new features introduced in Elation in January 2026.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR and Billing applications. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR](#EHR)
* [Celebrate Award-Winning Clinical Excellence](#KLAS)
* [More Pediatric Tools Available Now!](#pediatric_tools)
* [Personalize Patient Communications](#patient_list)
* [Navigate Charts with Clarity](#clinical_insights)
* [Elation Billing](#Elation_Billing)
* [Capture Every Offline Payment with Ease](#offline_payments)
* [Sync non-Stripe payments seamlessly](#non_Stripe_payments)
* [Developer Platform](#Developer_Platform)
* [Stay Updated](#stay_updated)
## Elation EHR
### Celebrate Award-Winning Clinical Excellence
Elation Health has been named Best in KLAS 2026, earning the #1 ranking for Small Practice Ambulatory EHR/PM: Independent (1–10 Physicians) in the 2026 Best in KLAS: Software and Services report for the second consecutive year. Because KLAS rankings are based entirely on clinician feedback, this recognition reflects the real-world experiences of independent primary care practices and reinforces Elation’s commitment to a clinical-first platform built to reduce administrative burden and support strong physician–patient relationships.
![]()
### More Pediatric Tools Available Now!
Our pediatric toolkit is designed for safety, accuracy, and engagement, empowering you to nurture every child’s health journey. You can check out the [Pediatrics Guide](/articles/Pediatric-Features) for more details.
#### Streamline Autism Screening for Pediatric Care
Clinicians can now access the Modified Checklist for Autism in Toddlers (M-CHAT-R) directly within the Cognitive section of the Clinical Profile or embed the questionnaire into patient forms. This integration eliminates manual documentation steps and ensures a seamless screening process for practices serving pediatric populations. Please visit our Help Center to learn more about incorporating this clinical tool into your existing workflows. Check out the [Clinical Structured Questionnaires guide](/articles/growth-charts-for-pediatric-patients) for more information.
![]()
#### Monitor infant growth trends accurately
Practices can now access the WHO 0-24 month weight-for-length growth chart automatically whenever growth charts are launched. This addition eliminates the need for manual charting and allows clinicians to visualize patient development against standard growth percentiles instantly. Read through the [Clinical Profile guide](/articles/growth-charts-for-pediatric-patients) for more information.
![]()
### Personalize Patient Communications
Elation Health now includes the Preferred Name column in patient CSV exports to ensure outreach lists reflect the chosen names stored in patient charts. This update reduces manual reconciliation for staff and prevents misnaming during offline workflows, fostering a clinical environment where every patient feels seen and respected. Please visit our [Patient List Report Guide](/articles/find-patients-with-elations-patient-list) for more information on managing patient exports.
### Navigate Charts with Clarity
Elation Health has redesigned the chart search bar and Clinical Insights entry point to align with our modern, clinical-first interface. This update reduces friction by streamlining search behaviors and making AI-powered insights easier to discover without requiring staff retraining. By refining these essential workflows, we help your team find critical information more quickly while building a stronger foundation for future AI-driven enhancements. Please visit our [Chronological Record Guide](/articles/using-the-search-tool-in-your-patient-chart) for more information on using the enhanced chart search and Clinical Insights.
![]()
## Elation Billing
### Capture Every Offline Payment with Ease
Your staff can now record offline patient payments in Elation even when a patient lacks a verified email address or SMS number. This update removes clinical and administrative blockers by allowing the front desk to print physical receipts on the spot, ensuring complete financial records for every patient interaction.
### Sync non-Stripe payments seamlessly
All-In-One (AIO) practices can now record non-Stripe payments directly in the EHR and sync them automatically to Elation Billing. This update supports accurate revenue reporting and serves as a foundational step toward managing patient collections across multiple tax IDs. Please visit our Help Center for detailed guidance on recording these payments and managing your financial workflows.
![]()
## Developer Platform
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates - July 2025
Source: https://help.elationhealth.com/articles/Product-Updates-July-2025
This article will describe all of the new features introduced in Elation in July 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR Updates](#EHR)
* [A Central Place for Product Updates](#resource_center)
* [Simplify Prior Authorizations from the Start](#ePA)
* [See Patient Trends at a Glance with Magic Table](#search_tables)
* [New Bidirectional Lab Integrations](#bidi_labs)
* [Improved Subscription Access for Admin Users](#subscription)
* [Elation Billing Updates](#Elation_Billing)
* [Enhanced Denials Reporting](#denials_reporting)
* [Developer Platform Updates](#Developer_Platform)
* [Stay Updated](#updates)
## Elation EHR Updates
### A Central Place for Product Updates
You can find all the latest Elation product updates in one easy-to-access location—right inside your workflow. We know in-app messages and pop-ups don’t always come at the right time. That’s why we’ve added a permanent Resource Center, where you can catch up on new features and enhancements whenever it works for you. This means fewer interruptions and more control—so you can stay informed, adopt new tools at your own pace, and get the most out of Elation.
### Simplify Prior Authorizations from the Start
Prior authorizations have long been a source of delays and admin burden. Elation’s new electronic prior authorization (ePA) streamlines the process—letting clinicians initiate PAs directly from the Prescription Form and manage all activity in a centralized Worklist. By reducing turnaround times and eliminating the need for faxes, portals, and spreadsheets, ePA helps practices move faster, stay organized, and focus more on patient care. For more information, check out the [Prescription Guide](/articles/Managing-electronic-prior-authorizations)!
### See Patient Trends at a Glance with Magic Table
The new Magic Table gives you a smarter, more intuitive way to review labs and vitals—right in the patient chart. It organizes data chronologically from left to right, shows the most recent values next to clear labels, and includes helpful features like units, quick search, and visual consistency across the record. You can quickly spot trends, track changes over time, and make faster clinical decisions without hunting through cluttered lists or raw numbers. It’s designed to reduce mental effort, improve onboarding, and lay the groundwork for powerful AI features—helping you interpret complex data with less friction and more confidence. [Click here for more information](/articles/using-the-search-tool-in-your-patient-chart).
### New Bidirectional Lab Integrations
The following bidirectional lab integrations are now available:
* Millennium Health - a national specialty lab that supports clinicians in all states with drug testing services to monitor prescription use, illicit substance exposure, and treatment effectiveness.
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. [Click here for more information](/articles/Electronic-Lab-Order-Form).
### Improved Subscription Access for Admin Users
This new feature streamlines access to billing and payment information for admin users. A direct link to Recurly will now appear on the Manage Users page, provided a valid Recurly link exists for the practice in Salesforce.
This enhancement allows admin users to:
* View invoices
* Manage payment methods
* Update billing contacts
## Elation Billing Updates
### Enhanced Denials Reporting
Gain insights on your denied claims with Denial Reporting features in Elation Billing. New Lightning Insight reports slice denial data by reason code, payer, and more while drill-down capabilities help you work denials more easily. If more customized analysis is needed, no problem! A new Lightning Report lets you download a full list of denied claims for further review. Check out our [Denial Reporting article](https://help.billing.elationemr.com/en/articles/11682857-denials-reporting) for more information.
## Developer Platform Updates
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates — July 2026
Source: https://help.elationhealth.com/articles/Product-Updates-July-2026
New features and improvements released across Patient Passport, Elation EHR, Elation Billing, and the Developer Platform in July 2026.
## Patient Passport
### Expanded Tools in Patient Passport
Patients can complete forms directly from Passport and join virtual visits with one tap. Appointment detail cards in Patient Passport now surface visit instructions, patient forms with completion status, and a meeting join link for virtual appointments. For more information, see [Patient Passport Guides](/patient-passport).
## Elation EHR
### Manage Scheduled Work When Terming Users
New workflows help you manage and transition patient care appropriately when a provider leaves your practice. When disabling access for provider-level users, practice admins now have the ability to generate reports for both future scheduled appointments and post-dated (future) messages. For staff-level inactivations, only the message report is available for download. For more information, see [Best practices for deactivating accounts](/articles/User-Accounts-Guide-Best-practices-for-deactivating-accounts) and [Managing User Accounts](/articles/managing-user-accounts).
### Lab Orders Settings: Pagination and Search
A faster, easier way to work in select Settings pages is now available.
* The Lab Orders settings page now loads lab order sets grouped by vendor and compendium, each with its own paginated, searchable, alphabetized list. For more information, see [Managing Lab Order Sets](/articles/Managing-lab-order-sets).
* The Templates settings page now has tabbed navigation across Physical Exam, Review of Systems, Letters & Referrals, and Visit Note templates. For more information, see [Templates Settings](/articles/templates-settings).
### Non-Visit Note Templates Now Available
Simplify phone call documentation and care coordination workflows, particularly for PACE and value-based care teams. Non-visit note templates are now available to all practices using Non-Visit Notes, supporting accurate billing and regulatory reporting. For more information, see [Non-Visit Note Templates](/articles/non-visit-note-templates).
### Require Payment Method Upon Appointment Booking
To help ensure your practice can recoup costs for missed appointments, you can now require patients to add a valid credit card or bank account (ACH) to their record before booking a self-scheduled appointment. No charge is made at booking; the payment method is only verified and stored on file. For more information, see [Patient Booking Site](/articles/Patient-Booking-Site).
### Improved Letter Drafting in Wordsmith
Fuller access to chart details and refined prompts drive higher-quality, more accurate letters from Elation's AI-powered letter-writing tool, Wordsmith. For more information, see [Wordsmith](/articles/Auto-drafting-letters-and-referrals-with-Wordsmith#what-does-wordsmith-do).
## Elation Billing
### Configure Patient Statements for Each Legal Entity
Ensure patients receive clear, accurate, and correctly branded statements. Practices can now configure statement settings per practice entity, including business name, phone number, payment plan messaging, and Stripe account. The system automatically selects the correct entity when sending a statement, based on the outstanding claim. For multi-stripe practices, the patient-facing payment portal also now automatically uses the appropriate Stripe account. For more information, see [Practice Entities](/articles/practice-settings-setup-and-overview#practice-entities).
## Developer Platform
### Enhanced Billing & Financial Reporting
New improvements to Hosted Database reporting for the Elation Billing solution provide greater visibility into your financial data.
* **Generate more granular financial and operational reports** with `billing_status_detail` exposing full bill status (Signed, Awaiting sign-off, Received by PMS) and four provider reference columns (rendering, referring, supervising, ordering) now denormalized on the bill table — no joins required
* **Build complete claim context and reporting** with five new lookup tables (`legal_entity`, `worklist`, `worklist_reason`, `tag`, `tag_system`) providing the reference data surrounding EB claims
* **Track patient responsibility and statement workflows** via new `patient_guarantor` (demographics), `patient_statement_tracking` (statement state), `user_practice` (practice membership), and `elation_sso_user` (EHR-EB user cross-reference) tables
* **Analyze payer relationships and transaction capabilities** with the new `payer` table offering a unified view of every practice payer, paired with the Claim.MD directory — including payer type, alternate names, and supported transaction types (eligibility, ERAs, claims)
For more information, see [HDB Release Notes](https://help.elationhealth.com/articles/hdb/2026-07-29).
### HDB Change Log and RSS Feed
Stay updated on HDB changes automatically. An RSS feed is now available so customers can subscribe and be notified of every new release. The release notes page has also been rebuilt as a standardized change log with per-release entries, GA/Beta tags, and links to full notes. For more information, see [HDB Release Notes](/articles/hdb/hdb-snowflake).
# Product Updates - June 2025
Source: https://help.elationhealth.com/articles/Product-Updates-June-2025
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Note Assist, and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR](#EHR)
* [Added Quick Reschedule](#reschedule)
* [Tightened Chart Access Permissions](#restrict_access)
* [Created Chronological Records Filters](#chart_filters)
* [Insurance Management](#insurance_management)
* [Self-Service MFA Capabilities](#MFA)
* [New Bidirectional Lab Integrations](#bidi_labs)
* [Note Assist](#note_assist)
* [Added Medication Change Actions](#medication_actions)
* [Developer Platform](#developer_platform)
* [Created Insurance-Policy-Specific Endpoints](#insurance_policy)
* [Stay Updated](#updates)
## Elation EHR Updates
### Added Quick Reschedule
Quick Reschedule streamlines the process of moving appointments by letting you instantly select a new date and time for a patient visit—all without leaving your current workflow. With just a few clicks, you can rebook appointments and keep both your schedule and your patients on track. This feature reduces manual steps and eliminates the need to cancel and re-create appointments, saving your practice valuable time. [Click here to learn more about this feature](/articles/how-to-use-elation-calendar#reschedule).
### Tightened Chart Access Permissions
If you're a[Premium EHR](/articles/Premium-EHR-Features-Guide) user, you now have full control over who can access sensitive patient charts in your practice. With flexible options to block or restrict access by individual, patient cohorts, or provider assignment, you can protect privacy for VIP, behavioral health, and other confidential records. These safeguards let you meet strict privacy standards and ensure only authorized team members can view or act on sensitive chart information. [Click here to learn more about these permissions](/articles/User-Accounts-Guide-Chart-access-permission-options).
### Created Chronological Records Filters
Over time, a patient’s Chronological Record becomes bloated with documentation making it difficult for clinicians to find pertinent patient data. This creates obstacles in caring for their patients and increases the time it takes to prepare for patient visits, practice clinically and document patient care. You can now use quick filters Note Type, Document Type, and My Last Visit Note directly under the search bar. This will make it easier for users to navigate the chronological record and find documents they are looking for quickly. [Click here for more information about chronological record filters](/articles/using-the-search-tool-in-your-patient-chart).
### Insurance Management
Elation’s enhanced Insurance Management streamlines how you handle patient insurance details, making it easy to update information, access both current and historical records, and [verify eligibility](/articles/Real-Time-Eligibility) right in your workflow. You can efficiently swap primary and secondary insurances without data loss and quickly reference insurance cards. This dramatically improves billing accuracy, reduces administrative headaches, and helps you deliver a smoother patient experience—all within your existing EHR. [Click here for more information about Insurance Management](/articles/Patient-Demographics-Insurance-Management).
### Self-Service MFA Capabilities
Multi-factor Authentication (MFA) reduces disruptions along with more flexibility and convenience. You can now add or remove authentication factors and manage your own login options directly through self-service in Account Details. These enhancements give you more control over how you login while maintaining strong security. Please note, this update does not impact Single Sign-On (SSO) users. Refer to our [MFA Guide](/articles/Multifactor-Authentication-MFA) for more information.
### New Bidirectional Lab Integrations
The following bidirectional lab integrations are now available:
* Cove Diagnostics - a clinical laboratory specializing in infectious disease testing via PCR, as well as genetic testing for most major diseases. They support patients and providers in all U.S. states except New York and California.
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. [Click here to learn more about eOrdering](/articles/Electronic-Lab-Order-Form).
## Note Assist Updates
### Added Medication Change Actions
Actions now further streamlines your prescribing workflow by automatically pre-filling prescription details—such as medication name, strength, and directions—when it recognizes medication changes spoken during the visit. Prescription forms are auto-filled from your documentation, reducing manual entry and saving time. With fewer steps and less room for error, you can prescribe faster and more confidently. Click here for more information about [Actions](/articles/Note-Assist-Guide-Using-Note-Assist).
## Developer Platform Updates
### Created Insurance-Policy-Specific Endpoints
Access new, insurance-policy-specific APIv2 endpoints if your organization has Insurance Management enabled. These dedicated endpoints give you more precise and reliable control over insurance data, making integrations cleaner and future-proofed. Full APIv2 documentation will be available soon.
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates — June 2026
Source: https://help.elationhealth.com/articles/Product-Updates-June-2026
New features and improvements released across Patient Passport, Elation EHR, Note Assist, Elation Note, Elation Billing, and the Developer Platform in June 2026.
## Patient Passport
### Native Mobile Apps (iOS & Android)
Native Passport apps are now live on iOS and Android, including Elation's first-ever Android app! The new Passport mobile apps support all web app functionality plus biometric login (Face ID/Touch ID).
### Now Available in More Languages
Patients who speak Chinese, Japanese, Korean, Tagalog, or Vietnamese can now use Patient Passport in their own language. These languages were selected because they are spoken by a significant number of Elation patients whose first language is not English or Spanish.
### Enhanced Patient (User) Settings
Patients with access to multiple charts can now choose which chart displays by default when they log in to Passport. A new Manage Access page lets patients set their primary chart and remove access to charts they no longer need, without contacting support.
### Clearer Registration Link Messaging
Patients who click an already-used Passport registration link now see a clear explanation with a direct link to log in. Patients with a truly expired, unused link can request a new invitation directly from the page — replacing a generic "Registration Unavailable" error.
### Print Immunization History
Passport users can now download and print just the immunization history from a patient chart, without including other medical record data. This feature is especially valuable for pediatric patients who need vaccine records for school and sports physicals.
### Print Messages
Patients can now print their Passport messages directly from the new Passport experience, addressing a print-formatting gap that was generating support cases. Attachments print separately from the message itself.
## Elation EHR
### Amendment Workflow
Reduce ambiguity related to note amendments. Additional details show exactly who requested a change, when, and its current status, with distinct actions for amending vs. documenting.
### Restore Deleted Notes and Reports
Clinicians and staff can quickly restore a note or report that was deleted in error. From an open chart, select the **Help** button in the blue Elation toolbar, then select **I accidentally deleted a note or report.** A list of deleted reports and notes for the patient will display, and one click of the **Restore** button will restore the desired record.
### Clearer Cancel Notifications
Cancel Prescription (CancelRx) notifications in Practice Home now use more descriptive labels, making it easier to distinguish between a failed ePrescription, a rejected cancellation request, and an unanswered cancellation request. Users can also choose, per prescription, whether to receive a notification if a cancellation request goes unanswered.
### "Received by Pharmacy" Badge
A new badge in the ePrescribing workflow confirms when a pharmacy has received an electronic prescription request (eRx). The badge makes it clear to prescribers that an eRx was successfully sent to the pharmacy, and helps reduce the instances of unnecessary escalations between practices, Elation, our prescribing network, and the pharmacy.
### Fax Outbox
Elation's new Fax Outbox feature, available on the main toolbar in Practice Home, delivers a consolidated view of every outbound fax sent by anyone at your practice, with real-time delivery status. Failed faxes are retried automatically, and users can resend, fix the fax number, or cancel without rebuilding the original letter or referral.
### Staff Preview for Patient Forms
Preview exactly how a patient form appears to patients before sending it. A new **Preview** button is available in the Patient Forms activity in EHR settings.
### Spanish-Language Structured Demographics Forms
Demographic forms can now be completed in English or Spanish, helping patients provide information in the language they're most comfortable using.
When you create a Patient Form using the standard Demographics Template provided by Elation, the patient will be able to complete the form in either English or Spanish. The form will default to Spanish when the patient's preferred or device language is Spanish. Please note, only the standard demographics fields are translated; customized text will appear in English.
### Failed Payment Visibility
Quickly see why membership payments fail — insufficient funds, card expired, etc. — from the new **View Failed Payments** report, accessed from the **Payments** button drop-down on Practice Home. A live count badge shows active failures, and the Stripe failure message column shows the specific error. The report includes both credit card and ACH payment failures.
### Clearer Patient Payment Decline Messaging
When a DPC membership payment is declined by Stripe, patients now see the specific reason (e.g., "insufficient funds," "card expired") instead of a generic error, helping them understand what went wrong and how to fix it.
### Enhancements for Clinical Insights
Clinical Insights now has access to additional medication context and provides more transparency regarding time windows and data limitations affecting its answers.
### Barcode Scanner Calibration Tool
A new self-service calibration page lets you verify that your handheld vaccine barcode scanner is configured correctly, checking for the Group Separator delimiter and scan terminator that Elation needs to auto-fill NDC, lot number, and expiration. The tool does not require an additional login and does not store patient data.
### Quest eOrder Requirement
When creating a Quest eOrder with the Bill Type designated as **third-party**, the patient's insurance carrier address must be complete, or a warning will display. To remove the warning, update the insurance carrier address accordingly. The insurance carrier validation is a result of Quest integration requirements.
### Vitals Auto-Conversion
Pediatric and family medicine providers can now type weight and height in kilograms and centimeters, and Elation converts the measurements automatically into pounds (lbs) and inches (in).
## Note Assist
### Note Assist Transcript Copy and Download
Clinicians can now copy or download their visit transcript directly from the Note Assist transcript tab. Downloads save as a `.txt` file named with the note ID and date, giving clinicians a supported way to retain transcripts for personal or workflow records.
## Elation Note
*Elation Note is Elation's newest visit note workflow, currently in beta.*
### Co-Sign Elation Notes
Practices with residents, NPs, or co-signature requirements can now co-sign Elation Notes, with activity logged for compliance.
## Elation Billing
### Payment Plan Messaging Toggle on Patient Statements
Practices can now choose whether or not patient statements mention payment plans, preventing confusion for practices that do not offer them.
### Send \$0 Claims for Reporting Purposes
Value-based practices can now report \$0 claims without clearinghouse rejection by enabling a new "Zero Dollar Claims" setting in Billing Rules. When activated, qualifying claims are automatically tagged with the proper reporting code.
### AI Coding Citations
AI-suggested CPT and DX codes now include a citation icon showing a plain-language rationale and the exact visit note text supporting each suggestion.
### AI Coding: Telehealth Modifiers and POS Auto-Population
AI Coding now populates the correct Place of Service and modifier 95 for telehealth visits, with citations explaining each addition, eliminating the need for clinicians to manually add this documentation.
### AI Coding Now Reads Lab and Vaccination Data
AI Coding now incorporates recent lab measurements (including point-of-care labs) and vaccination history when generating codes within the Billing section of a visit note. This feature is particularly valuable for quality coding requirements.
## Developer Platform
### HDB: Additional Elation Billing Data Now Available
HDB customers can now query billing claims and charge-level line items. Claim-level payer/provider/patient detail plus individual service-line charges can be queried, joined via `charge.claim_id`, enabling full claim and charge-level reporting alongside existing ERA data.
### API: User Impersonation
APIv2 now supports an optional `X-On-Behalf-Of` header that attributes API actions to a specific user in the practice rather than the generic service account. This enhancement is useful for integrations creating visit notes, orders, or other records on behalf of a specific provider.
### HDB: Prior Authorization Table in Elation Billing Schema
HDB customers on Elation Billing can now query prior authorizations directly — payer, auth number, units, validity window — and join them to claims via `claim.authorization_id` for renewal dashboards and payer-mix reporting.
### HDB: Documentation Update
We have reorganized the Hosted Database dbdocs page to be easier to navigate.
# Product Updates - March 2025
Source: https://help.elationhealth.com/articles/Product-Updates-March-2025
This article will describe all of the new features introduced in Elation in March 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing, and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR Updates](#EHR)
* [PMP State selection for multi-state practices](#PMP)
* [New Bidirectional Lab Interface](#Bidi_Labs)
* [Elation Billing Updates](#Elation_Billing)
* [Refinements to Lightning Insights](#Lightning_Insights)
* [Developer Platform Updates](#Developer_Platform)
* [Webhook subscriptions for Document updates](#new_webhooks)
* [Stay updated](#stay_updated)
## Elation EHR Updates
### PMP State selection for multi-state practices
Eliminate the risk of inaccurate PMP requests due to location discrepancies. Providers in practices with multiple locations across **different** states who use Bamboo PMP can now set their current practicing state, ensuring more accurate PMP requests and a smoother workflow.
When a provider clicks **Check PMP**, they will be prompted to select their current state. This selection is saved to the **computer** they are using, so they won’t be asked again unless they switch devices. If a provider needs to update their state, they can easily do so by selecting **Edit PMP State** under the Med Hx dropdown in the toolbar. Ensure accurate PMP checking and make compliance and medication history checks more seamless for providers working across multiple states! [Click here for more information about the Bamboo PMP Integration](/articles/Prescription-Monitoring-Program-Integration-Bamboo-Health).
### New Bidirectional Lab Interface
The following bidirectional lab integration is now available:
* [Tribal Diagnostics](https://tribaldiagnostics.com/) - a full-service, CAP-accredited clinical laboratory that partners with all providers but has a passion for underserved communities in Texas, Louisiana, Oklahoma, and Missouri.
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. Refer to our [Bidirectional Lab Interface guide](/articles/Bidirectional-Lab-Interface-Guide) for more information.
## Elation Billing Updates
### Refinements to Lightning Insights
Get clearer, more actionable insights with a smoother experience. We've introduced several small but meaningful enhancements to **Lightning Insights** that improve clarity, usability, and visual presentation:
* **Simplified date display**: Date values in the visualization tables\*\* are now shown in a single column (e.g., Feb 7, 2025 or Feb 2025) instead of separate Year, Month, and Day columns, making the data easier to read and work with.
* **Report date context**: When viewing a report, you’ll now see the date range used to generate the report displayed clearly beneath the report title.
* **Visual enhancements**: We’ve added more intuitive snapshot report names, clearer row indicators (+ / - replacing up/down arrows), and color-coded rows (green for increases, red for decreases) to make changes stand out at a glance. Additionally, the KPI reports have been renamed for clarity and consistency.
## Developer Platform Updates
### Webhook subscriptions for Document updates
Stay informed about changes to important documents! Integrators can now subscribe to receive webhooks when Document Tags (Doctags) are updated for the following document types:
* Visit Notes
* Non-Visit Notes
* Letters
* Reports
Enhance real-time notifications and enjoy a smoother, more efficient integration with your workflows. Refer to our [API and Webhooks](https://help.elationhealth.com/articles/rest/overview/webhooks) documentation for more information.
### Stay updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates — March 2026
Source: https://help.elationhealth.com/articles/Product-Updates-March-2026
New features and improvements released across Elation EHR, Elation Billing, and the Developer Platform in March 2026.
## What's new
Elation Health is excited to announce our latest updates designed to enhance your experience with Elation EHR, Elation Billing, Note Assist, and the Developer Platform. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency.
## Elation EHR
### Review Charts Faster with Intelligent AI Caching
AI medication analysis now uses intelligent caching to instantly return medication insights when you review the same patient multiple times within a 24-hour period. The cache automatically refreshes when clinical prompts or models change, so recommendations stay accurate while wait times for repeat chart reviews drop significantly. Learn more in our [Clinical Insights AI FAQ](/articles/clinical-insights-ai-faq).
### Complete Reports Without Leaving Your Inbox
Clinicians can now preview reports, add annotations (text, signatures, dates, and checkmarks), and generate Provider Letters directly from the **Practice Home** Reports queue. The new workflow eliminates the need to open patient charts or rely on print-sign-scan processes, helping you complete high-volume report tasks faster and reduce after-hours administrative work. See our [Requiring Action Guide](/articles/check-for-your-offices-daily-to-do-list) for more on managing your daily inbox.
### Streamline Vaccination Records Across Multiple Locations
Vaccination records can now be saved with location-specific details, automatically populating fields like lot number and expiration date based on both the vaccine and the location where it was administered. For practices with multiple sites where vaccine inventory varies by location, this saves time while reducing documentation errors and supporting accurate, compliant records. See the [Vaccination Form Guide](/articles/Vaccination-Form-Guide) for related workflows.
### Simplify Workflows with Workspace-Specific Controls
Admins can now control the visibility of appointment types, rooms, and prescription templates within specific workspaces. Users only see the options relevant to their workspace when scheduling appointments, updating appointment statuses, or prescribing medications. For practices with multiple locations, these controls simplify decision-making, reduce errors, and streamline workflows by surfacing only context-appropriate options. Learn more in our [Workspaces Guide](/articles/workspaces-guide).
### Start Visit Notes with Pre-Configured Templates
Elation Note templates can now be configured for appointment types in **Settings → Calendar & Booking**. When a clinician clicks **Start Visit Note** from the calendar, Elation automatically creates an Elation Note and applies the configured template in a single step. Clinicians save clicks and setup time, and practices can drive more consistent documentation across visits with centrally managed templates. See our [Calendar and Booking Settings](/articles/calendar-and-booking-settings) article for related configuration steps.
### Reconcile Medications with Automatic Merging
The medication reconciliation workflow now automatically merges identical medications, and users can also merge and unmerge medication threads manually. Only identical medications merge automatically — brand and generic medications and different dosages remain separate. With automatic assistance from Elation, managing medication lists becomes far less laborious, streamlining the entire medication reconciliation workflow. See our [Reconciling Active Medications](/articles/Reconciling-active-medications) and [Merging and Reconciling Downloaded Medications](/articles/mergingreconciling-downloaded-meds-with-existing-meds) guides for details.
![Reconcile Medications panel showing busPIRone and Cotempla marked "Auto Merged," GoodSense flagged "Likely Not Taking" with "Merge with other med" action visible, and Lipitor and Lisinopril marked "Merged"]()
## Elation Billing
### Activate AI Billing on Your Own Timeline
Practices can now enable AI Billing independently through a new self-service workflow in settings, complete with built-in guidance and configuration prompts. The feature removes the need for support calls or onboarding appointments, allowing your practice to explore AI-assisted billing workflows when it works best for you. Read more in [AI Billing Introduction](https://help.elationhealth.com/articles/AI-Billing-Introduction).
### Capture More Revenue with Smarter Coding Suggestions
AI Billing now includes enhanced quality coding logic that analyzes encounter documentation more deeply to suggest clinically appropriate diagnosis and procedure codes with greater accuracy. The improved AI-generated suggestions help practices capture appropriate revenue, reduce claim denials, and maintain documentation standards while reducing cognitive load during charge entry.
### Manage Multi-Entity Configurations with Confidence
Practice entity configuration now provides clearer visibility and more intuitive controls for managing legal entities, locations, and associated billing settings. Administrators can review and edit entity-level configurations — including NPI, Tax ID, and address details — with improved validation and inline guidance. Read more in the [Entity Configuration article](https://help.elationhealth.com/articles/practice-settings-setup-and-overview#practice-entities).
### Tag Emergency Charges for Accurate Reimbursement
Elation Billing users can now tag appropriate charges with the **EMG / Emergency Indicator** attribute at the charge level. Practices have a way to indicate when the emergency indicator (box 24c on the CMS-1500 form) should be tagged, helping ensure timely and correct payment while removing the need for workarounds such as printing the claim form to fill it out manually.
![Charge Line Note dialog with EMG checkbox checked and EPSDT and Family Planning unchecked, alongside an empty Line Note field and Saved Line Notes button]()
### Access Multiple Stripe Accounts
Practices that bill under multiple Tax IDs can now connect and manage separate Stripe accounts for each entity. The flexible payment configuration ensures patient payments are processed through the appropriate Stripe account based on the billing entity, streamlining revenue collection while maintaining accurate financial records across your organization.
![Patient Payments settings showing two connected Stripe accounts: "Thor - Asgard" (Primary Account) and "Tobias Funke," each with a "Connected" status and a "Manage Account" link.]()
![Patient Payments section of the Pediatrics entity settings, with Payment Processor dropdown open showing Stripe Accounts: "Thor - Asgard (Primary Account)" and "Tobias Funke," plus an "External Payments" option.]()
## Stay Updated
To stay informed of all the latest updates to our Developer Platform services, bookmark the individual changelogs and monitor them regularly:
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog)
* [Hosted Database changelog](https://help.elationhealth.com/articles/hdb/hdb-snowflake)
# Product Updates - May 2025
Source: https://help.elationhealth.com/articles/Product-Updates-May-2025
This article will describe all of the new features introduced in Elation in May 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing, Note Assist, and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR Updates](#EHR)
* [RxInform: Automated Medication Texts for Patients](#RxInform)
* [Self-Service MFA Capabilities](#MFA)
* [New Bidirectional Lab Integration](#bidi_labs)
* [Visual Updates to Patient Demographics](#demographics)
* [Note Assist Updates](#Note_Assist)
* [Expanded Language Support](#languages)
* [Developer Platform Updates](#developer_platform)
* [Enhanced Reports Endpoint](#Reports)
* [Stay Updated](#stay_updated)
## Elation EHR Updates
### RxInform: Automated Medication Texts for Patients
Help patients stay on track with their medications—effortlessly. RxInform sends automated text messages to adult patients when a prescription is sent to the pharmacy. These timely messages include medication and pharmacy details, along with manufacturer coupons when available, making it easier for patients to follow your care plan. It’s a seamless way to improve medication adherence and enhance communication—without adding to your workload.
RxInform is a free service for all Elation customers. It requires virtually no change to your prescribing workflow and can help cut down on follow-up calls and messages to your practice. Patients can opt out at any time, and clinicians or staff can manage opt-outs in Patient Demographics or per prescription. If your practice is not activated for RxInform, an admin can enable it in **Security & Privacy** settings. Learn more in our [RxInform guide](/articles/prescription-reminders-for-patients).
### Self-Service MFA Capabilities
Existing Multi-factor Authentication (MFA) users will enjoy fewer disruptions along with more flexibility and convenience. You can now add or remove authentication factors and manage your own login options directly through self-service in Account Details. These enhancements give you more control over how you login while maintaining strong security. . Please note, this update does not impact Single Sign-On (SSO) users. Refer to our [MFA Guide](/articles/Multifactor-Authentication-MFA) for more information.
Additionally, Elation is currently rolling out Multi-Factor Authentication (MFA) for all Elation users. Look for important updates in-app if you have not yet enabled MFA for your practice.
### New Bidirectional Lab Integration
The following bidirectional lab integration is now available:
* St. Joseph’s Hospital Medical Center Lab - providing specialized laboratory services tailored to oncology patients. Please note this is an Arizona specific location, not the St. Joesph's located in California or Oregon.
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. Refer to our [Bidirectional Lab Interface guide](/articles/Bidirectional-Lab-Interface-Guide) for more information.
### Visual Updates to Patient Demographic
Locate patient contact details faster! The Contact Information section of Patient Demographics now sports a crisp, easy-to-scan layout. SMS opt-in status stands out, contact details are neatly organized, and picking a state is effortless. Plus, when you add a previous address or emergency contact, you can start typing immediately—no extra clicks, just faster data entry to keep your day moving.
## Note Assist Updates
### Expanded Language Options
Clinicians can deliver more personalized care with enhanced language support, and experience the benefit of Note Assist with more patients! Note Assist now supports 12 additional languages in addition to English and Spanish—all within Elation. When you select a language, Note Assist seamlessly captures both English and the chosen language, making conversations with patients more natural. Spoken content is detected and transcribed in real time, but the final clinical note is always generated in English to ensure clear documentation and streamlined workflows. Note Assist also remembers your choice for next time, streamlining future encounters. Refer to our [Note Assist guide](/articles/Note-Assist-Guide) for more information.
## Developer Platform Updates
### Enhanced Reports Endpoint
Integration partners using our API can now directly list and download individual files from reports, making file retrieval and automation more efficient. If a report or file doesn’t exist, the system immediately responds with an error, reducing time spent searching for missing files.
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates — May 2026
Source: https://help.elationhealth.com/articles/Product-Updates-May-2026
New features and improvements released across Elation EHR, Elation Note, Elation Billing, and the Developer Platform in May 2026.
## Elation EHR
### Prior Authorization Info at Appointment Scheduling
Increase the likelihood of first-attempt claim success by entering prior authorization information when creating or editing an appointment. The data automatically syncs to the billing note and claim, eliminating the need to re-enter it later in the workflow.
### Device Camera Barcode Scanning for Vaccines
Save time and eliminate the need for a separate handheld scanner. Users can now scan vaccine barcodes using their device's built-in camera to auto-populate the vaccine form. Both scanning options are fully supported, and the form "remembers" your last scanning method (camera or handheld) between sessions.
### Patient Passport Redesign
Patients now have access to a modern, easy-to-navigate Patient Passport experience! The fully redesigned web app introduces Spanish language support, access to multiple charts from a single account, full appointment history, appointment cancellation, attachments on message replies, and self-service demographics updates including Preferred Name and SOGI info. *Native iOS and Android apps for Patient Passport are coming soon.*
Review the [Patient Passport practice-facing resources](https://help.elationhealth.com/articles/elation-patient-passport-an-introduction) for more details. We have also centralized **patient-facing resources** at [help.elationhealth.com](https://help.elationhealth.com). The menu at the top of the page view lets patients quickly navigate to the [Patient Passport](https://help.elationhealth.com/patient-passport) resources that are designed to support and answer their common questions.
### Preferred Name in Patient-Facing Communications
To better support inclusive patient care, patients with a preferred name documented (in the **Full name** field) now see it in appointment cancellation emails, appointment confirmation SMS and phone confirmations, SMS opt-in page, booking confirmation, booking patient form header, and patient profile print view. Please note, some clinical and compliance-sensitive workflows still require legal name handling and are being evaluated separately.
### Pre-Term Growth Charts Updated to Fenton 2025
Ensure clinicians have current, globally recognized reference data for tracking pre-term infant growth. Pre-term growth charts have been updated with Fenton 2025 height, weight, and head circumference measurements, the global gold standard recommended by the American Academy of Pediatrics (AAP).
### Annotate Drawings on Reports
A simple pencil tool for freehand drawing is now available in report annotations, allowing users to sketch and mark up reports in addition to existing annotation options. Learn more about the annotations feature in [Patient Chart Guide- Annotate and eSign Clinical Reports and Documents](https://help.elationhealth.com/articles/Patient-Chart-Guide-Annotate-and-eSign)**.**
## Elation Note
### Elation Note Amendment Diffs
Audit exactly what changed between note versions. Clicking on an amendment at the bottom of the note preview now shows a diff view highlighting what was added or removed. Custom block diffing is coming in a follow-up release.
## Elation Billing
### Clearinghouse Rejection Report
Get earlier visibility into clearinghouse pre-submission rejection data to correct issues before they become downstream denials. A new claim-level report, Rejections Report in Lightning Reports, surfaces clearinghouse rejection data and detailed rejection reasons, complementing the existing post-adjudication denials detail report to cover the full claims lifecycle.
### Claim History View Improvements
Get clearer, more actionable visibility into claim-level financial details. The claim history modal has been rebuilt with CPT codes shown alongside corresponding charges and a direct link to financial history for specific charges.
### Simplified Stripe Setup for All-in-One Practices
Practices can now start collecting payments immediately after adding a Stripe account. The first Stripe account added is now automatically associated with the default practice entity, removing a manual set-up step for single-Stripe practices.
## Developer Platform
### Select Elation Billing Data Available in the Hosted Database
Hosted Database (HDB) customers can now query reconciled insurance payment data, and link it directly to the appointments that generated it without any manual data stitching required. This first release exposes reconciled ERA details. Review details in the [Elation Billing: ERA Matched Adjustment](https://help.elationhealth.com/articles/hdb/era-matched-adjustment) resource.
### FHIR Server Now Operating at Near-Realtime
Partners and integrators can now build reliably against Elation's FHIR server with current data, unlocking integration possibilities previously blocked by sync lag time. All FHIR resources are now in near-realtime sync with the EHR.
### Technical Documentation Consolidated
All of Elation's technical documentation — API, FHIR, and HDB — is now in one searchable, centralized location at [help.elationhealth.com](https://help.elationhealth.com). The menu at the top of the page view lets you quickly navigate directly to the [API Reference](https://help.elationhealth.com/api-reference) and [Hosted Database](https://help.elationhealth.com/hosted-database) resources.
# Product Updates - November 2025
Source: https://help.elationhealth.com/articles/Product-Updates-November-2025
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing, Note Assist, and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR updates](#EHR)
* [A central place for product updates](#updates)
* [Pediatric tools available now!](#peds)
* [Membership management just got easier](#membership)
* [Maximize context with Clinical Insights](#clinicalinsights)
* [Integrate Cardiac, Pulmonary, and Sleep Orders](#orders)
* [Elevate your medication workflows](#meds)
* [Draft replies faster with Wordsmith](#wordsmith)
* [Note Assist updates](#NoteAssist)
* [A smarter, more concise Note Assist is here](#NAimprove)
* [Elation Billing updates](#Elation_Billing)
* [Elation Billing now supports multi-TIN practices!](#multi_tin)
* [Developer Platform updates](#Developer_Platform)
* [Sparklines bring your patient data to life](#magictable)
* [Stay updated](https://docs.google.com/document/d/17hm3lWV8FzDJcOwQARJ-FO9lv_vW5Vyd1ZfTu02m8l8/edit?tab=t.0#heading=h.fpb0i41kz3w4)
## Elation EHR updates
### A central place for product updates
You can find all the latest Elation product updates in one easy-to-access location—right inside your workflow. We know in-app messages and pop-ups don’t always come at the right time. That’s why we’ve added a permanent **Resource Center**, where you can catch up on new features and enhancements whenever it works for you. This means fewer interruptions and more control—so you can stay informed, adopt new tools at your own pace, and get the most out of Elation.
### Pediatric tools available now!
Our pediatric toolkit is designed for safety, accuracy, and engagement, empowering you to nurture every child’s health journey. You can check out the [Pediatrics Guide](/articles/Pediatric-Features) for more details.
#### Streamline referrals with enhanced growth charts
Easily attach growth charts to provider letters and referrals—now beyond just patient letters—with exact percentile displays, expanded sharing and printing options, streamlined visual upgrades, and several additional enhancements that further improve pediatric workflows. Learn more about these updates in [this Help Center Article](/articles/growth-charts-for-pediatric-patients).
![Growth Charts menu open showing "Height for Age" selected under 2-20 years (CDC), with a pediatric height-for-age growth curve chart displaying multiple plotted data points, the most recent at 54.5 inches.]()
#### Enhance pediatric safety with weight-based dosing
Our new in-form pediatric dosing calculator streamlines the weight-based dosing process by surfacing the patient’s weight, computing the correct SIG and quantity, and pre-populating concentrations where available. Learn more in [this Help Center Article.](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
![Prescription Form showing Amoxicillin 250 mg/5ML Suspension with weight-based dosing calculator pre-populated with patient weight 45.81 kg and concentration 250/5, beside juvenile weight and height vitals.]()
#### Gather pediatric data before the visit
Complete the new NICHQ Vanderbilt ADHD PARENT and follow-up PARENT screeners in-visit or send them as Patient Forms to caregivers ahead of time, with results that are easily exportable into the Visit Note. Learn how in [this Help Center Article](/articles/structured-questionnaires).
![Cogn field showing "add special" dropdown, with Vanderbilt - PARENT screener listed as "Administered on Nov 6, 2025. Completed" and Vanderbilt Follow-up - PARENT showing "Fill out form"]()
#### Document Well-Child Visits quickly
Elation Note now includes Well-Child Check (WCC) templates for patients from newborn through 18 years old with developmentally appropriate questions. Learn more about selecting visit note templates in [this Help Center Article](/articles/Elation-Note-Guide-Documenting-an-encounter#template).
![Office Visit Note for a Well Child Visit showing the HPI section with a "History 12–30 mos" template populated with fields like Special healthcare needs, Elimination, Sleep, and Behavior set to "None" or "Normal," alongside an empty Vitals & Observations panel.]()
### Membership management just got easier
Elation’s new DPC membership features simplify enrollment and payments — reducing vendor complexity and giving practices more time to focus on patient care.
#### Patient self-enrollment
Lets patients join your membership plans through a seamless, integrated workflow that reduces staff workload and accelerates onboarding. For more details, check out our [Help Center Article](/articles/Membership-Management-Patient-Self-Enrollment).
![Patient self-enrollment form showing Patient Information, Contact Information, and Payment Information fields, with Card selected as payment method and Basic Adult Plan at $50.00/month displayed on the right.]()
#### ACH payment support now available
ACH (Automated Clearing House) Payments provide a cost-effective, automated way to collect membership fees. Learn how in our [Patient Payments Guide](/articles/Patient-Payments-Guide-ACH-Transactions).
![Payment request form for Elation South showing $50.00 due for outstanding balance, with "US bank account" selected under Payment details and a bank search grid displayed below.]()
### Maximize context with Clinical Insights
Clinical Insights now includes vaccination history context to better support your most common health maintenance and immunization questions. With vaccination details consolidated in one view, and the experience now running twice as fast, you can assess immunization status quickly and make decisions without slowing down your visit flow. Visit the [Chronological Records Guide](/articles/using-the-search-tool-in-your-patient-chart) for more details.
### Integrate Cardiac, Pulmonary, and Sleep Orders
Elation Note now includes Cardiac, Pulmonary, and Sleep Order Blocks, letting you create, edit, and track diagnostic orders directly in the visit note. These blocks streamline documentation with real-time visibility and point-of-care ordering, making it easier to manage active diagnostics with clear, up-to-date status indicators. Check out the [Elation Note Guide](/articles/Elation-Note-Guide-Managing-Templates) for more.
![Three placeholder Order Blocks in Elation Note: Pulmonary Order, Sleep Order, and Cardiac Order, each tagged "Placeholder" with a "Click to add tests" prompt.]()
### Elevate your medication workflows
Elation’s updated Med Reconciliation experience brings clarity and control to your medication workflows by unifying documentation, prescribing, and AI-guided decision support—all in one streamlined view. Check out our [Help Center Article](/articles/Reconciling-active-medications) for more information.
#### Redesigned med reconciliation in Elation Note
Clearly distinguishes a patient’s full Reconciled Medications history from current Rx Orders, helping you document confidently and keep both records aligned. (Full guidance available in [the Help Center](/articles/Reconciling-active-medications).)
![Reconciled Medications list showing four medications with status badges: "Doc'd Change" for amLODIPine, "Doc'd Refill" for Lipitor, "Doc'd New" for Percocet, and "Doc'd D/C" for Zepbound, alongside a Prescription panel showing Lipitor 10 mg Tab marked D/C.]()
#### In-workflow med reconciliation feedback
Lets you quickly rate and respond to the AI’s “Likely Not Taking” suggestions, giving us real-world insight that continuously sharpens accuracy and improves the reconciliation experience for every practice. (Learn more in [the Help Center](/articles/Reconciling-active-medications).)
![Med Rec Feedback dialog showing a 3-star rating for patient Scoobert Doo on 11/12/2025, with issue options "Missing Suggestion(s)," "Inaccurate," and "Other," and a "Submit to Med Rec Team" button.]()
### Draft replies faster with Wordsmith
Wordsmith now supports drafting replies to patient and provider letters directly from Practice Home and the Patient Chart. Previously used for outbound letters, this expanded capability brings AI-powered assistance into your most common communication workflows—helping you move through correspondence faster while staying fully in control. Check out the [Letters and Referral Guide](/articles/Auto-drafting-letters-and-referrals-with-Wordsmith) for more information.
## Note Assist updates
### A smarter, more concise Note Assist is here
A new **improved Note Assist** documentation experience is now available! Instead of updating notes incrementally during the encounter, Note Assist now creates your entire note in a single, streamlined pass at the end of the visit. Built directly from customer feedback, the enhanced note generation is faster and delivers better organized, more concise visit notes with significantly less duplication. The new experience is automatically on for all Note Assist users. For setup tips and details, see our [Note Assist Guide](/articles/Note-Assist-Guide#use).
**What customers are saying about Note Assist’s upgrade:**
* **You just made my day! Note Assist filtered out the non- relevant chit chat, captured all of the salient issues, and saved me 20+ minutes.**
* **SOOOO much better! I actually did a head-to-head, had two scribes going and I didn’t even look at the Heidi one. Elation had everything I needed. It was so good.**
## Elation Billing updates
### Elation Billing now supports multi-TIN practices!
Elation Billing now fully supports multi-TIN workflows, allowing you to manage distinct TIN/NPI/Taxonomy combinations and complete EDI enrollments for each entity directly in the platform. Once entities are set up and linked to service locations or providers, claims are automatically generated with the correct details—streamlining workflows, reducing denials, and making it easier to scale across service lines, locations, or states. Learn more with [this Help Center Article](https://help.billing.elationemr.com/en/articles/6882487-practice-settings-setup-and-overview).
## Developer Platform updates
### Sparklines bring your patient data to life
The Magic Table now includes inline, row-level visualizations, or sparklines, for your patient's trended vitals and labs, making it easier to spot changes at a glance. This enhancement builds on the recent redesign that improved readability by aligning the chronology with how you naturally think: newest values to the right. By visually highlighting trends directly in the patient chart, you can reduce cognitive load and identify patterns faster during chart review and at the point of care.
![Vitals Magic Table showing 20 results with sparkline trend charts for HT, WT, BMI, BP, Temp, HR, RR, O2%, %BF, Ketone, and BFM across visits from 2023 to 2024/10, with Chart Visualization Controls set to Time-based spacing and All Data time window.]()
### Stay updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates - October 2025
Source: https://help.elationhealth.com/articles/Product-Updates-October-2025
This article will describe all of the new features introduced in Elation in October 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR updates](#EHR)
* [A central place for product updates](#updates)
* [Simplify patient insights in one click](#clinical_insights)
* [Schedule ongoing care efficiently](#recurring_appointments)
* [Calculate exact dosing every time](#dosage_calculator)
* [Improve interoperability instantly](#Carequality)
* [New bidirectional lab integration](#bidi_labs)
* [Elation Billing updates](#Elation_Billing)
* [Elation Billing now supports multi-TIN practices!](#multi_tin)
* [Spot downcoded claims immediately](#downcoded_claims)
* [Developer Platform updates](#Developer_Platform)
* [Enhanced security and compliance](#security)
* [Added new endpoints](#new_endpoints)
* [Analyze clinical data with new hosted database tables](#new_tables)
* [Stay updated](https://docs.google.com/document/d/17hm3lWV8FzDJcOwQARJ-FO9lv_vW5Vyd1ZfTu02m8l8/edit?tab=t.0#heading=h.fpb0i41kz3w4)
## Elation EHR updates
### A central place for product updates
You can find all the latest Elation product updates in one easy-to-access location—right inside your workflow. We know in-app messages and pop-ups don’t always come at the right time. That’s why we’ve added a permanent **Resource Center**, where you can catch up on new features and enhancements whenever it works for you. This means fewer interruptions and more control—so you can stay informed, adopt new tools at your own pace, and get the most out of Elation.
### Simplify patient insights in one click
The **Quick Action Buttons** makes extracting key patient insights easier and faster with just one click. These customizable buttons are located just beneath the Chronological Record search bar within a dropdown bar at the top of the patient chart. By default their behavior summarizes the last three visits, but you can tailor it to surface specific information so you can simply click a button instead of typing the same search prompt throughout the day. Learn how to customize your **Quick Action Button** to match your specific workflow in our [Chronological Records Guide](/articles/using-the-search-tool-in-your-patient-chart#use_quick_action).
### Schedule ongoing care efficiently
**Recurring appointments** simplify ongoing care by allowing your front-office teams to schedule weekly, biweekly, or monthly visits in a single, streamlined workflow, saving them up to 15 minutes per patient. The system automatically carries forward key details and flags scheduling conflicts before saving, reducing errors and helping your staff be more efficient. Check out the [Calendar Guide](/articles/recurring-patient-appointments) for more information.
### Calculate exact dosing every time
Our new **weight-based pediatric calculator** assists you in calculating the appropriate sig and quantity for a pediatric prescription. The calculator automatically appears when you're prescribing and will surface the patient's weight, ensuring every dose is accurate for a child's size. By minimizing manual calculation errors, the calculator directly contributes to improved medication safety for children and offers major relief for clinicians when dosing varies. Check out our [Prescribing Guide](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) for more information on using the calculator and integrating it into your practice.
### Improve interoperability instantly
Admins can now enable seamless data sharing through enhanced interoperability with a new self-serve opt-in into **Carequality**. This update lets your practice securely query and share patient data with other networks and EHRs via the Outside Care workflow—no manual setup required. Admins can enable it instantly in **Settings** → **Security & Privacy** → **Patient Data Sharing with Outside Care**, then accept the compliance checkbox. Remember to record patient consent before sharing. This streamlined process reduces admin work and improves care continuity. For more information on Carequailty, check out our [Carequality Integration Introduction](/articles/Carequality-Integration-Introduction).
### New bidirectional lab integration
The following bidirectional lab integration is now available:
* American Health Associates - U.S.-wide diagnostics company delivering rapid, tech-enabled lab and mobile specimen services to healthcare providers and patients ― especially in long-term care and home settings.
Bidirectional lab interfaces enable eOrdering in addition to eResults, ensuring efficiency and accuracy when placing lab orders and reducing administrative burden and paperwork for your practice. Elation is thrilled to offer these integrations at no additional cost to its valued customers. Refer to our [Bidirectional Lab Interface Guide](/articles/Bidirectional-Lab-Interface-Guide) for more information.
## Elation Billing updates
### Elation Billing now supports multi-TIN practices!
The first iteration of multi-TIN claim submission in Elation Billing is here, allowing billers to specify the correct TIN, Taxonomy, and NPI at the claim level using the **More Fields** dialog on the Superbill. Look for our fully automated solution arriving by the end of the year! Check out our [Help Center](https://help.billing.elationemr.com/en/articles/7884140-how-elation-billing-corresponds-to-the-hcfa-1500) for more information.
### Spot downcoded claims immediately
In response to recent payer policy changes, we released changes to help you identify claims that have been downcoded. Elation will automatically identify and tag downcoded charges, adding the relevant claims to your Worklist for immediate review. Alerts will also display on the Superbill and Payment pages, giving you additional visibility into the downcoding events and allowing you to review the claim history and take action as needed. Look for additional updates in-app or review our [Help Center](https://help.billing.elationemr.com/en/articles/12453286-monitoring-for-downcoded-claims) for more information.
## Developer Platform updates
### Enhanced security and compliance
Elation is upgrading to SMART on FHIR V2, a secure, standards-based framework that enables approved apps to connect seamlessly to your EHR with stronger privacy controls, improved interoperability, and full compliance—without disrupting existing integrations.
### Added new endpoints
We’ve added new USCDI v3-aligned data elements to our FHIR and CCDA exports to improve completeness and ensure closer alignment with the Hosted Database model. This update reduces data gaps and makes downstream integrations and analytics more consistent.
### Analyze clinical data with new hosted database tables
Elation's Hosted Database (HDB) now includes beta Elation Note (VN2) tables that surface structured documentation data for deeper analysis in Snowflake. These new tables include key information such as custom blocks and signatures. Messaging threads also remain available through existing HDB messaging tables, enabling your teams to combine both documentation and communication insights in your analytics programs. This enhanced data access is crucial for sophisticated clinical analysis and quality improvement efforts. Check out our [Hosted Database Guide](/articles/Elation-Analyst) for more details on integrating these new HDB tables into your analytics program.
### Stay updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# Product Updates - September 2025
Source: https://help.elationhealth.com/articles/Product-Updates-September-2025
This article will describe all of the new features introduced in Elation in September 2025.
## What’s New?
Elation Health is excited to announce our latest updates designed to enhance your experience with our EHR, Billing, and Developer Platform services. All of our releases focus on reducing documentation burden, streamlining workflows, and improving efficiency. Here's what's new:
* [Elation EHR updates](#standard_EHR)
* [A central place for product updates](#updates)
* [Experience smarter chart prep with Clinical Insights](#Clinical_Insights)
* [Quick-start forms](#quick_forms)
* [Structured demographics](#demographics)
* [AI insurance card reader](#insurance_card)
* [Premium EHR updates](#premium_EHR)
* [Customize security for sensitive charts](#sensitive_charts)
* [Elation Billing Updates](#Elation_Billing)
* [Elation Billing now supports multi-TIN practices!](#multi_TIN)
* [Developer Platform Updates](#Developer_Platform)
* [Stay Updated](#stay_updated)
## Elation EHR Updates
### A central place for product updates
You can find all the latest Elation product updates in one easy-to-access location—right inside your workflow. We know in-app messages and pop-ups don’t always come at the right time. That’s why we’ve added a permanent Resource Center, where you can catch up on new features and enhancements whenever it works for you. This means fewer interruptions and more control—so you can stay informed, adopt new tools at your own pace, and get the most out of Elation.
### Experience smarter chart prep with Clinical Insights
Clinical Insights helps you quickly understand a patient’s health history, giving you the context you need to navigate the visit with confidence. With AI built into the Chronological Record search, you can simply enter a query and see results displayed in a clear, summarized format. These AI-generated summaries pull from the patient’s clinical profile, recent notes, and lab results, giving you the most relevant information without the need to dig through charts, keyword search, or re-request data. Available to all users with Elation AI enabled, Clinical Insights saves you time and reduces information overload — helping you spend less time searching and more time caring for your patients. For more information, check out our [Chronological Records Guide](/articles/using-the-search-tool-in-your-patient-chart).
### Quick-start forms
AI Quick Start Forms make it easy for you to turn paper or PDF intake forms into digital versions in Elation. Instead of manually recreating forms with limited question types and minimal conditional logic, you can simply upload a scanned image or PDF. A draft digital form is automatically generated and opens in the new form builder for quick review and edits. Once you save it, the form is ready to use in your patient intake workflows — no manual rebuilding required. For more information check out our [Patient Forms Guide](/articles/Patient-Forms-Guide#upload_form).
### Structured demographics
Our latest feature delivers an enhanced Patient Demographic template that allows you to collect key demographic details directly from patients via digital intake forms. The completed forms automatically generate structured data when imported into the EHR, filing directly into the appropriate discrete fields within the Patient Demographics activity. The enhanced workflow ensures accurate and up-to-date patient records with less manual entry for your staff. Explore the [Patient Forms Guide](/articles/Patient-Forms-Guide#template) in our Help Center for more
### AI insurance card reader
Manually inputting long Group IDs and Member IDs from insurance cards is a common source of typos, compromising data accuracy. The new AI Insurance Card Reader automatically extracts these numbers and matches them to the correct demographic fields. While plan names and cardholder names still require manual entry, this automation streamlines intake and ensures reliable data is saved in the patient chart. Check out our [Patient Forms Guide](/articles/Managing-forms-responses#insurance_cards) to learn more.
## Premium EHR Updates
### Customize security for sensitive charts
Premium EHR Users now have more control over protecting sensitive patient data by separately configuring access rules for Patient Cohorts and VIP charts\*\* from the Security & Privacy settings page. This new flexibility allows you to tailor whether unauthorized users see a warning or are blocked from opening sensitive charts, helping your organization better safeguard patient data as you scale. Check out our [Patient Cohorts](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria) and [VIP Charts](/articles/vip-chart-feature) articles for more information.
## Elation Billing Updates
### Elation Billing now supports multi-TIN practices!
The first iteration of Multi-TIN Claim Submission in Elation Billing is here, allowing billers to specify the correct TIN, Taxonomy, and NPI at the claim level using the **More Fields** dialog on the Superbill. Look for our fully automated solution arriving by the end of the year! Check out our [Help Center](https://help.billing.elationemr.com/en/articles/7884140-how-elation-billing-corresponds-to-the-hcfa-1500) for more information.
## Developer Platform Updates
### Stay Updated
To stay informed of all the latest updates to our Developer Platform services, we recommend bookmarking the individual changelogs and monitoring them regularly.
* [API V2 changelog](https://help.elationhealth.com/articles/rest/changelog/changelog#2025-02-16)
* [Hosted Database changelog](/articles/hdb/hdb-snowflake)
# MIPS (2024)- Promoting Interoperability Category
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2024
This article describes the Promoting Interoperability Performance Category for MIPS 2024.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## What is Promoting Interoperability (MIPS PI Category)?
In 2024, MIPS-Eligible Professionals (EPs), that do not have an existing exclusion for the PI category, must attest to their performance on objectives and measures, across 4 categories; Promoting Interoperability, is 1 of the 4 categories. Interoperability, or the use of technology to exchange and make use of information, makes communicating patient information less burdensome and improves outcomes. The Promoting Interoperability category historically was designed for inpatient facility reporting and is the newest iteration of what was previously known as Meaningful Use, and Advancing Care Information. It has since been targeted towards outpatient providers, and finally extended to any MIPS providers that trigger the requirements (not excluded for other reasons). The MIPS Promoting Interoperability performance category emphasizes the electronic exchange of health information using certified electronic health record technology (CEHRT) to improve:
* Patient access to their health information;
* The exchange of information between clinicians and pharmacies; and
* The systematic collection, analysis, and interpretation of healthcare data.
Promoting Interoperability accounts for 25% of an EP’s MIPS score unless you qualify for a Hardship Exception.
[Click here](https://vimeo.com/elationhealth/2023-ia-pi?share=copy) to watch a recording of our 2023 Improvement Activities and Promoting Interoperability Webinar.
## Reporting Requirements
For Performance Year 2024, you must submit collected data for certain measures from each of the 4 objective measures (unless an exclusion is claimed) for the same 180 continuous days or more during 2024 (this is an increase from the previous 90 day minimum). The 4 objectives and measures that Elation supports are:
1. [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
2. [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
3. [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
4. [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
In addition to submitting measures, you must enter Elation's CMS Identification code (0015C1H7GK8MY31) during reporting and submit a **yes** to:
* The Actions to Limit or Restrict Compatibility or Interoperability of CEHRT (previously named the Prevention of Information Blocking) Attestation,
* The ONC Direct Review Attestation,
* [The security risk analysis](/articles/Promoting-Interoperability-Security-Risk-Analysis), and;
* [The SAFER Guides measure](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment) (High Priority Practices Guide)
## Scoring
The scoring for the Promoting Interoperability objectives and measures are as follows.
* [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX) (10 points)
* [Query of PDMP](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program) (10 points)
* [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (30 points total)
* [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange) (30 points)
* [Enabling Exchange Under TEFCA](/articles/Promoting-Interoperability-MIPS-TEFCA) (30 points)
* [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange) (25 points)
* [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)(25 points total)
You must report all required measures (submit a **yes**/report at least 1 patient in the numerator, as applicable, or claim an exclusion) or you will earn a zero for the Promoting Interoperability performance category.
For the Public Health and Clinical Data Exchange objective, you will be awarded full points if a **yes** is submitted for the 2 required measures (Immunization Registry and Electronic Case Reporting) or one “yes” and one exclusion.
The Electronic Case Reporting registry integration is still under construction. If you have interest in the Electronic Case Reporting functionality to meet the Promoting Interoperability category requirements, reach out to the Elation using the **Contact Elation Support** button and contact your local or regional Public Health Agency to register for the intent to submit data.
Reporting on this objective will require an exclusion for the Electronic Case Reporting measure to be claimed, unless your practice has set up a request with your local Public Health Agency to submit data.
If exclusions are claimed, the points for those measures will be reallocated to other measures.
### Bonus Points
Certain optional measures will allow you to receive bonus points:
* You can earn 5 bonus points for submitting a yes response for one of the optional Public Health and Clinical Data Exchange measures (Public Health Registry Reporting, Clinical Data Registry Reporting, or Syndromic Surveillance Reporting).
## Hardship Exceptions
Hardship Exceptions allow for the Promoting Interoperability performance category to receive a weight of 0% when calculating your final score and the 25% will be redistributed to another performance category (or categories) unless you choose to submit data for Promoting Interoperability.
Some clinicians will be **automatically** reweighted based on:
* Their special status (for example, hospital-based clinicians),
* **If they are a part of a small practice (less than 15 providers).**
These clinicians will not need to submit a Promoting Interoperability hardship exception application.
If you’re reporting as a group or virtual group all MIPS eligible clinicians in the group or virtual group must qualify for reweighting for the group to be reweighted, unless the group or virtual group has a special status that qualifies them for automatic reweighting.
You may submit a MIPS Promoting Interoperability Performance Category Hardship Exception Application, citing one of the following reasons for review and approval:
* MIPS eligible clinician using decertified EHR technology
* Insufficient Internet connectivity
* Extreme and uncontrollable circumstances
* Lack of control over the availability of CEHRT
If your hardship exception is approved, the Promoting Interoperability performance category will be reweighted.
## Achieving Objectives in Elation
Follow the instructions below for the measures that Elation supports:
1. [e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
2. [Health Information Exchange (HIE) - Support Electronic Referral Loops by Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
3. [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange)
4. [Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
5. [Public Health & Clinical Data Exchange- Immunization Registry Reporting and Electronic Case Reporting](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
6. [Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)
## Additional Resources
* \[QPP Promoting Interoperability Performance Category Overview]\([https://qpp.cms.gov/mips/promoting-interoperability”](https://qpp.cms.gov/mips/promoting-interoperability”) with “[https://qpp.cms.gov/mips/promoting-interoperability?py=2024](https://qpp.cms.gov/mips/promoting-interoperability?py=2024))
* [2024 Promoting Interoperability Performance Category Quick Start Guide: Traditional MIPS](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2688/2024PromotingInteropGuide.pdf)
\*This article is provided for instructional purposes only. Elation Health does not support or guarantee anything other than relay useful information from various organizations. Elation Health also does not provide support for third-party technologies. We recommend consulting[CMS guidelines](https://qpp.cms.gov/resources/resource-library)for the most up to date information.
Copyright U.S Centers for Medicare & Medicaid Services. All rights reserved.
## Related Articles
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
* [Promoting Interoperability (MIPS) - e-Prescribing](/articles/Promoting-Interoperability-MIPS-eRX)
* [Promoting Interoperability (MIPS) - Health Information Exchange (HIE) - Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
* [Promoting Interoperability (MIPS) - Public Health and Clinical Data Exchange](/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange)
* [Promoting Interoperability (MIPS) - Security Risk Analysis](/articles/Promoting-Interoperability-Security-Risk-Analysis)
* [Promoting Interoperability (MIPS) - SAFER Guides Assessment](/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment)
* [Promoting Interoperability (MIPS) - Query of Prescription Drug Monitoring Program (PDMP)](/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program)
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024)
# Promoting Interoperability (MIPS 2025) - Health Information Exchange (HIE) - Bi-Directional Exchange
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2025-HIE-Bidirectional-Exchange
This article describes the Health Informational Exchange, Bi-directional Information Exchange measure for the MIPS Promoting Interoperability performance category.
## Measure Details
This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:
* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) - (2 measures with performance numerator/denominator metrics)
* [Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2025-TEFCA)
## Measure Parameters
The MIPS eligible clinician or group must attest that they engage in bi-directional exchange with an HIE to support transitions of care. The MIPS eligible clinician must attest YES to the following:
* I participate in an HIE in order to enable secure, bi-directional exchange to occur for every patient encounter, transition or referral, and record stored or maintained in the electronic health record (EHR) during the performance period in accordance with applicable law and policy.
* The HIE that I participate in is capable of exchanging information across a broad network of unaffiliated exchange partners including those using disparate EHRs, and does not engage in exclusionary behavior when determining exchange partners.
* I use the functions of certified electronic health record technology (CEHRT) to support bi-directional exchange with an HIE.
## Elation Workflows
Using the bidirectional integration with [Carequality](/articles/Carequality-Integration-Introduction) will satisfy this measure. A bidirectional connection with a regional HIE will also satisfy this measure.
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [Promoting Interoperability - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS 2025) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2025-TEFCA)
# Promoting Interoperability (MIPS 2025) - Public Health and Clinical Data Exchange
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2025-Public-Health-and-Clinical-Data-Exchange
Elation supports the automatic calculation of the MIPS Promoting Interoperability Medicare Public Health and Clinical Data Exchange Objective.
## Part 1: Immunization Registry Reporting
### Measure Details
Reporting on this measure requires selecting one of two options regarding active engagement with an Immunization registry. Active engagement may be demonstrated in one of the following ways:
* **Option 1** – Pre-Production and Validation: The MIPS eligible clinician must first register to submit data with the PHA or, where applicable, the CDR to which the information is being submitted. Registration must be completed within 60 days after the start of the performance period, while awaiting an invitation from the PHA or CDR to begin testing and validation. MIPS eligible clinicians that have registered in previous years do not need to submit an additional registration for subsequent performance periods. Upon completion of the initial registration, the MIPS eligible clinician must begin the process of testing and validation of the electronic submission of data. The MIPS eligible clinician must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within a performance period would result in the MIPS eligible clinician not meeting the measure.
* **Option 2** – Validated Data Production: The MIPS eligible clinician has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.
Production data – Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and **test data** which may be submitted for the purposes of enrolling in and testing electronic data transfers.
Active engagement – The MIPS eligible clinician is in the process of moving towards sending "production data" to a public health agency (PHA) or clinical data registry (CDR), or is sending production data to a PHA or CDR.
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the Immunization Registry Reporting measure if the MIPS eligible clinician:
* Does not administer any immunizations to any of the populations for which data is collected by its jurisdiction’s immunization registry or immunization information system during the performance period.
* Operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required to meet the CEHRT definition at the start of the performance period.
* Operates in a jurisdiction where no immunization registry or immunization information system has declared readiness to receive immunization data as of 6 months prior to the start of the performance period.
### Elation Workflows
Elation now offers Immunization Registry connections in over 30 states. Elation is also continuously working with the non-connected State Immunization Registries to establish a connection. [Learn more about the states where the Bidirectional Immunization Registry integration is available](/articles/Immunization-Registry-Interface-Introduction).
You must utilize Elation's Immunization Registry connection or separately connect to your State Immunization Registry outside of Elation to qualify for this measure. If you have an active Immunization Registry connection, select Option 2: Validated Data Production for this measure. If you do not have an active Immunization connection, you may select Option 1: Pre Production and Validation if you are seeking to establish a registry connection in 2025 and have begun the registration process.
## Part 2: Electronic Case Reporting
### Measure Details
The MIPS eligible clinician is in active engagement with a public health agency to electronically submit case reporting of reportable conditions. Active engagement may be demonstrated in one of the following ways:
* Option 1 – Pre-Production and Validation: The MIPS eligible clinician must first register to submit data with the PHA or, where applicable, the CDR to which the information is being submitted. Registration must be completed within 60 days after the start of the performance period, while awaiting an invitation from the PHA or CDR to begin testing and validation. MIPS eligible clinicians that have registered in previous years do not need to submit an additional registration for subsequent performance periods. Upon completion of the initial registration, the MIPS eligible clinician must begin the process of testing and validation of the electronic submission of data. The MIPS eligible clinician must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within a performance period would result in the MIPS eligible clinician not meeting the measure.
* Option 2 – Validated Data Production: The MIPS eligible clinician has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.
Production data – Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and **test data** which may be submitted for the purposes of enrolling in and testing electronic data transfers.
Active engagement – The MIPS eligible clinician is in the process of moving towards sending "production data" to a public health agency (PHA) or clinical data registry (CDR), or is sending production data to a PHA or CDR.
In 2025 Elation is building an integration for electronic Case Reporting which must be certified to meet this measure.
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the Electronic Case Reporting measure if the MIPS eligible clinician:
* Does not treat or diagnose any reportable diseases for which data is collected by their jurisdiction’s reportable disease system during the performance period.
* Operates in a jurisdiction for which no public health agency is capable of receiving electronic case reporting data in the specific standards required to meet the CEHRT definition at the start of the performance period.
* Operates in a jurisdiction where no public health agency has declared readiness to receive electronic case reporting data as of 6 months prior to the start of the performance period.
* Uses CEHRT that is not certified to electronic case reporting certification criterion prior to the start of the performance period they select in the 2022 calendar year.
### Elation Workflows
To meet this measure you must select Option 1: Pre Production and Validation. To select Option 1: you must reach out to Elation Health and your regional Public Health Agency to declare intent to submit data and let Elation know your intention to submit data and enroll with your regional Public Health Agency.
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# Promoting Interoperability (MIPS 2025) - Query of Prescription Drug Monitoring Program (PDMP)
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2025-Query-of-Prescription-Drug-Monitoring-Program
This article describes the Query of Prescription Drug Monitoring Program (PDMP) measure for the MIPS Promoting Interoperability performance category.
## Measure Details
This measure builds on e-prescribing. The intent of the measure is when a scheduled prescription is prescribed, before sending the prescription to the pharmacy, the provider queries the regional Prescription Drug Monitoring Program which provides insights to ensure there are no contraindicated medications or historical medication flags. Beginning in 2023 (and continuing beyond) attestation of 'yes' to this measure is required or an eligible exclusion. This measure is worth 10 points towards the Promoting Interoperability category score.
For at least one Schedule II opioid or Schedule III or IV drug electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a PDMP for prescription drug history.
## Measure Parameters
The MIPS eligible clinician must attest YES to conducting a query of a PDMP for at least one Schedule II opioid or Schedule III or IV drug electronically prescribed using CEHRT.
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the PDMP measure if the MIPS eligible clinician;
1. Is unable to electronically prescribe Schedule II opioids and Schedule III and IV drugs in accordance with applicable law during the performance period.
2. Does not electronically prescribe any Schedule II opioids or Schedule III or IV drugs during the performance period.
## Elation Workflows
If you have an [integration with your regional PDMP](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP) that will satisfy this measure.
This measure may also be met by querying a PDMP portal outside of Elation during the prescription process. There must be a minimum of one query of the PDMP that takes place during the prescription process during the performance time.
## Related Articles
* [State Prescription Monitoring Program (PMP/PDMP)](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
# Promoting Interoperability (MIPS 2025) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2025-TEFCA
This article describes enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA) for the MIPS Promoting Interoperability performance category.
## Measure Details
This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:
* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (2 measures with performance numerator/denominator metrics)
* [Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2025-HIE-Bidirectional-Exchange) (attestation to engagement of a bidirectional exchange)
## Measure Parameters
The MIPS eligible clinician or group must attest to the following:
* Participating as a signatory to a Framework Agreement (as that term is defined by the Common Agreement for Nationwide Health Information Interoperability as published in the Federal Register and on ONC’s website) in good standing (that is, not suspended) and enabling secure, bi-directional exchange of information to occur, in production, for every patient encounter, transition or referral, and record stored or maintained in the EHR during the performance period, in accordance with applicable law and policy.
* Using the functions of CEHRT to support bi-directional exchange of patient information, in production, under this Framework Agreement.
## Elation Workflows
For 2025, there are no workflows in Elation to meet this measure. We recommend using the workflows detailed in one of the following two measures that Elation does support for the Health Information Exchange Objective:
* [Health Information Exchange (HIE) - Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2025-HIE-Bidirectional-Exchange)(for customers using Elation’s Carequality connection only)
Elation is currently not a QHIN recognized under TEFCA. In the future Elation may have integrations with QHINs that would satisfy this measure.
## Related Articles
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)
* [Promoting Interoperability - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS 2025) - Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2025-HIE-Bidirectional-Exchange)
# Promoting Interoperability (MIPS 2026) - Health Information Exchange (HIE) - Bi-Directional Exchange
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange
This article describes the Health Informational Exchange, Bi-directional Information Exchange measure for the MIPS Promoting Interoperability performance category.
## Measure Details
This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:
* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) - (2 measures with performance numerator/denominator metrics)
* [Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2026-TEFCA)
## Measure Parameters
The MIPS eligible clinician or group must attest that they engage in bi-directional exchange with an HIE to support transitions of care. The MIPS eligible clinician must attest YES to the following:
* I participate in an HIE in order to enable secure, bi-directional exchange to occur for every patient encounter, transition or referral, and record stored or maintained in the electronic health record (EHR) during the performance period in accordance with applicable law and policy.
* The HIE that I participate in is capable of exchanging information across a broad network of unaffiliated exchange partners including those using disparate EHRs, and does not engage in exclusionary behavior when determining exchange partners.
* I use the functions of certified electronic health record technology (CEHRT) to support bi-directional exchange with an HIE.
## Elation Workflows
Using the bidirectional integration with [Carequality](/articles/Carequality-Integration-Introduction) will satisfy this measure. A bidirectional connection with a regional HIE will also satisfy this measure.
## Additional Information
[2026 MIPS Promoting Interoperability Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3599/2026-Promoting-Interoperability-Quick-Start-Guide.pdf)
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Promoting Interoperability - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS 2026) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-2026-TEFCA)
# Promoting Interoperability (MIPS 2026) - Public Health and Clinical Data Exchange
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2026-Public-Health-and-Clinical-Data-Exchange
Elation supports the automatic calculation of the MIPS Promoting Interoperability Medicare Public Health and Clinical Data Exchange Objective.
## Part 1: Immunization Registry Reporting
### Measure Details
Reporting on this measure requires selecting one of two options regarding active engagement with an Immunization registry. Active engagement may be demonstrated in one of the following ways:
* **Option 1** – Pre-Production and Validation: The MIPS eligible clinician must first register to submit data with the PHA or, where applicable, the CDR to which the information is being submitted. Registration must be completed within 60 days after the start of the performance period, while awaiting an invitation from the PHA or CDR to begin testing and validation. MIPS eligible clinicians that have registered in previous years do not need to submit an additional registration for subsequent performance periods. Upon completion of the initial registration, the MIPS eligible clinician must begin the process of testing and validation of the electronic submission of data. The MIPS eligible clinician must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within a performance period would result in the MIPS eligible clinician not meeting the measure.
* **Option 2** – Validated Data Production: The MIPS eligible clinician has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.
Production data – Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and **test data** which may be submitted for the purposes of enrolling in and testing electronic data transfers.
Active engagement – The MIPS eligible clinician is in the process of moving towards sending "production data" to a public health agency (PHA) or clinical data registry (CDR), or is sending production data to a PHA or CDR.
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the Immunization Registry Reporting measure if the MIPS eligible clinician:
* Does not administer any immunizations to any of the populations for which data is collected by its jurisdiction’s immunization registry or immunization information system during the performance period.
* Operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required to meet the CEHRT definition at the start of the performance period.
* Operates in a jurisdiction where no immunization registry or immunization information system has declared readiness to receive immunization data as of 6 months prior to the start of the performance period.
### Elation Workflows
Elation now offers Immunization Registry connections in over 30 states. Elation is also continuously working with the non-connected State Immunization Registries to establish a connection. [Learn more about the states where the Bidirectional Immunization Registry integration is available](/articles/Immunization-Registry-Interface-Introduction).
You must utilize Elation's Immunization Registry connection or separately connect to your State Immunization Registry outside of Elation to qualify for this measure. If you have an active Immunization Registry connection, select Option 2: Validated Data Production for this measure. If you do not have an active Immunization connection, you may select Option 1: Pre Production and Validation if you are seeking to establish a registry connection in 2026 and have begun the registration process.
## Part 2: Electronic Case Reporting
### Measure Details
The MIPS eligible clinician is in active engagement with a public health agency to electronically submit case reporting of reportable conditions. Active engagement may be demonstrated in one of the following ways:
* Option 1 – Pre-Production and Validation: The MIPS eligible clinician must first register to submit data with the PHA or, where applicable, the CDR to which the information is being submitted. Registration must be completed within 60 days after the start of the performance period, while awaiting an invitation from the PHA or CDR to begin testing and validation. MIPS eligible clinicians that have registered in previous years do not need to submit an additional registration for subsequent performance periods. Upon completion of the initial registration, the MIPS eligible clinician must begin the process of testing and validation of the electronic submission of data. The MIPS eligible clinician must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within a performance period would result in the MIPS eligible clinician not meeting the measure.
* Option 2 – Validated Data Production: The MIPS eligible clinician has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.
Production data – Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and **test data** which may be submitted for the purposes of enrolling in and testing electronic data transfers.
Active engagement – The MIPS eligible clinician is in the process of moving towards sending "production data" to a public health agency (PHA) or clinical data registry (CDR), or is sending production data to a PHA or CDR.
In 2026 Elation is building an integration for electronic Case Reporting which must be certified to meet this measure.
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the Electronic Case Reporting measure if the MIPS eligible clinician:
* Does not treat or diagnose any reportable diseases for which data is collected by their jurisdiction’s reportable disease system during the performance period.
* Operates in a jurisdiction for which no public health agency is capable of receiving electronic case reporting data in the specific standards required to meet the CEHRT definition at the start of the performance period.
* Operates in a jurisdiction where no public health agency has declared readiness to receive electronic case reporting data as of 6 months prior to the start of the performance period.
* Uses CEHRT that is not certified to electronic case reporting certification criterion prior to the start of the performance period they select in the 2022 calendar year.
### Elation Workflows
To meet this measure you must select Option 1: Pre Production and Validation. To select Option 1: you must reach out to Elation Health and your regional Public Health Agency to declare intent to submit data and let Elation know your intention to submit data and enroll with your regional Public Health Agency.
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [MIPS (2026) - Promoting Interoperability Category](/articles/MIPS-2026-Promoting-Interoperability-Category)
# Promoting Interoperability (MIPS 2026) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-2026-TEFCA
## Measure Details
This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:
* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (2 measures with performance numerator/denominator metrics)
* [Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange) (attestation to engagement of a bidirectional exchange)
## Measure Parameters
The MIPS eligible clinician or group must attest to the following:
* Participating as a signatory to a Framework Agreement (as that term is defined by the Common Agreement for Nationwide Health Information Interoperability as published in the Federal Register and on ONC’s website) in good standing (that is, not suspended) and enabling secure, bi-directional exchange of information to occur, in production, for every patient encounter, transition or referral, and record stored or maintained in the EHR during the performance period, in accordance with applicable law and policy.
* Using the functions of CEHRT to support bi-directional exchange of patient information, in production, under this Framework Agreement.
## Elation Workflows
For 2026, Elation Health offers an [integration with Zus Health](https://partners.elationhealth.com/partners/zus-health) as an additional partner with an associated cost. Zus participates in TEFCA by querying the CommonWell QHIN.
## Related Articles
* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Promoting Interoperability - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS 2026) - Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange)
# Promoting Interoperability (MIPS 2024) - Health Information Exchange (HIE) - Bi-Directional Exchange
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange
This article describes the Health Informational Exchange, Bi-directional Information Exchange measure for the MIPS Promoting Interoperability performance category.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:
* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) - (2 measures with performance numerator/denominator metrics)
* [Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-TEFCA)
## Measure Parameters
The MIPS eligible clinician or group must attest that they engage in bi-directional exchange with an HIE to support transitions of care. The MIPS eligible clinician must attest YES to the following:
* I participate in an HIE in order to enable secure, bi-directional exchange to occur for every patient encounter, transition or referral, and record stored or maintained in the electronic health record (EHR) during the performance period in accordance with applicable law and policy.
* The HIE that I participate in is capable of exchanging information across a broad network of unaffiliated exchange partners including those using disparate EHRs, and does not engage in exclusionary behavior when determining exchange partners.
* I use the functions of certified electronic health record technology (CEHRT) to support bi-directional exchange with an HIE.
## Elation Workflows
Using the bidirectional integration between Elation and [Carequality](/articles/Carequality-Integration-Introduction) will satisfy this measure. A bidirectional connection with a regional HIE will also satisfy this measure.
## Additional Information
[2024 MIPS Promoting Interoperability Measure Specifications](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2650/2024MIPSPISpecifications.zip)
## Related Articles
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [Promoting Interoperability (MIPS) - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)](/articles/Promoting-Interoperability-MIPS-TEFCA)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# Promoting Interoperability (MIPS) - Health Information Exchange (HIE) - Sending & Receiving Health Information
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information
This article describes the Health Informational Exchange, Sending & Receiving Health Information measure for the MIPS Promoting Interoperability performance category.
## Part 1: Support Electronic Referral Loops by Sending Health Information
### Measure Details
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider — (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.
### Measure Parameters
**Numerator**: The number of transitions of care and referrals in the denominator where a summary of care record was created using CEHRT and exchanged electronically.
**Denominator**: Number of transitions of care and referrals during the performance period for which the MIPS eligible clinician was the transferring or referring health care clinician.
**Exclusion**: Any MIPS eligible clinician who transfers a patient to another setting or refers a patient fewer than 100 times during the performance period.
### Elation Workflows
This objective needs to be met for at least 1 patient. In the patient's visit note, attach any reports that you have reviewed during the encounter. At the bottom of the visit note, you must indicate that the patient is undergoing a transition of care to an outside provider in the MIPS section. Afterwards, sign the visit note, attach the visit note to an Elation Referral and send the referral electronically to the receiving provider via Elation. Please reference the exact steps outlined below:
1. Start a visit note draft for a patient encounter
2. Link any reports relevant to the visit to the visit note draft. While the visit note draft is open, you can link a report to a visit note with the options below:
3. Find the report in the patient’s Chronological Record. Click **Actions** >> **Export to Note as Data**
*
If your computer display is large enough for the 3 Pane View and you can see the Chronological Record alongside your visit note draft, click on the report’s name to open the report. The report will automatically be referenced in the **Data** section of your visit note draft.
2. Click on the **Reports** button at the top of the patient's chart to open the 'Reports' window. Click on the name of a report to expand the report. The report will automatically be referenced in the 'Data' section of your visit note draft.
3. Check the box for **Referring to another setting or provider** at the bottom of the visit note draft.
4. Click **Yes** for **Was summary of care record provided?**.
5. Lastly, sign your visit note. This will associate the patient to the Denominator for this measure.
![Visit note bottom section showing "Referring to other setting or provider" checked and "Was a summary of care record provided?" set to Yes, with Sign Visit Note button highlighted.]()
1. Attach the visit note to a Referral and send the Referral. This will associate the patient with the Numerator for this measure.
2. Click the **Referral** button at the top of the same patient's chart.
3. In the **To** field, enter the recipient. If sending to a non-Elation provider, you must include either a fax, email, or Direct Address in the recipient's [Contact details](/articles/Using-the-Provider-Directory). If the provider is already using Elation, the Referral will be sent directly to their Elation account.
![Referral form with the "To" field highlighted, showing recipient phone number 4151231234 entered, with "Add Details" link visible to complete provider contact information.]()
1. Scroll to the Attachments section. Do not delete any of the existing attachments (Clinical Profile and Demographics). Click **Select chart items to attach** and check the box for the visit note that you signed. When prompted to include linked reports, click **Yes**. Afterwards click **Attach Items**.
!["Attach Chart Items" dialog with the 10/22/2019 Office Visit Note checked, and the "Additional Attachments" prompt asking whether to include a linked Lab Report, with the "Yes" button highlighted.]()
1. Lastly, click either **Sign, Send & Print Pt Copy** to send the Referral and print a copy for the patient or **Sign & More** >> **Sign & Send** if you do not need to print.
### Additional Info/FAQs
Your signed Visit Note must be sent to a provider via an Elation Referral in order for you to receive credit for both the numerator and denominator for this measure. Simply checking the fields at the bottom of the Visit Note in the absence of a Referral does not qualify. Sending a Referral without the Visit Note attached also does not qualify.
[CMS 2023 MIPS Promoting Interoperability User Guide](https://www.cms.gov/files/document/medicare-pi-program-webinar-presentation.pdf)
## Part 2: Support Electronic Referral Loops by Receiving and Reconciling Health Information
### Measure Details
For at least one electronic summary of care record received for patient encounters during the performance period for which a MIPS eligible clinician was the receiving party of a transition of care or referral, or for patient encounters during the performance period in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician conducts clinical information reconciliation for medication, medication allergy, and current problem list.
### Measure Parameters
**Numerator**: The number of electronic summary of care records in the denominator for which clinical information reconciliation is completed using CEHRT for the following three clinical information sets: (1) Medication – Review of the patient's medication, including the name, dosage, frequency, and route of each medication; (2) Medication allergy – Review of the patient's known medication allergies; and (3) Current Problem List – Review of the patient’s current and active diagnoses.
**Denominator**: Number of electronic summary of care records received using CEHRT for patient encounters during the performance period for which a MIPS eligible clinician was the receiving party of a transition of care or referral, and for patient encounters during the performance period in which the MIPS eligible clinician has never before encountered the patient.
**Exclusion**: Any MIPS eligible clinician who receives transitions of care or referrals or has patient encounters in which the MIPS eligible clinician has never before encountered the patient fewer than 100 times during the performance period.
### Elation Workflows
Receive a CCDA from the care setting who referred the patient to your practice within 2 months of the encounter date (up to 1 month before or after the visit). This can be achieved in two ways:
1. Receive a CCDA in Elation through Direct Message. All Elation providers are assigned a Direct Address and providers outside of Elation can send a CCDA file directly to this Direct Address. Providers can locate their Direct Address under **Settings** >> **Account Details** >> **Direct address**. The Direct address ends with **direct.elationemr.com**. If you do not see a Direct Address listed, you can [Contact Support](https://help.elationemr.com/s/contactsupport) to request one.
2. Receive a CCDA outside of Elation. If you’ve obtained a CCDA file outside of Elation, you can drag and drop the CCDA file into the Elation chart to upload. (instructions [linked here](/articles/import-patient-information-from-another-ehr-c-cda-format))
Follow the workflow below to complete clinical information reconciliation:
1. Sign Off on the CCDA file and import any relevant medications, allergies and problems from the CCDA file into the patient's chart
2. At the bottom of your visit note, check the box for Select **Received from other setting or provider**. This must be done before you sign off on the visit note.
3. Specify **Yes** for the question "Were medications, allergies, and problems reconciled during encounter?"
4. Sign the Visit Note
### Additional Info/FAQs
The CCDA for the encounter must be imported into the patient’s chart within 2 months of the encounter (up to 1 month before and 1 month after the encounter date) in order for the CCDA to be counted towards the measure.
[CMS 2023 MIPS Promoting Interoperability User Guide](https://www.cms.gov/files/document/medicare-pi-program-webinar-presentation.pdf)
## Related Articles
* [Promoting Interoperability (MIPS 2024)](/articles/Promoting-Interoperability-MIPS-2024)
# Promoting Interoperability (MIPS) - Provider to Patient Exchange
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange
This article describes the Provider to Patient Exchange measure for the MIPS Promoting Interoperability performance category.
## Measure Details
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient’s health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programming Interface (API) in the MIPS eligible clinician’s certified electronic health record technology (CEHRT).
## Measure Parameters
**Numerator**
: The number of patients in the denominator (or patient authorized representative) who are provided timely access to health information to view online, download, and transmit to a third party and to access using an application of their choice that is configured meet the technical specifications of the API in the MIPS eligible clinician’s CEHRT.
**Denominator**
: The number of unique patients seen by the MIPS eligible clinician during the performance period.
## Elation Workflows
Invite at least 1 patient to Patient Passport within 4 days of the encounter. Elation will automatically share a summary of each completed visit with the patient via their Passport account.
For customers who do not want to use the Patient Passport feature, click the **Print Clinical Summary of Encounter (MIPS)** button at the bottom of your visit note to provide the patient with a summary of their visit and then sign the visit note.
![Office Visit Note with "Print Clinical Summary of Encounter (MIPS)" button highlighted in the Follow Up section, before signing the visit note.]()
Reference our
[Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
for more information on how to invite patients to Passport.
## Additional Information
For customers using the Patient Passport workflow,
[extending an invitation to Patient Passport](/articles/elation-patient-passport-an-introduction)
is sufficient to meet the requirements for this objective (patients are not required to register).
[CMS 2023 MIPS Promoting Interoperability User Guide](https://www.cms.gov/files/document/medicare-pi-program-webinar-presentation.pdf)
## Related Articles
* [Promoting Interoperability (MIPS 2024)](/articles/Promoting-Interoperability-MIPS-2024)
# Promoting Interoperability (MIPS 2024) - Public Health and Clinical Data Exchange
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-Public-Health-and-Clinical-Data-Exchange
Elation supports the automatic calculation of the MIPS Promoting Interoperability Medicare Public Health and Clinical Data Exchange Objective.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Part 1: Immunization Registry Reporting
### Measure Details
Reporting on this measure requires selecting one of two options regarding active engagement with an Immunization registry. Active engagement may be demonstrated in one of the following ways:
* **Option 1** – Pre-Production and Validation: The MIPS eligible clinician must first register to submit data with the PHA or, where applicable, the CDR to which the information is being submitted. Registration must be completed within 60 days after the start of the performance period, while awaiting an invitation from the PHA or CDR to begin testing and validation. MIPS eligible clinicians that have registered in previous years do not need to submit an additional registration for subsequent performance periods. Upon completion of the initial registration, the MIPS eligible clinician must begin the process of testing and validation of the electronic submission of data. The MIPS eligible clinician must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within a performance period would result in the MIPS eligible clinician not meeting the measure.
* **Option 2** – Validated Data Production: The MIPS eligible clinician has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.
Production data – Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and **test data** which may be submitted for the purposes of enrolling in and testing electronic data transfers.
Active engagement – The MIPS eligible clinician is in the process of moving towards sending "production data" to a public health agency (PHA) or clinical data registry (CDR), or is sending production data to a PHA or CDR.
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the Immunization Registry Reporting measure if the MIPS eligible clinician:
* Does not administer any immunizations to any of the populations for which data is collected by its jurisdiction’s immunization registry or immunization information system during the performance period.
* Operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required to meet the CEHRT definition at the start of the performance period.
* Operates in a jurisdiction where no immunization registry or immunization information system has declared readiness to receive immunization data as of 6 months prior to the start of the performance period.
### Elation Workflows
Elation now offers Immunization Registry connections in over 30 states. Elation is also continuously working with the non-connected State Immunization Registries to establish a connection. [Learn more about the states where the Bidirectional Immunization Registry integration is available](/articles/Immunization-Registry-Interface-Introduction).
You must utilize Elation's Immunization Registry connection or separately connect to your State Immunization Registry outside of Elation to qualify for this measure. If you have an active Immunization Registry connection, select Option 2: Validated Data Production for this measure. If you do not have an active Immunization connection, you may select Option 1: Pre Production and Validation if you are seeking to establish a registry connection in 2024 and have begun the registration process.
## Part 2: Electronic Case Reporting
### Measure Details
The MIPS eligible clinician is in active engagement with a public health agency to electronically submit case reporting of reportable conditions. Active engagement may be demonstrated in one of the following ways:
* Option 1 – Pre-Production and Validation: The MIPS eligible clinician must first register to submit data with the PHA or, where applicable, the CDR to which the information is being submitted. Registration must be completed within 60 days after the start of the performance period, while awaiting an invitation from the PHA or CDR to begin testing and validation. MIPS eligible clinicians that have registered in previous years do not need to submit an additional registration for subsequent performance periods. Upon completion of the initial registration, the MIPS eligible clinician must begin the process of testing and validation of the electronic submission of data. The MIPS eligible clinician must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within a performance period would result in the MIPS eligible clinician not meeting the measure.
* Option 2 – Validated Data Production: The MIPS eligible clinician has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.
Production data – Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and **test data** which may be submitted for the purposes of enrolling in and testing electronic data transfers.
Active engagement – The MIPS eligible clinician is in the process of moving towards sending "production data" to a public health agency (PHA) or clinical data registry (CDR), or is sending production data to a PHA or CDR.
**Important Note**: In 2024 Elation is building an integration for electronic Case Reporting which must be certified to meet this measure.
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the Electronic Case Reporting measure if the MIPS eligible clinician:
* Does not treat or diagnose any reportable diseases for which data is collected by their jurisdiction’s reportable disease system during the performance period.
* Operates in a jurisdiction for which no public health agency is capable of receiving electronic case reporting data in the specific standards required to meet the CEHRT definition at the start of the performance period.
* Operates in a jurisdiction where no public health agency has declared readiness to receive electronic case reporting data as of 6 months prior to the start of the performance period.
* Uses CEHRT that is not certified to electronic case reporting certification criterion prior to the start of the performance period they select in the 2022 calendar year.
### Elation Workflows
To meet this measure you must select Option 1: Pre Production and Validation. To select Option 1: you must reach out to Elation Health and your regional Public Health Agency to declare intent to submit data and let Elation know your intention to submit data and enroll with your regional Public Health Agency.
## Additional Information
[2024 MIPS Promoting Interoperability Measure Specifications](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2650/2024MIPSPISpecifications.zip)
## Related Articles
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# Promoting Interoperability (MIPS 2024) - Query of Prescription Drug Monitoring Program (PDMP)
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-Query-of-Prescription-Drug-Monitoring-Program
This article describes the Query of Prescription Drug Monitoring Program (PDMP) measure for the MIPS Promoting Interoperability performance category.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
This measure builds on e-prescribing. The intent of the measure is when a scheduled prescription is prescribed, before sending the prescription to the pharmacy, the provider queries the regional Prescription Drug Monitoring Program which provides insights to ensure there are no contraindicated medications or historical medication flags. Beginning in 2023 (and continuing in 2024) attestation of 'yes' to this measure is required or an eligible exclusion. This measure is worth 10 points towards the Promoting Interoperability category score.
For at least one Schedule II opioid or Schedule III or IV drug electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a PDMP for prescription drug history.
## Measure Parameters
The MIPS eligible clinician must attest YES to conducting a query of a PDMP for at least one Schedule II opioid or Schedule III or IV drug electronically prescribed using CEHRT .
### Measure Exclusions
Any MIPS eligible clinician meeting one or more of the following criteria may be excluded from the PDMP measure if the MIPS eligible clinician;
1. Is unable to electronically prescribe Schedule II opioids and Schedule III and IV drugs in accordance with applicable law during the performance period.
2. Does not electronically prescribe any Schedule II opioids or Schedule III or IV drugs during the performance period.
## Elation Workflows
If you have an [integration with your regional PDMP](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP) that will satisfy this measure.
This measure may also be met by querying a PDMP portal outside of Elation during the prescription process. There must be a minimum of one query of the PDMP that takes place during the prescription process during the performance time.
## Additional Information
[2024 MIPS Promoting Interoperability Measure Specifications](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2650/2024MIPSPISpecifications.zip)
## Related Articles
* [Promoting Interoperability (MIPS 2024)](/articles/Promoting-Interoperability-MIPS-2024)
* [State Prescription Monitoring Program (PMP/PDMP)](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# Promoting Interoperability (MIPS) - SAFER Guides Assessment
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-SAFER-Guides-Assessment
This article describes the SAFER Guides that must be completed for the MIPS Promoting Interoperability performance category.
## What are SAFER guides?
SAFER Guides consist of nine guides organized into three broad groups. These guides enable healthcare organizations to address EHR safety in a variety of areas. This required attestation measure is an attestation of completing the [High Priority Practices Guide](https://www.healthit.gov/sites/default/files/safer/guides/safer_high_priority_practices.pdf).
[Learn more about the SAFER Guides here](https://www.healthit.gov/topic/safety/safer-guides).
Safety Assurance For EHR Resilience (SAFER) Guides are intended to provide a series of checklists for best practices on EHR use across an organization. If your practice has been interested in ensuring certain workflows for security, privacy, or other are being followed, this may be a good opportunity to utilize an existing best practice worksheet designed by the Office of the National Coordinator for Health Information Technology (ONC).
## How to meet the measure outside of Elation
There is no action to take inside of Elation for this measure. It is related to a practice's own policies and procedures around EHR use, similar to the Security Risk Assessment for the MIPS PI category.
## How to report on SAFER Guides Assessment
The SAFER Guides Assessment measure for Promoting Interoperability is a required measure to attest “Yes” to, similar to the Security Risk Analysis requirement.. The requirement is to respond with a Yes/No attestation and a Yes will satisfy the measure, a No response will result in a score of 0 for the Promoting Interoperability category. The measure consists of completing the High Priority Practices SAFER Guide only.
## Additional Resources
[2024 MIPS Promoting Interoperability Measure Specifications](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2650/2024MIPSPISpecifications.zip)
## Related Articles
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# Promoting Interoperability (MIPS 2024) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-TEFCA
This article describes enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA) for the MIPS Promoting Interoperability performance category.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Measure Details
This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:
* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (2 measures with performance numerator/denominator metrics)
* [Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange) (attestation to engagement of a bidirectional exchange)
## Measure Parameters
The MIPS eligible clinician or group must attest to the following:
* Participating as a signatory to a Framework Agreement (as that term is defined by the Common Agreement for Nationwide Health Information Interoperability as published in the Federal Register and on ONC’s website) in good standing (that is, not suspended) and enabling secure, bi-directional exchange of information to occur, in production, for every patient encounter, transition or referral, and record stored or maintained in the EHR during the performance period, in accordance with applicable law and policy.
* Using the functions of CEHRT to support bi-directional exchange of patient information, in production, under this Framework Agreement.
## Elation Workflows
For 2024, there are no workflows in Elation to meet this measure. We recommend using the workflows detailed in one of the following two measures that Elation does support for the Health Information Exchange Objective:
* [Health Information Exchange (HIE) - Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange) (for customers using Elation’s Carequality connection only)
Elation is currently not a QHIN and recognized under TEFCA. In the future Elation may have integrations with QHINs that would satisfy this measure.
## Additional Information
[2024 MIPS Promoting Interoperability Measure Specifications](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2650/2024MIPSPISpecifications.zip)
## Related Articles
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [Promoting Interoperability (MIPS) - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS) - Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-HIE-Bidirectional-Exchange)
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
# Promoting Interoperability (MIPS) - e-Prescribing
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-MIPS-eRX
This article describes the ePrescribing measure for the MIPS Promoting Interoperability performance category.
## Measure Details
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
## Measure Parameters
**Numerator**
: The number of prescriptions in the denominator generated, queried for a drug formulary, and transmitted electronically using CEHRT.
**Denominator**
: The number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the performance period; or number of prescriptions written for drugs requiring a prescription in order to be dispensed during the performance period.
## Elation Workflows
Write and transmit at least one e-prescription using Elation. To maximize your score, ePrescribe as many of your prescriptions as possible (as opposed to printing/calling).
Our
[Prescription Form Guide](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
details how to write an electronic prescription. This needs to be performed at least once during the reporting period.
When completing your prescription, make sure you select **e-Prescribe** to receive credit. Scripts that are simply “Signed”, **Saved**, or **Printed** do not count towards the numerator.
![Prescription Form with the ePrescribe button highlighted, showing Lisinopril 20 mg, 1 tablet daily, qty 90. Select ePrescribe—not Sign & Close, Save, or Print—to count toward the numerator.]()
## Additional Information
In order to send an electronic prescription, providers must first complete
[Provider Account Authentication](/articles/how-to-complete-account-authentication)
.
[CMS 2023 MIPS Promoting Interoperability User Guide](https://www.cms.gov/files/document/medicare-pi-program-webinar-presentation.pdf)
## Related Articles
* [Promoting Interoperability (MIPS 2024)](/articles/Promoting-Interoperability-MIPS-2024)
# Promoting Interoperability (MIPS) - Security Risk Analysis
Source: https://help.elationhealth.com/articles/Promoting-Interoperability-Security-Risk-Analysis
This article describes the Security Risk Analysis measure that must be completed for the MIPS Promoting Interoperability performance category.
## Measure Details
Conduct or review a security risk analysis on your 2015 Edition CEHRT and/or 2015 Edition Cures Update CEHRT functionality on an annual basis, within the calendar year of the performance period.
## Measure Parameters
Eligible professionals (EPs) must attest YES to conducting or reviewing a security risk analysis and implementing security updates as necessary and correcting identified security deficiencies to meet this measure.
## Workflows outside of Elation
This measure refers to how you protect the health information within your practice. A security risk analysis needs to be completed by the practice outside of Elation.
There are 2 ways to conduct a security risk analysis review:
1. Use the following CMS-approved Security Risk Assessment Tool to conduct a security risk analysis yourself: [http://www.healthit.gov/providers-professionals/security-risk-assessment-tool](http://www.healthit.gov/providers-professionals/security-risk-assessment-tool)
2. Work with a CMS-approved Regional Extension Center representative to review your security risk analysis. Contact your local Regional Extension Center [here](https://ehrintelligence.com/news/list-of-regional-extension-center-contacts).
## Additional Information
[CMS 2023 MIPS Promoting Interoperability User Guide](https://www.cms.gov/files/document/medicare-pi-program-webinar-presentation.pdf)
## Related Articles
* [Promoting Interoperability (MIPS 2024)](/articles/Promoting-Interoperability-MIPS-2024)
# QRDA Export Guide- How to export QRDA files from Elation EHR
Source: https://help.elationhealth.com/articles/QRDA-Export-Guide
## What are QRDA files?
The Quality Reporting Document Architecture (QRDA) is the standard for data submission used in various Value Based Payment Programs administered by the Centers for Medicare and Medicaid Services (CMS). This includes the Merit-based Incentive Payment System (MIPS) Quality Category under the Quality Payment Program (QPP), a federally mandated Medicare program overseen by CMS. QRDA files are also used widely across other CMS programs, specifically most Alternative Payment Models (which include ACOs).
Elation is certified to the standard QRDA format written by CMS. Elation’s QRDA files are detailed and aggregate files that are built from electronic Clinical Quality Measures (eCQMs) that Elation is certified to.
There are two QRDA file types:
* QRDA Category I (QRDA-1)
* QRDA-1 is an individual patient-level report.
* A QRDA-1 report contains quality data for one patient for one or more eCQMs..
* QRDA-1 files are most commonly associated with programs that aggregate and de-duplicate data intended for group reporting, common among MSSP ACO with new requirements to report eCQMs.
* QRDA Category III (QRDA-3)
* QRDA-3 is an aggregate quality report.
* A QRDA-3 report contains quality data for all qualifying patients for multiple eCQMs.
* QRDA-3 files are most commonly associated with MIPS as an option to automatically upload Quality data to be scored.
## Exporting QRDA-1 files from Elation EHR
Only [Admin Level Users](/articles/administrative-privileges) can export QRDA-1 files and have access to the **Export QRDA-1** features listed below.
QRDA-1 files include PHI and should only be transferred in a secure manner. Once a practice or provider has downloaded the QRDA file(s) they should follow all applicable HIPAA rules and regulations to maintain secure transfers.
### Exporting a QRDA-1 file for a single patient
![Data Exchange Functions modal open on a patient chart with "Export QRDA1" button highlighted, among other export options like Export Complete Record and Bulk Export QRDA1.]()
To export a QRDA-1 file containing Clinical Quality Measure data for a single patient:
1. Open the patient’s chart.
2. Click on the **More** button in the navigation bar.
3. Click **Data Exchange**.
4. Click **Export QRDA-1**.
5. The QRDA-1 file will be downloaded to the default location set in your web browser.
### Exporting Bulk QRDA-1 files for all qualifying patients
#### Exporting QRDA-1 files for all qualifying patients from the Clinical Quality Measures report
![Clinical Quality Measures report with Export menu open showing "Export QRDA-1" option highlighted, and a confirmation dialog stating the QRDA-1 report is exporting and an email will be sent when complete.]()
To export QRDA-1 files for all qualifying patients that have Clinical Quality Measure data from the Clinical Quality Measures report:
1. Go to **Reports** at the top of any page in Elation and click **Clinical Quality Measures**.
2. Make sure Clinical Quality Measure data is visible (you need to select a Tax ID or Providers to load data).
3. Click **Export** at the top of the report.
4. Click **Export QRDA-1**
5. A window will appear to notify you that a download is in progress.
6. Elation will send an email to the email address for your EHR account once the download is complete.
7. Once you receive the email, click on the **Download QRDA-1 file** link in the email. For security reasons, you will be redirected to Elation EHR and you must log in to your Elation EHR account in order to be able to download the QRDA-1 .zip file and view the password for the file.
* If you are already logged in, you will not be prompted to log in again.
* If you are logged in to a different account than the account that matches the download link then you will not be able to download the files.
*
You will have 40 days to download the .zip file before the download link expires. If the download link has expired, initiate a new export.
8. After logging in, you will see a pop up with the password and a **Download** button. Click the “Download’ button to download the file. The file will be downloaded to the default location on your device as set in your web browser Settings. Double click on the encrypted .zip file on your device and then enter the password provided to unlock the file and view its contents.
!["QRDA-1 file ready" dialog showing Export ID #6, password mXLQKvesLVDZ, expiration 09/11/2024, with Download and Close buttons.]()
#### Exporting QRDA-1 files for all qualifying patients from the patient chart
![Data Exchange Functions dialog open on a patient chart with "Bulk Export QRDA1" button highlighted in an orange border, showing all available export options.]()
To export QRDA-1 files for all qualifying patients that have Clinical Quality Measure data from any patient’s chart:
1. Open a patient’s chart.
2. Click on the **More** button in the navigation bar.
3. Click **Data Exchange**.
4. Click **Bulk Export QRDA-1**. This will bring you to the Clinical Quality Measures report.
5. Follow the remainder of the instructions from the [Exporting QRDA-1 files for all patients from the Clinical Quality Measures report section](#bulk_export_QRDA1_CQM_Report) above.
## Exporting QRDA-3 files from Elation EHR
The QRDA-3 file can only be exported from the Clinical Quality Measure Report.
To export a QRDA-3 file with all of the Clinical Quality Measure data from your Clinical Quality Measures Report:
1. Go to **Reports** at the top of any page in Elation and click **Clinical Quality Measures**.
2. Make sure Clinical Quality Measure data is visible (If this is your first time opening the Clinical Quality Measure Report for the reporting year, you will need to select a Tax ID or Providers to load data).
3. Click **Export** at the top of the report.
4. Click **Download QRDA-3**
5. The QRDA-3 file will be downloaded to the default location on your device as set in your web browser Settings.
## Frequently Asked Questions
### What is the difference between QRDA-1 files and QRDA-3 files?
QRDA-1 and QRDA-3 files typically have different use cases and reporting programs. QRDA-3 files are typically associated with MIPS submission; submitting in the QPP Portal when it is time to submit your MIPS Quality reporting data for the year. [Click here to reference any MIPS related articles](/articles/MIPS-2026-Overview). QRDA-1 files are most commonly used among PCP practices as a mechanism for an MSSP ACO or other APM to request individual eCQM measure data to then aggregate and submit to a CMS program. The ACO may request the bulk QRDA-1 files be sent to a Qualified Clinical Data Registry or other technology vendor to support aggregating the data in the standard format required by CMS beginning in CY 2024. All details related to what measures (eCQMs) should be included, where the files should go, and what data is reported, should be driven by the outside organization (ex, ACO administrator). Elation provides this tool for practices and providers to meet their reporting requirements but does not provide direction on program requirements for Value Based Payment Programs as there is significant variation between programs and even among programs.
### I am unable to see the **Export QRDA-1** or **Bulk Export QRDA-1** option. Why?
Only [Admin Level Users](/articles/administrative-privileges) can export QRDA-1 files and have access to the **Export QRDA-1** features listed in this article.
### What measures are included in the QRDA-1 files?
QRDA-1 files are the detailed patient level files of how a patient was included as a qualifying patient in the eCQM specification. All measures that have qualifying patients in them will merit a QRDA-1 file.
### What measures are included in the QRDA-3 file?
All electronic Clinical Quality Measures (eCQMs) that Elation is certified to and have data from patients included in the numerator and denominators will be included in the QRDA-3 file.
eCQMs supported in CY 2024:
* [\[CMS124v12\] Cervical Cancer Screening (MIPS 2024)](/articles/CMS124v12-Cervical-Cancer-Screening-MIPS-2024)
* [\[CMS122v12\] Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%) (MIPS 2024)](/articles/CMS122v12-Diabetes-Hemoglobin-A1c-Poor-Control-MIPS-2024)
* [\[CMS131v11\] Diabetes: Eye Exam (MIPS 2024)](/articles/CMS131v12-Diabetes-Eye-Exam-MIPS-2024)
* [\[CMS139v12\] Falls: Screening for Future Fall Risk (MIPS 2024)](/articles/CMS139v12-Falls-Screening-for-Future-Fall-Risk-MIPS-2024)
* [\[CMS149v12\] Dementia: Cognitive Assessment (MIPS 2024)](/articles/CMS149v12-Dementia-Cognitive-Assessment-MIPS-2024)
* [\[CMS155v12\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2024)](/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2024)
* [\[CMS165v12\] Controlling High Blood Pressure (MIPS 2024)](/articles/CMS165v12-Controlling-High-Blood-Pressure-MIPS-2024)
* [\[CMS69v12\] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan](/articles/CMS69v12-Preventive-Care-and-Screening-Body-Mass-Index-BMI-Screening-and-Follow-Up-Plan)
* [\[CMS125v12\] Breast Cancer Screening](/articles/CMS125v12-Breast-Cancer-Screening)
* [\[CMS130v14\] Colorectal Cancer Screening](/articles/CMS130v14-Colorectal-Cancer-Screening)
### Which patients are included in QRDA files?
For each QRDA and its corresponding eCQM, the specifications outline the criteria for numerators and denominators. This information determines whether a patient meets the criteria to be included or excluded from a specific measure. Consequently, eCQMs and the associated QRDA files will only include patients who meet the numerator or denominator requirements. This is defined by eCQI specifications, not by Elation Health.
### How long does it take to export QRDA-1 files in bulk?
The time it takes to export QRDA-1 files in bulk depends on the number of patients that meet the numerator/denominator criteria for the relevant eCQMs. We try to provide an estimate for you. Please note, it will never exceed 24 hours. If you do not receive your bulk QRDA-1 export file via email after 24 hours, [see the following FAQ](#did_not_receive_email).
### Can I change which email the bulk QRDA-1 export file is sent to?
The bulk QRDA-1 export file is sent to the email tied to your Elation account (your login email). In order to change the email which the bulk QRDA-1 export file is sent to you must update the email associated with your account.
### What happens if I never receive the bulk QRDA-1 export file in my email?
If you have not received the bulk QRDA-1 export file within 24 hours from when you initiated the export, reach out to Elation’s Support Team using the **I need help** -> **Contact Elation Support** option in the EHR and include “Bulk QRDA-1 Report” in the description of the issue. In the meantime try to export the QRDA-1 files in bulk again to see if you receive the files the second time around.
### Can I share the download link for the bulk QRDA-1 export file?
No, for security purposes only the person that initiated the export can access the emailed download link for the bulk QRDA-1 export file.
**Important Note**: QRDA-1 files include PHI and should only be transferred in a secure manner. Once a practice or provider has downloaded the QRDA file(s) they should follow all applicable HIPAA rules and regulations to maintain secure transfers.
### I opened the QRDA file but the information is not in a readable format. Why?
QRDA files are .xml files and are not designed for easy reading.
### Can I add my own measures to the QRDA files?
QRDA files are standardized and certified files. They are built by Elation to pass rigorous testing and meet explicit standards. There is not a way to change, add, or adjust the files or they may be rendered not usable by the administering agency.
### I need different measures than what are included, can Elation build more measures?
Elation is certified to 13 eCQMs, some of which have been deprecated over time, or are not usable across programs. The measures Elation is certified to reflect the primary needs at the time of certification. These are significant development requirements and must be built to standard and then certified before offering to our users.
If you are reporting different measures to different programs CMS expects providers to understand their technical requirements independently and as an EHR vendor all of our certified features are available on the [CHPL site](https://chpl.healthit.gov/#/listing/9876) where users may make themselves familiar with Elation’s certified features. Additional measures may be considered as a product request, but Elation is not required to build measures that CMS requires.
### What measures am I required to send to \[any CMS program]?
Reporting requirements and familiarity with CMS program requirements should be directed to the program you participate with. Elation does not administer programs but understands requirements to the best of product abilities to ensure our product features enable reporting needs. However, Elation does not provide consulting or guidance on reporting requirements. Those are the sole responsibility of the provider or practice. Useful places to direct questions on your reporting requirements include the QPP helpdesk or your ACO administrator. Elation provides tools to meet requirements, and you should be familiar with your requirements and the relevant eCQMs and QRDA files available in Elation to ensure they meet your needs, or find alternate means for your reporting requirements and workflows to extract the data you need. Elation does not submit data on behalf of providers.
### I do not believe the QRDA file captures my data accurately, can Elation change their logic?
eCQMs and QRDA files are built to standards determined by the [electronic Clinical Quality Improvement](https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ec-ecqms\&global_measure_group=eCQMs\&globalyearfilter=2024) Resource Center. These standards are then adopted by the Office of National Coordinator for Health IT (ONC), which administers the CEHRT program that Elation is certified for, and then required by CMS for their reporting programs. We can not change the logic of our QRDA files due to certification requirements.
### Can Elation send the QRDA files to someone else on my behalf?
No, Elation cannot send QRDA files to someone on your behalf. QRDA files are available for you to use at your discretion to upload, send, or submit to the relevant reporting program and following all applicable rules and regulations. To send data to your ACO, you can ask our ACO for directions on what to do once you have your QRDA-1 files and where to send them and on what cadence.
### My ACO told me to ask Elation for a contact to report for me, who can I contact?
Elation does not provide a consultant at this point in time to support your reporting needs. If your ACO has told you to contact Elation for reporting you should first identify:
1. What data is your ACO requesting?
2. What is the purpose of the data for your reporting?
3. Is this an integration for reporting, for data capture, or other benchmarking requirements?
4. What eCQMs or CQMs does your ACO report on?
5. How do you submit eCQM data to your ACO?
Then, you may submit a ticket to our Support Team using the **I need help** -> **Contact Elation Support** button in the EHR to route the integration request. These are all required components for reporting and should help you be more familiar with your requirements, and help identify what you are tracking and where to send data.
## Related Articles
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
# Qualified Clinical Data Registry (QCDR) Guide
Source: https://help.elationhealth.com/articles/Qualified-Clinical-Data-Registry-Guide
## What is a Qualified Clinical Data Registry (QCDR)?
A Qualified Clinical Data Registry (QCDR) is an entity approved by the Centers for Medicare & Medicaid Services (CMS) to collect clinical data for the purpose of tracking to support quality improvement. Unlike traditional claims-based reporting, QCDRs can collect a broader range of clinical data, including patient-reported outcomes and data from electronic health records (EHRs). They often offer measures beyond those available in the standard MIPS program, allowing for more specialized and relevant quality reporting, and are frequently used by ACOs to aggregate and report quality metrics across participating practices. QCDRs are an outside entity that is registered to calculate quality measures and report that data to CMS programs.
QCDRs accept data in multiple formats, have a variety of ways to work with them, and are available for additional understanding and hands on support of providers for reporting requirements. Elation customers have worked with outside QCDRs successfully to report to MIPS and other CMS programs. If you would prefer hands on support for MIPS reporting, a QCDR would be a good option as Elation offers the technology tools, but does not offer hands on support for reporting. Here are some QCDRs you can use:
* [Healthmonix](https://healthmonix.com/?utm_term=healthmonix\&utm_campaign=RR+-+MIPS+Campaign\&utm_source=adwords\&utm_medium=ppc\&hsa_acc=8408405268\&hsa_cam=16602259110\&hsa_grp=131965243902\&hsa_ad=588439124547\&hsa_src=g\&hsa_tgt=kwd-1644891274937\&hsa_kw=healthmonix\&hsa_mt=e\&hsa_net=adwords\&hsa_ver=3\&gad_source=1\&gclid=Cj0KCQjwhMq-BhCFARIsAGvo0KcgOoPDyUdWOMWF0u5-4HBTs0vvWlsTTknzR1U4ntqlqS2L8wWI-r8aAo3zEALw_wcB)
* [MDinteractive](https://mdinteractive.com/)
Working with a QCDR generally works by providing the CCDA download from Elation which can be accomplished by referencing this [Help Center Article](/articles/Supported-Elation-CCDA-types).
An analogy of how this works is similar to reporting taxes. Elation is similar to a TurboTax and provides the technology and information but as you have more complicated tax reporting and schedules to report you may need to hire a CPA. A QCDR works similarly in this way that they will take the data and support you with your submission beyond what Elation supports.
## Collection Types
* **Electronic Clinical Quality Measures (eCQMs)**
* eCQMs are standardized measures that a Certified EHR Technology (CEHRT) meets to specification and is certified to. There are currently 47 eCQMs available to report to MIPS in 2025. Elation is certified to 12 eCQMs, and 9 eCQMs are eligible for Traditional MIPS reporting. eCQMs are measured as part of your regular workflows and can be found regularly in the Quality Dashboard of Elation. During reporting, eCQMs are extracted as a QRDA file and submitted to the QPP.
* Important Note: (QRDA files and eCQMs are used and submitted to other CMS programs and are applicable for other program participants as such, eCQMs no longer applicable in traditional MIPS are applicable for MVPs and APMs and remain in production and functionality in Elation.s well).
* These are the eCQMs that Elation supports in 2025 (9 bolded eCQMs that contribute to traditional MIPS and the total 12):
* [\[CMS124v13\] Cervical Cancer Screening (MIPS 2025)](/articles/CMS124v13-Cervical-Cancer-Screening-MIPS-2025)
* [\[CMS122v13\] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2025)](/articles/CMS122v13-Diabetes-Glycemic-Status-Greater-than-9percent)
* [\[CMS131v13\] Diabetes: Eye Exam (MIPS 2025)](/articles/CMS131v13-Diabetes-Eye-Exam-MIPS-2025)
* [\[CMS139v13\] Falls: Screening for Future Fall Risk (MIPS 2025)](/articles/CMS139v13-Falls-Screening-for-Future-Fall-Risk-MIPS-2025)
* [\[CMS149v13\] Dementia: Cognitive Assessment (MIPS 2025)](/articles/CMS149v13-Dementia-Cognitive-Assessment-MIPS-2025)
* [\[CMS155v13\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2025)](/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2025)
* [\[CMS165v13\] Controlling High Blood Pressure (MIPS 2025)](/articles/CMS165v13-Controlling-High-Blood-Pressure-MIPS-2025)
* **\[CMS2v14] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2025)**
* **\[CMS159v13] Depression Remission at Twelve Months (MIPS 2025)**
* [\[CMS69v13\] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan (not available for Traditional MIPS)](/articles/CMS69v13-Preventive-Care-and-Screening-Body-Mass-Index-BMI-Screening-and-Follow-Up-Plan)
* [\[CMS125v13\] Breast Cancer Screening (not available for Traditional MIPS)](/articles/CMS125v13-Breast-Cancer-Screening)
* [\[CMS130v13\] Colorectal Cancer Screening (not available for Traditional MIPS)](/articles/CMS130v13-Colorectal-Cancer-Screening)
* **MIPS Clinical Quality Measures (CQMs)**
* MIPS CQMs are often collected by third party intermediaries and submitted on behalf of MIPS eligible clinicians. You may choose to work with a Qualified Registry.
* **Medicare Part B Claims Measures**
* This collection type is only available to those designated with the small practice special status (15 or fewer clinicians). Medicare Part B claims measures are always reported with the clinician’s individual (rendering) NPI even when reporting as a group, subgroup (MVPs only) virtual group (traditional MIPS), or APM Entity. For more information about reporting quality measures through Medicare Part B claims, download [this guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2649/2024PartBClaimsReportingGuide.pdf) from the QPP.
## What does Elation support for Quality measures and collection types?
Elation supports 12 eCQMs, 9 of which count in Traditional MIPS, and 3 are used in the MVP Value in Primary Care group. Administrative Claims Based measures may be selected to support additional measure selections for MIPS to report for Traditional MIPS and MVPs. Elation supports APM reporting with the selected eCQMs, and other measures supported depending on collection type.
* **Traditional MIPS:** You may report using 6 eCQMs or a combination of eCQMs and claims based measures, or reporting through a registry. To report through a registry, we recommend connecting with MDInteractive.
* **MVPs:** You may report on the Value in Primary Care MVP the 4 bolded measures above which include 3 eCQMs and 1 Claims Based Measures.
* **APP:** If you have signed up with an APM to participate this year, such as an ACO, or REACH, ensure your quality reporting is aligned with the measures the ACO administrator selected and only one quality submission is required, the quality submission reported with your APM.
Elation Health provides the tools to support certain reporting requirements. All reporting requirements are the sole responsibility of the reporting provider. The changing nature of CMS programs and MIPS as part of those programs, require continuous changes to the program. If you have concerns with the measures required to report to MIPS or CMS programs please direct that feedback to CMS and the QPP. Elation Health provides a certain set of eCQMs that require significant development work to meet requirements for PCPs. If you have additional needs beyond the eCQMs that are supported in Elation, such as, support with reporting to MIPS or CMS programs, that should be directed to those relevant agencies. The QPP provides a not insignificant amount of support for reporting.
## Related Articles
* [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types)
# Qualified Clinical Data Registry (QCDR) Introduction (2026)
Source: https://help.elationhealth.com/articles/Qualified-Clinical-Data-Registry-Introduction-2026
## What is a Qualified Clinical Data Registry (QCDR)?
A Qualified Clinical Data Registry (QCDR) is an entity approved by the Centers for Medicare & Medicaid Services (CMS) to collect clinical data for the purpose of tracking to support quality improvement. Unlike traditional claims-based reporting, QCDRs can collect a broader range of clinical data, including patient-reported outcomes and data from electronic health records (EHRs). They often offer measures beyond those available in the standard MIPS program, allowing for more specialized and relevant quality reporting, and are frequently used by ACOs to aggregate and report quality metrics across participating practices. QCDRs are an outside entity that is registered to calculate quality measures and report that data to CMS programs.
QCDRs accept data in multiple formats, have a variety of ways to work with them, and are available for additional understanding and hands on support of providers for reporting requirements. Elation customers have worked with outside QCDRs successfully to report to MIPS and other CMS programs. If you would prefer hands on support for MIPS reporting, a QCDR would be a good option as Elation offers the technology tools, but does not offer hands on support for reporting. Here are some QCDRs you can use:
* [Healthmonix](https://healthmonix.com/?utm_term=healthmonix\&utm_campaign=RR+-+MIPS+Campaign\&utm_source=adwords\&utm_medium=ppc\&hsa_acc=8408405268\&hsa_cam=16602259110\&hsa_grp=131965243902\&hsa_ad=588439124547\&hsa_src=g\&hsa_tgt=kwd-1644891274937\&hsa_kw=healthmonix\&hsa_mt=e\&hsa_net=adwords\&hsa_ver=3\&gad_source=1\&gclid=Cj0KCQjwhMq-BhCFARIsAGvo0KcgOoPDyUdWOMWF0u5-4HBTs0vvWlsTTknzR1U4ntqlqS2L8wWI-r8aAo3zEALw_wcB)
* [MDinteractive](https://mdinteractive.com/)
* [Prime Registry](https://primeregistry.org/)
Working with a QCDR generally works by providing the CCDA download from Elation which can be accomplished by referencing this [Help Center Article](/articles/Supported-Elation-CCDA-types). There are also other methods of integration or supplemental data that can be used for reporting with a registry.
An analogy of how this works is similar to reporting taxes. Elation is similar to a TurboTax® and provides the technology and information but as you have more complicated tax reporting and schedules to report you may need to hire a CPA. A QCDR works similarly in this way that they will take the data and support you with your submission beyond what Elation supports.
## Collection Types
* **Electronic Clinical Quality Measures (eCQMs)**
* eCQMs are standardized measures that a Certified EHR Technology (CEHRT) meets to specification and is certified to. There are currently 46 eCQMs available to report to MIPS in 2026. Elation is certified to 12 eCQMs, and 9 eCQMs are eligible for Traditional MIPS reporting. eCQMs are measured as part of your regular workflows and can be found regularly in the Quality Dashboard of Elation. During reporting, eCQMs are extracted as a QRDA file and submitted to the QPP.
* Important Note: (QRDA files and eCQMs are used and submitted to other CMS programs and are applicable for other program participants as such, eCQMs no longer applicable in traditional MIPS are applicable for MVPs and APMs and remain in production and functionality in Elation.s well).
* These are the eCQMs that Elation supports in 2026 (9 bolded eCQMs that contribute to traditional MIPS and the total 12):
* **\[CMS124v14] Cervical Cancer Screening (MIPS 2026)**
* **\[CMS122v14] Diabetes: Glycemic Status Assessment Greater Than 9% (MIPS 2026)**
* **\[CMS131v14] Diabetes: Eye Exam (MIPS 2026)**
* **\[CMS139v14] Falls: Screening for Future Fall Risk (MIPS 2026)**
* **\[CMS149v14] Dementia: Cognitive Assessment (MIPS 2026)**
* **\[CMS155v14] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2026)**
* **\[CMS165v14] Controlling High Blood Pressure (MIPS 2026)**
* **\[CMS2v15] Preventive Care and Screening: Screening for Depression and Follow-Up Plan (MIPS 2026)**
* **\[CMS159v14] Depression Remission at Twelve Months (MIPS 2026)**
* [\[CMS69v14\] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan (not available for Traditional MIPS)](/articles/CMS69v14-Preventive-Care-and-Screening-BMI-Screening-and-Follow-Up-Plan)
* [\[CMS125v14\] Breast Cancer Screening (not available for Traditional MIPS)](/articles/CMS125v14-Breast-Cancer-Screening)
* [\[CMS130v14\] Colorectal Cancer Screening (not available for Traditional MIPS)](/articles/CMS130v14-Colorectal-Cancer-Screening)
* **MIPS Clinical Quality Measures (CQMs)**
* MIPS CQMs are often collected by third party intermediaries and submitted on behalf of MIPS eligible clinicians. You may choose to work with a Qualified Registry.
* **Medicare Part B Claims Measures**
* This collection type is only available to those designated with the small practice special status (15 or fewer clinicians). Medicare Part B claims measures are always reported with the clinician’s individual (rendering) NPI even when reporting as a group, subgroup (MVPs only) virtual group (traditional MIPS), or APM Entity. For more information about reporting quality measures through Medicare Part B claims, download [this guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2649/2024PartBClaimsReportingGuide.pdf) from the QPP.
## What does Elation support for Quality measures and collection types?
Elation supports 12 eCQMs, 9 of which count in Traditional MIPS, and 3 are used in the MVP Value in Primary Care group. Administrative Claims Based measures may be selected to support additional measure selections for MIPS to report for Traditional MIPS and MVPs. Elation supports APM reporting with the selected eCQMs, and other measures supported depending on collection type.
* **Traditional MIPS:** You may report using 6 eCQMs or a combination of eCQMs and claims based measures, or reporting through a registry. To report through a registry, we recommend connecting with MDInteractive.
* **MVPs:** You may report on the Value in Primary Care MVP the 4 bolded measures above which include 3 eCQMs and 1 Claims Based Measures.
* **APP:** If you have signed up with an APM to participate this year, such as an ACO, or REACH, ensure your quality reporting is aligned with the measures the ACO administrator selected and only one quality submission is required, the quality submission reported with your APM.
Elation Health provides the tools to support certain reporting requirements. All reporting requirements are the sole responsibility of the reporting provider. The changing nature of CMS programs and MIPS as part of those programs, require continuous changes to the program. If you have concerns with the measures required to report to MIPS or CMS programs please direct that feedback to CMS and the QPP. Elation Health provides a certain set of eCQMs that require significant development work to meet requirements for PCPs. If you have additional needs beyond the eCQMs that are supported in Elation, such as, support with reporting to MIPS or CMS programs, that should be directed to those relevant agencies. The QPP provides a not insignificant amount of support for reporting.
*©1997-2026 Intuit, Inc. All rights reserved.*
## Related Articles
* [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types)
* [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category)
# MIPS (2024)- Quality Category
Source: https://help.elationhealth.com/articles/Quality-Category-MIPS-2024
This article describes the Quality Performance Category for MIPS 2024.
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
## Quality Category Overview
The Quality category in MIPS provides a variety of reporting flexibilities. There are reporting options and collection types to consider. The Quality category is intended to measure Quality performance based on certain measures. Most providers are most familiar with Traditional MIPS and APP Reporting (reporting with an ACO).
MIPS Quality reporting covers a 12 month performance period (full calendar year January 1-December 31, 2024)
## Reporting Options
### Traditional MIPS
Traditional MIPS, established in the first year of QPP, is the original reporting option for MIPS. You select the quality measures and improvement activities that you'll collect and report from all of the quality measures and improvement activities finalized for MIPS. You’ll also report the complete Promoting Interoperability measure set, if you are required to report MIPS and the PI category and do not have an existing exclusion. The QPP collects and calculates data for the cost performance category for you.
General reporting requirements are as follows:
* You’ll need to submit collected data for at least **6 quality measures** (including one outcome measure or high priority measure in the absence of an applicable outcome measure), or a complete specialty measure set.
* New for 2024: Beginning with the 2024 performance period, you’ll need to report performance data for at least 75% of the denominator eligible cases for each quality measure (data completeness), which is an increase from the previous data completeness threshold of 70%.
* You can submit measures from different collection types to fulfill the requirement to report data for at least 6 quality measures.
You may supplement Claims Based measure collection .
### MIPS Value Pathways
MIPS Value Pathways (MVPs) are the newest reporting option that offer clinicians a subset of measures and activities relevant to a specialty or medical condition. MVPs offer more meaningful groupings of measures and activities, to provide a more connected assessment of the quality of care. You’ll select, collect, and report on a reduced number of quality measures and improvement activities (as compared to traditional MIPS). You’ll also report the complete Promoting Interoperability measure set (the same as reported in traditional MIPS), if you are required to report MIPS and the PI category and do not have an existing exclusion. The QPP collects and calculates data for the cost performance category and population health measures for you. MVPs must be pre-registered for in the QPP portal during the calendar year (you can not elect MVPs to report on in Q1 2025 during reporting). A new MVP measure set includes a Value in Primary Care measure bundle that is the most relevant and currently the only MVP bundle supported by Elation. To report on an MVP measure set you must select 4 quality measures from the measure bundle offered. The **bolded measures** and collection types are the measures that are available for the Value in Primary Care MVP:
1. **Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, MIPS CQMs Specifications
2. **Advance Care Plan**
* Collection Type: **Medicare Part B Claims Measure Specifications**, MIPS CQMs Specifications
3. **Preventive Care and Screening: Screening for Depression and Follow-Up Plan**
* Collection Type: **Medicare Part B Claims Measure Specifications**, eCQM Specifications, MIPS CQMs Specifications
4. **Controlling High Blood Pressure**
* Collection Type: Medicare Part B Claims Measure Specifications, **eCQM Specifications**, MIPS CQMs Specifications
5. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
* Collection Type: eCQM Specifications
6. CAHPS for MIPS Clinician/Group Survey
* Collection Type: CAHPS Survey Vendor
7. Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
* Collection Type: eCQM Specifications, MIPS CQMs Specifications
8. HIV Screening
* Collection Type: eCQM Specifications
9. Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM)
* Collection Type: MIPS CQMs Specifications
10. Screening for Social Drivers of Health
* Collection Type: MIPS CQMs Specifications
11. Adult Immunization Status
* Collection Type: MIPS CQMs Specifications
12. Preventive Care and Wellness (composite)
* Collection Type: MIPS CQMs Specifications
13. Initiation, Review, And/Or Update To Suicide Safety Plan For Individuals With Suicidal Thoughts, Behavior, Or Suicide Risk
* Collection Type: MIPS CQMs Specifications
### To Report MVPs
1. Register in the QPP portal
2. Select one population health measure during registration. CMS will calculate these measures through administrative claims and will be scored as part of the quality performance category.
3. For the 2024 performance period, there are 2 population health measures proposed to be available for selection:
4. Hospital-Wide, 30-day, All-Cause Unplanned Readmission (HWR) Rate for the Merit-Based Incentive Payment System (MIPS) Groups
5. Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions
6. Quality Performance Category
7. Select and submit 4 quality measures
8. Improvement Activities Performance Category
9. Select and submit 2 medium-weighted improvement activities OR one high-weighted improvement activity.
10. Promoting Interoperability Category
11. Do not need to submit data if you have an existing exclusion (small practices with 15 or fewer providers)
### APM Performance Pathways
The Alternative Payment Model (APM) Performance Pathway (APP) is a streamlined reporting option for clinicians who participate in a MIPS APM. The APP is designed to reduce reporting burden, create new scoring opportunities for participants in MIPS APMs, and encourage participation in APMs. You’ll report a predetermined measure set made up of quality measures in addition to the complete Promoting Interoperability measure set (the same as reported in traditional MIPS), if you are required to report the PI category and do not have an existing exclusion (example, you are not in a small practice). MIPS APM participants currently receive full credit in the improvement activities performance category.
*If you participate in an ACO/APM reach out to that APM administrator to understand how to report MIPS with the ACO or other APM. ACOs and other APMs get full credit for Improvement Activities and the only reporting requirement for APM participants is the Quality category which is reported as a whole (with the ACO/APM).*
## Collection Types
* **Electronic Clinical Quality Measures (eCQMs)**
* eCQMs are standardized measures that a Certified EHR Technology (CEHRT) meets to specification and is certified to. There are currently 43 eCQMs available to report to MIPS in 2024. Elation is certified to 10 eCQMs, and 7 eCQMs are eligible for Traditional MIPS reporting. eCQMs are measured as part of your regular workflows and can be found regularly in the Quality Dashboard of Elation. During reporting, eCQMs are extracted as a QRDA file and submitted to the QPP. (QRDA files and eCQMs are used and submitted to other CMS programs as well).
* These are the eCQMs that Elation supports in 2024 (7 bolded eCQMs that contribute to traditional MIPS and the total 10):
* [\[CMS124v12\] Cervical Cancer Screening (MIPS 2024)](/articles/CMS124v12-Cervical-Cancer-Screening-MIPS-2024)
* [\[CMS122v12\] Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%) (MIPS 2024)](/articles/CMS122v12-Diabetes-Hemoglobin-A1c-Poor-Control-MIPS-2024)
* [\[CMS131v12\] Diabetes: Eye Exam (MIPS 2024)](/articles/CMS131v12-Diabetes-Eye-Exam-MIPS-2024)
* [\[CMS139v12\] Falls: Screening for Future Fall Risk (MIPS 2024)](/articles/CMS139v12-Falls-Screening-for-Future-Fall-Risk-MIPS-2024)
* [\[CMS149v12\] Dementia: Cognitive Assessment (MIPS 2024)](/articles/CMS149v12-Dementia-Cognitive-Assessment-MIPS-2024)
* [\[CMS155v12\] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (MIPS 2024)](/articles/CMS155v12-Weight-Assessment-and-Counseling-for-Nutrition-and-Physical-Activity-for-Children-and-Adolescents-MIPS-2024)
* [\[CMS165v12\] Controlling High Blood Pressure (MIPS 2024)](/articles/CMS165v12-Controlling-High-Blood-Pressure-MIPS-2024)
* \[CMS69v12] Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan (not available for Traditional MIPS)
* \[CMS125v12] Breast Cancer Screening (not available for Traditional MIPS)
* \[CMS130v12] Colorectal Cancer Screening (not available for Traditional MIPS)
* **MIPS Clinical Quality Measures (CQMs)**
* MIPS CQMs are often collected by third party intermediaries and submitted on behalf of MIPS eligible clinicians. You may choose to work with a Qualified Registry.
* **Medicare Part B Claims Measures**
* This collection type is only available to those designated with the small practice special status (15 or fewer clinicians). Medicare Part B claims measures are always reported with the clinician’s individual (rendering) NPI even when reporting as a group, subgroup (MVPs only) virtual group (traditional MIPS), or APM Entity. For more information about reporting quality measures through Medicare Part B claims, [download this guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2649/2024PartBClaimsReportingGuide.pdf) from the QPP.
### What does Elation support for Quality measures and collection types?
Elation supports 10 eCQMs, 7 of which count in Traditional MIPS, and 2 are used in the MVP Value in Primary Care group. Administrative Claims Based measures may be selected to support additional measure selections for MIPS to report for Traditional MIPS and MVPs. Elation supports APM reporting with the selected eCQMs, and other measures supported depending on collection type.
* **Traditional MIPS**: You may report using 6 eCQMs or a combination of eCQMs and claims based measures, or reporting through a registry. To report through a registry, we recommend connecting with MDInteractive.
* **MVPs**: You may report on the Value in Primary Care MVP the 4 bolded measures above which include 2 eCQMs and 2 Claims Based Measures.
* **APP**: If you have signed up with an APM to participate this year, such as an ACO, or REACH, ensure your quality reporting is aligned with the measures they selected and only one quality submission is required, the quality submission reported with your APM.
## Additional Resources
* [QPP 2024 Quality Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2661/2024QualityQuickStartGuide.pdf)
* [QPP 2024 MIPS Quality Measure List](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2661/2024QualityQuickStartGuide.pdf)
* [MIPS Quality Performance Category Fact Sheet](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2402/MIPS%20Quality%20Performance%20Category%20Fact%20Sheet.pdf)
* [2024 Part B Claims Reporting Quick Start Guide](https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2649/2024PartBClaimsReportingGuide.pdf)
## Related Articles
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quality Category](/articles/Quality-Category-MIPS-2024)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
* [Elation Support Clinical Quality Measures](/admin-compliance)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [MIPS (2024)- Promoting Interoperability Category](/articles/Promoting-Interoperability-MIPS-2024)
* [MIPS (2024)- Improvement Activities Category](/articles/Improvement-Activities-MIPS-2024)
# Questions of the Month - April 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-April-2024
This article houses the most frequently asked questions from Elation customers for April 2024.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from April 2024 can be divided into the following categories:
* [Charting](#charting)
* [Patient Communication](#patient_communication)
## Charting
### Can I export content from an existing visit note to new visit note?
Yes, you can export all notes from an existing visit note to a new visit note by following the instructions below. Please note that vitals and orders will not be copied over as this data changes on a visit by visit basis.
1. Find the existing visit note in the patient's chart
2. Click **Actions** and then click **Export to New Note**
### What dictation softwares are compatible with Elation?
There are currently a few dictation software options that are able to be used alongside Elation when documenting information in the patient chart. Many of our practices have been known to utilize Dragon, M Modal, or Speech Notes. Please note that Apple Dictation is not HIPAA compliant and Dragon is not available for Apple devices.
### How do I keep track draft orders and draft notes?
Draft orders and draft notes will appear in the **Draft Notes**, **Draft Letters** or **Draft Orders** inbox in the Practice Home Requiring Action Queue for the assigned user.
[Click here to learn more about the Practice Home Requiring Action Queue](/articles/check-for-your-offices-daily-to-do-list).
## Patient Communication
### Can I send custom visit instructions to my patients?
You can send custom visit instructions to patients who have an appointment with you on an appointment by appointment basis. To send custom visit instructions:
1. Locate the patient appointment in which you want to send visit instructions for in the Calendar.
2. Click **Edit** in the appointment overlay.
3. Add your custom visit instructions in the **Visit instructions for patients** field.
4. Click **Save** to save your changes.
5. Click the **Send** button next to the visit instructions in the appointment overlay.
If the mode of the appointment is **Virtual** you can add your visit instructions in the **Virtual visit instructions for patients** field. If the visit instructions will be the same for every virtual appointment you can add these default instructions to **Settings** --> **Virtual Visits** --> **Virtual visit instructions** for each Provider Level User that is using the Zoom integration with Elation.
### How do I use Elation to generate a medical excuse letter for the patient for school or work?
You can use the **Letter to Provider** feature in Elation to generate a medical excuse letter for the patient for school or work. Here is how we recommend composing the letter:
1. Open the patient's chart.
2. Click the **Letter** option at the top of the chart.
3. Click **To Provider**.
4. In the **To** field enter the name of the recipient if you have them saved in your contact list or simply enter "To Whom It May Concern" or anything else in free text if preferred.
5. Fill in the **Subject** and **Body** as you would for an excuse letter
* You can optionally save the subject and body content as a template for future use with any patient by clicking **Save as Template**.
* You can select from your saved Letter Templates by clicking **Templates**
6. Click **Sign & Send** if you select a contact with an email or fax number on file OR click **Sign & Print w/Attachments** if you simply want to print the letter for the patient to take home with them.
[Click here to learn more about the Letters feature](/articles/letter-and-referral-introduction) .
## Related Articles
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/letter-and-referral-introduction)
* [Practice Home Guide- Checking for requiring action items](/articles/check-for-your-offices-daily-to-do-list)
# Questions of the Month - August 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-August-2024
This article houses the most frequently asked questions from Elation customers for August 2024.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from August 2024 can be divided into the following categories:
* [Charting](#charting)
* [Following up on outstanding orders](#close_the_loop)
* [Patient alerts](#patient_alerts)
## Charting
### How can I see the Clinical Profile, Chronological Record and Visit Note, all in a single screen?
If your screen resolution is 1440x900 or higher (usually available for 15" widescreen monitors/screen size or larger), you will see a **halfscreen** or **fullscreen** button at the top right corner of your visit note.
* Clicking **halfscreen** to see the Clinical Profile, Chronological Record and Visit Note draft side by side on the same screen.
* Click **fullscreen** to see the Clinical Profile and Visit Note draft side by side on the same screen.
## Following up on outstanding orders
### How can I track outstanding orders and make sure the patient completed them?
You can use the Close-the-Loop feature to highlight outstanding orders, including referrals, and then associate patient records with outstanding orders to mark them as fulfilled.
[Click here to learn more about the Close-the-Loop feature](/articles/follow-up-outstanding-orders-referrals)
.
## Patient alerts
### Is there a way to flag charts where patients have the same exact name?
You can use the Patient Tags feature and add a tag to the patient's chart (ie 'Same Name') to flag charts where patients have the same exact name.
[Click here to learn more about the Patient Tags feature](/articles/adding-patient-tags)
.
### How do I add reminders or alerts in patient charts?
You can use the post-date feature in Office Messages to create reminders or alerts in the patient chart.
[Click here to learn more about the post-date feature](/articles/post-date-a-message-to-yourself-or-a-colleague)
.
## Related Articles
* [Orders Guide- Following up on outstanding referrals, labs, radiology or other orders](/articles/follow-up-outstanding-orders-referrals)
* [Patient Tags Guide- Classifying patients for administrative efficiency](/articles/adding-patient-tags)
* [Post Date a Message Guide- Reminders & Task Follow Up](/articles/post-date-a-message-to-yourself-or-a-colleague)
# Questions of the Month - August 2025
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-August-2025
This article includes common questions that were asked in August 2025.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Chart Management](#chart_management)
* [Encounter Documentation](#encounter_documentation)
* [Telehealth](#telehealth)
## Chart Management
### How do I merge patient charts?
To merge duplicate patient charts:
| **1** | Open the duplicate patient chart you would like removed (we will call this the **Losing Chart**). |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Click **Merge Char** t in the pink banner at the top of the chart if you see one. |
| **3** | If you don't see a pink banner, click on the patient's name to access the patient's demographics and then click **Merge Chart** in **Notes & Chart Management** . |
| **4** | Search for and select the name of the original patient chart you want the duplicate chart to merge into (we will call this the **Winning Chart**), and click **Merge Chart** . |
### What is affected when charts are merged?
All signed documents, orders, messages, appointments and items in the Clinical Profile of the **Losing Chart** (the chart you don't want to keep) will be moved to the **Winning Chart** (the chart you want to keep). Historical and pending patient payment records and membership subscriptions will also be moved into the **Winning Chart**. All demographic information and credit cards on file in the **Losing Chart** will be deleted and not be available in **Winning Chart**.
## Encounter Documentation
### Can I apply rich-text formatting to my visit notes?
Rich-text formatting is available in the Elation Note. [Click here for more information on how to apply rich-text formatting when documenting an encounter using the Elation Note](/articles/Elation-Note-Guide-Documenting-an-encounter#richtext).
## Telehealth
### How are virtual visit instructions shared with patients?
By default, virtual visit instructions are sent to patients along with automatic appointment reminders. If any of the following apply to your practice or patients then you must manually send the patient their virtual visit instructions:
* Your practice does not use Elation's appointment reminders feature.
* The patient booked an appointment after the usual timeframe for automatic appointment reminders.
* The patient's preferred contact method is Phone.
To manually send the patient their virtual visit instructions:
| **1** | Click into the empty space of their appointment. |
| ----- | -------------------------------------------------------------- |
| **2** | Click Send next to the Visit instructions for patient section. |
[Click here for more information about virtual visits](/articles/Elation-Telehealth-powered-by-Zoom).
# Questions of the Month - December 2023 & January 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-December-2023-and-January-2024
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from December 2023 and January 2024 can be divided into the following categories:
* [Charting](#charting)
* [Faxing](#faxing)
* [MIPS](#mips)
* [Patient Intake](#patient_intake)
* [Scheduling](#scheduling)
## Charting
### How do I create a new visit note type (visit note category)?
Admin Level Users can go to the **Report & Visit Note Categories** settings page in Elation to customize visit note categories for visit notes.
[Click here to learn more about this setting.](/articles/visit-note-categories)
## Faxing
### How do I send a fax that is not linked to a specific patient?
Best practice is to
[create a generic patient chart](/articles/Patient-Chart-Guide-Creating-a-new-patient-chart)
(ex. called 'Fax Out') and then fax the document from the generic patient chart using the
[Provider Letter feature](/articles/letter-and-referral-introduction#Fax)
.
**How do I fax an imaging order to the Imaging Center?**
You can use the Letter to Provider feature in Elation to fax an imaging order to the Imaging Center.
[Click here to learn more about this feature.](/articles/efaxing-lab-and-radiology-orders)
## MIPS
### How do I submit my MIPS data for the 2023 reporting period?
The following Help Center Article provides you with detailed information and instructions about data submissions for MIPS 2023:
[MIPS 2024 Guide- End of Year Reminders & Data Submission FAQs](/articles/MIPS-2024-Guide-End-of-Year-Reminders-Data-Submission-FAQs)
## Patient Intake
### How do I import information from complete patient forms to the patient's chart?
To import information from completed forms to the patient's chart or visit note:
1. Open the patient’s chart. Submitted forms will appear under **Outstanding Items**.
2. Click on the form’s name to open and review patient responses.
* Both providers and staff will have visibility of all the question texts and answers including the patient's agreement status, signature, and the date and time the signature was provided for signature questions.
3. If you’d like to export any responses to the chart, check the checkbox to the left of the response.
4. Choose whether you are exporting to the **Clinical Profile**, **Visit Note** or both, and click **Export**.
5. Provider Level Users will be able to sign off on the complete Patient Form(s) to file it into the Chronological Record of the chart.
[Click here to learn more about the Patient Forms feature.](/articles/Patient-Forms-Guide)
### How do I request an electronic signature from a patient using Patient Forms?
You can add the **Patient Signature** question to new and existing patient forms in your settings to collect an electronic signature from the patient.
[Click here to learn more about the 'Patient Signature' question for the Patient Forms feature.](/articles/Patient-Forms-Guide)
## Scheduling
### How do I view the calendar for two providers side by side?
To view the calendar of multiple providers side by side, click the **Expand** button at the top of the calendar and then click **All Providers**.
[Click here to learn more about the expanded Calendar view](/articles/how-to-use-elation-calendar#Expanded)
### How do I add an appointment to the calendar from the patient's chart?
The feature to add an appointment to the calendar from the patient's chart is currently unavailable. We will notify you if this feature becomes available in the future.
[Click here to learn more about the Calendar feature.](/articles/how-to-use-elation-calendar)
## Related Articles
* [Calendar Guide- Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar)
* [Letters & Referrals Guide- Faxing lab, radiology or other orders to vendors](/articles/efaxing-lab-and-radiology-orders)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/letter-and-referral-introduction)
* [MIPS 2024 Guide- End of Year Reminders & Data Submission FAQs](/articles/MIPS-2024-Guide-End-of-Year-Reminders-Data-Submission-FAQs)
* [Patient Chart Guide- Creating a new patient chart](/articles/Patient-Chart-Guide-Creating-a-new-patient-chart)
* [Patient Forms Guide](/articles/Patient-Forms-Guide)
* [Visit Note Categories Guide](/articles/visit-note-categories)
# Questions of the Month - December 2025
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-December-2025
This article includes common questions that were asked in December 2025.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Interoperability](#interoperability)
* [Scheduling](#scheduling)
## Interoperability
### Can I retrieve a patient's records from a hospital or another doctor's office?
Elation has a Carequality integration that can be used to exchange patient health information across health platforms and vendors. Elation’s Carequality integration unlocks access to data available via Commonwell, and eHealth Exchange as well as data from other EHRs and data repositories connected to Carequality. You can query for patient files, such as Continuity of Care Documents (CCDs), visit notes and results in various formats (PNGs, PDFs, TIFFs, etc.) as long as the patient’s affirmative consent to query and share their data from or to outside care entities has been obtained and recorded.
Data pulled from the Carequality network is solely dependent on what data is made available by [Carequality-enabled providers](https://carequality.org/active-sites-search/) with mutual patients. [Click here for more information about the Carequality integration](/articles/Carequality-Integration-Introduction).
### What options exist to control which patient charts are shared via Carequality?
The patient (and/or patient’s legal guardian or representative) must consent to querying and sharing the data in their chart. You should follow applicable state and federal laws regarding minor consent.
To record patient's consent, go to the **Consents** section of their Patient Demographics. If a consent isn't recorded in the Patient’s Demographics, you will be prompted to record one before querying for patient data.
[Click here for more information about the Carequality integration](/articles/Carequality-Integration-Introduction).
## Scheduling
### Can you create recurring appointments in Elation?
Yes, you can create recurring appointments in Elation. [Click here for step by step instructions](/articles/recurring-patient-appointments#create).
### Can patients cancel their appointment via their Passport account?
No, patients cannot cancel their appointment via their Passport account. Patients can only cancel their appointments from appointment reminders if your practice allows it. [Click here for more information](/articles/appointment-reminders#cancel).
## Related Articles
* [Calendar Guide - Scheduling recurring patient appointments](/articles/recurring-patient-appointments#create)
* [Calendar Guide- Using automated appointment reminders](/articles/appointment-reminders#cancel)
* [Elation-Carequality Integration Introduction](/articles/Carequality-Integration-Introduction)
# Questions of the Month - February 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-February-2024
This article includes questions from Elation customers regarding topics such as managing to do items, ordering tests and procedures and scheduling appointments.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from February 2024 can be divided into the following categories:
* [Managing To Do's](#managing_to_dos)
* [Ordering Tests & Procedures](#ordering)
* [Scheduling](#scheduling)
## Managing To Do's
### I am a Staff Level User but I am seeing Draft Notes in my Requiring Actions. Why does this happen?
If a Staff Level User starts a visit note draft then the visit note draft will be assigned to a Provider Level User. If there are multiple Provider Level Users in the practice, then the assignment will follow these rules:
* If the visit note draft was created via the [Visit Note Automation feature](/articles/visit-note-automation) in the Calendar, then the visit note draft will be assigned to the Provider that the appointment belongs to.
* If the visit note draft was created from the patient's chart and is not tied to an appointment, then the visit note draft will be assigned to the **Provider assigned in practice** for the patient.
### How do I check another staff member's inbox to find a message I sent them?
You can check another user's inbox by clicking on the **View Queue For:** button a the top of the inbox list and then selecting their name. [Click here to learn more about this dropdown](/articles/check-for-your-offices-daily-to-do-list#View).
## Ordering Tests & Procedures
### What do I use to order a test for something that doesn't fit the current order forms (ex. EEG)?
We recommend using the Referral Form to order tests that do not fall in the lab, imaging, cardiac, pulmonary or sleep categories.
[Click here to learn more about the Referral Form](/articles/letter-and-referral-introduction)
.
### How do I order durable medication equipment?
There are two options for ordering durable medical equipment depending on the order is going to:
* Use the [Prescription Form](/articles/How-to-order-durable-medical-equipment#Pharmacy) if the order is going to a pharmacy.
* Use the [Referral Form](/articles/How-to-order-durable-medical-equipment#DME_provider) if the order is going to any other supplier.
[Click here to learn more about the two workflows for ordering durable medical equipment](/articles/How-to-order-durable-medical-equipment)
.
## Scheduling
### When a patient cancels an appointment, how will I be notified?
When a patient cancels their appointment via an appointment reminder, your office will be notified in two ways:
1. The Provider Level User that the patient was scheduled with with receive an email about the cancellation. The email will be sent to the Provider Level User's EHR login email.
2. The patient's appointment status will be updated to **Cancelled**. The 'Show canceled appointments in the calendar' Setting must be turned on in order for you to see canceled appointments in the Calendar. [Learn more about this Setting](/articles/appointment-reminders).
### I want to include a link to the exact appointment type I want my patient to book in a Patient Letter. Is this possible?
You can include a link to the exact appointment type you want you patient to book if you are using the Booking Site feature. Each Appointment Type as a Direct URL that can be found in the main **Appointments** tab at the bottom of each appointment type.
[Click here to learn more about the Booking Site feature](/articles/Patient-Booking-Site)
.
![Calendar & Booking Settings, Appointments tab, showing a Phone appointment type with its Direct URL field highlighted: https://demo.elationemr.com/book/ElationEast/phone, with a Copy button.]()
## Related Articles
* [Best Practice- How to order durable medical equipment](/articles/How-to-order-durable-medical-equipment#DME_provider)
* [Calendar Guide- How to set up the provider calendar](/articles/calendar-and-booking-settings)
* [Letters & Referrals Introduction- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Practice Home Guide- Checking for requiring action items](/articles/check-for-your-offices-daily-to-do-list)
* [Visit Note Documentation Guide- Using visit note automation for appointments](/articles/visit-note-automation)
# Questions of the Month - February 2025
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-February-2025
This article includes common questions that were asked in February 2025.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Managing patient requests](#patient_requests)
* [Managing user accounts](#user_accounts)
* [Scheduling](#scheduling)
## Managing patient requests
### How do I fill out a form brought in by a patient?
To fill out a form brought in by a patient, follow these steps:
1. Upload the form to the patient's chart using the drag-and-drop feature. [Click here to learn more about the drag-and-drop feature](/articles/filing-documents-to-a-patient-chart).
2. Use the annotate feature to fill out any parts of the form. [Click here to learn more about the annotate feature](/articles/Patient-Chart-Guide-Annotate-and-eSign).
## Managing user accounts
### What should I be mindful of when disabling a provider?
[Click here to learn about the key action items to consider when disabling a Provider Level User account](/articles/User-Accounts-Guide-Best-practices-for-deactivating-accounts).
## Scheduling
### How can I tell which staff member scheduled a patient appointment?
Follow these steps to see which staff member schedule a patient appointment:
1. Click on the colored area of the appointment.
2. Click **Edit**.
3. Scroll down to the bottom of the appointment details box until you get to the **Activity Log** section.
4. Look for the text **Scheduled by...** to see which staff member scheduled the appointment.
### How do I block my schedule for a 1 week vacation?
To block your schedule for a vacation:
1. Click the **+ Appointment** button at the top of your calendar.
2. Click **Other Event**.
3. Enter an **Event title** such as **Vacation**.
4. Enter the start date of your vacation in the **Date** field.
5. Select the **Start Time** and **End Time** that corresponds with your business hours.
6. Click the **Recurrence** box and select **Weekly**.
7. Select the days of the week that your business is open.
8. Enter the end date of your vacation in the **Ends** field.
9. Click **Create Event**.
10. You should now see that your Calendar is blocked off during the days and hours you are on vacation.
## Related Articles
* [Patient Chart Guide- Annotate and eSign Clinical Reports and Documents](/articles/Patient-Chart-Guide-Annotate-and-eSign)
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
* [User Accounts Guide- Best practices for disabling accounts](/articles/User-Accounts-Guide-Best-practices-for-deactivating-accounts)
# Questions of the Month - January 2025
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-January-2025
This article includes common questions that were asked in January 2025.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Charting](#charting)
* [Medication/Supplement Management](#medications)
* [Patient Intake](#intake)
## Charting
### I am a mid-level Provider. How can I cosign visit notes with my supervising Provider?
The following Help Center article outlines Elation's recommendations for co-signing visit notes:
* [Visit Note Documentation Guide- Best practices for co-signing visit notes](/articles/Visit-Note-Documentation-Guide-Best-practices-for-co-signing-visit-notes)
## Medication/Supplement Management
### A medication I prescribed is listed as a temporary medication. How do I move it to the permanent medications list?
To move a temporary medication to the permanent medications list, follow these steps:
1. Click **Meds Hx** at the top of the patient's chart
2. Click **Medication History**
3. Click **Actions** next to the medication you want to set as a permanent medication and then click **Set as Permanent Med**
4. You will now see the medication in the Permanent Medications section of the Medication History and Clinical Profile.
### Can I track supplement plans in Elation?
You can use Elation's Fullscript integration to track supplement plans and supplement dispensing with Elation. [Click here to learn more about the Fullscript integration](/articles/Elation-Fullscript-Integration-Guide).
## Patient Intake
### How can I tell if a patient completed the electronic intake forms I sent them?
Here's how you can tell if a patient completed the electronic intake forms you sent them depending on how they were sent:
* Forms sent via appointment reminders:
* You will see a forms status indicator on appointments that have forms. A 'clock' indicates there are forms that are incomplete; a 'green check mark' indicates all forms are completed.
* Forms sent via the patient's chart:
* You will see a forms status indicator on sent patient forms within the patient's chronological record. A 'clock' indicates there are forms that are incomplete; a 'green check mark' indicates all forms are completed.
* The form's sender will receive a reminder in their **Reminders** inbox in the Practice Home if the patient fails to complete their forms within the specified time period.
### Can I send Patient Forms to the patient via Passport?
Patient Forms are usually sent to the patient via text or email. To send the patient their forms via Passport, follow these steps below:
1. Copy the URL of the patient's forms:
* From an appointment:
1. Click on the colored area of the appointment
2. Click **Copy URL** next to the **Forms** section
* From forms sent via the patient's chart
1. Click **Actions** -> **Copy URL**
2. Click **Letter** -> **To Patient**
3. Paste the URL into the body of the letter and then send the letter.
### Can I create and send surveys to my patient?
Yes, you can use the [Patient Forms](/articles/Patient-Forms-Guide) feature to create a survey and then send the **survey** to the patient from their chart.
## Related Articles
* [Elation-Fullscript Integration Guide - Using Fullscript to manage supplement dispensing](/articles/Elation-Fullscript-Integration-Guide)
* [Patient Forms Guide](/articles/Patient-Forms-Guide)
* [Visit Note Documentation Guide- Best practices for co-signing visit notes](/articles/Visit-Note-Documentation-Guide-Best-practices-for-co-signing-visit-notes)
# Questions of the Month - July 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-July-2024
This article houses the most frequently asked questions from Elation customers for July 2024.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from July 2024 can be divided into the following categories:
* [Annotating documents](#annotate)
* [Connecting to a State Immunization Registry](#Immunization_Registry)
* [Creating Procedure templates](#visit_note_templates)
* [Sending Prescriptions via Passport](#send_prescriptions_via_Passport)
## Annotating documents
### A patient sent me a form via a Patient Letter. How do I fill it out and send it back to them via Passport?
When patients send you documents via Passport and those documents need to be completed or signed, use Elation annotate feature to complete or sign these documents. To do this:
1. Open the Patient Letter containing the attached document.
2. Download the document to your computer.
3. Use the [drag & drop feature](/articles/filing-documents-to-a-patient-chart#uses) to upload the document back into the patient's chart.
4. Leave the document as unsigned.
5. Use the [annotate feature](/articles/Patient-Chart-Guide-Annotate-and-eSign) to annotate the document.
6. Sign the document after you have completed your annotations.
7. Attach the document to a Patient Letter and send it back to the patient.
## Connecting to a State Immunization Registry
### Is there a way to pull state immunization data into my patient's chart?
Elation has Immunization Registry interfaces with 42 states. When you use one of these Immunization Registry interfaces, you will be able to query for a patient's immunization history from the connected registry and import that data into your patient's chart if desired.
[Click here to learn more about Elation's Immunization Registry Interfaces](/articles/Immunization-Registry-Interface-Introduction)
.
## Creating Procedure templates
### How would I document Procedures and create templates for them?
You can document
[Procedures](/articles/documenting-procedures)
in the the visit note and use the Visit Note Template feature to create templates for common Procedures.
[Click here to learn more about the Visit Note Template feature](/articles/elation-visit-note-templates)
.
## Sending Prescriptions via Passport
### Is there a way to share prescriptions with patients via Passport?
To share prescriptions with patient via Passport,
[print the prescription to a PDF using your web browser](https://pdf.wondershare.com/pdf-knowledge/print-to-pdf-firefox-chrome-ie-safari.html)
and then upload the Prescription back to the patient's chart. Afterwards, attach the upload Prescription to a Patient Letter to send the prescription to the patient. This allows for more intentional control over sharing Prescriptions and preventing medication abuse.
## Related Articles
* [Immunization Registry Interface Introduction](/articles/Immunization-Registry-Interface-Introduction)
* [Patient Chart Guide- Annotate and eSign Clinical Reports and Documents](/articles/Patient-Chart-Guide-Annotate-and-eSign)
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
* [Visit Note Documentation Guide- Procedures](/articles/documenting-procedures)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
# Questions of the Month - June 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-June-2024
This article houses the most frequently asked questions from Elation customers for June 2024.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from June 2024 can be divided into the following categories:
* [Faxing](#faxing)
* [Patient Passport](#passport)
* [Scheduling](#scheduling)
## Faxing
### How do I add a new contact to my directory for sending faxes?
To add a new contact to the directory for sending faxes:
1. Open a patient's chart.
2. Click on the **Referral** or **Letter (to Provider)** button in the gray navigation bar.
3. Type in the name of the Contact (ex. John Doe) and then hit the **Tab** key on your keyboard OR click into the **Subject** or **Body** of the Letter.
4. Click on the **Add Details** button that now appears to the right of the name.
5. Choose whether the contact is an **Individual** or **Organization** and then fill out their contact information. Most importantly, enter their Phone Number, Fax Number and Email if you have this information to facilitate contact.
6. Once you have entered in all of the contacts' details, click **Save** and the Contact will now show up in your Contact List when you write Letters or Referrals.
[Click here for more information about creating contacts](/articles/Using-the-Provider-Directory)
.
### Can I fax an imaging order from Elation to the Imaging Center?
Yes, you can fax an imaging order from Elation to the Imaging Center. To fax an imaging order from Elation:
1. Locate the imaging order that you’d like to send in your patient’s chart. Hover over the imaging order, and click **Actions** --> **Provider Letter**.
2. In the **To** field, type the fax number of the Imaging Center.
* If this is an Imaging Center you will fax to often, you can save them as a contact by following the instructions in [this article](/articles/Using-the-Provider-Directory).
3. Type a subject and message to the Imaging Center as needed.
4. Next, click on **Select Chart Items to Attach**.
5. Check the checkbox for **Patient Demographics** and then click **Attach Items**.
6. At the bottom of the letter, check the checkbox for **Also fax copies of attachments**.
7. Click **Sign & Send** to fax the imaging order to the Imaging Center.
[Click here for more information about faxing orders to vendors](/articles/efaxing-lab-and-radiology-orders).
## Patient Passport
### How do I share the passport invitation code with my patient?
Passport invitations are sent to the email on file in the patient's chart. When patients click **Register for Passport** from their Passport invitation, Elation will immediately send a text message with the passport invite code to the mobile number on file in the patient's chart. If the patient calls your office for the invitation code, you can follow these instructions to retrieve the invite code from the patient's code:
1. Open the patient's chart.
2. Click on the **Passport** (globe) button at the top of the patient's chart
3. Click **details** to find the invitation code.
[Click here for more information about Patient Passport](/articles/elation-patient-passport-an-introduction)
.
### How do patient’s upload their medical records via Patient Passport?
Patients can upload medical records through Patient Passport when initiating a new message to your practice. This is because patients can only attach documents to new messages. Patients cannot attach documents to replies to existing messages. For patients to upload their medical records via their Patient Passport account:
1. Click the **New Message** button when logged in via a browser (or press the **draft** button when logged in via the Passport mobile application).
2. Click **Add Attachment** (or press the **paperclip** button when logged in via the Passport mobile application).
3. Select the medical records from their computer (or take photos or documents from the library when logged in via the Passport mobile application).
4. Click the **Send** button to send the message and attachments.
[Click here for more information about how patients can utilize their Patient Passport account](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
.
## Scheduling
### We are a multi-Provider practice but not all Providers work on all days. How can I only see the calendar for Providers who are working on a given day?
A feature you can use to only show available providers in the expanded calendar view is the
[User Groups](/articles/user-groups)
feature. Here is what the set up could look like:
1. Let's say only Provider A, Provider B and Provider C work on Mondays. First, create a User Group that only has Provider A, Provider B and Provider C and name the User Group 'Monday Providers' or anything similar.
2. Next, click the **Expand** button at the top of the Elation Calendar.
3. Then click **All Providers** in the expanded calendar view.
4. Then, each Monday, in the dropdown at the top of the calendar, click on the name of the **Monday Providers** User Group. This will allow you to only see the Providers that work on Mondays.
5. Repeat step 1 for each day of the week until you have grouped all the Providers by the days they work each week.
[Click here to learn more about using the User Groups feature for the Expanded View in the Calendar](/articles/user-groups#calendar)
.
## Related Articles
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Elation Patient Passport Guide- Patient's Point of View](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
* [Letters & Referrals Guide- Creating New Contacts](/articles/Using-the-Provider-Directory)
* [Letters & Referrals Guide- Faxing lab, radiology or other orders to vendors](/articles/efaxing-lab-and-radiology-orders)
* [User Groups Guide- Simplifying office messages & expanded calendar view](/articles/user-groups)
# Questions of the Month - June & July 2025
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-June-July-2025
This article includes common questions that were asked in June & July 2025.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Medication management](#medications)
* [Patient communication](#patient_communications)
* [Scheduling](#scheduling)
## Medication management
### Is there a way to check if the pharmacy got my prescription?
Yes, some pharmacies may acknowledge receipt of your prescription. If they do, an asterisk will appear at the end of the note in the prescription that says ***Sent to \[Pharmacy Name] ...***. If you place your cursor over the asterisk you will see a note that says **The pharmacy has permanently accepted the order**.
### Where can I view temporary medications?
You can view the temporary medications by clicking **Meds Hx** -> **Medication History** at the top of the patient's chart.
## Patient communication
### How can I automatically share a patient's lab results with them via Passport?
Lab results cannot be shared automatically with patients via Passport. You must manually send the lab results to the patient via a [Patient Letter](/articles/letter-and-referral-introduction#Patient).
### Can I set up an automated out-of-office reply for patient messages?
Automated out-of-office replies aren’t currently available. However, you can use the Bulk Letter feature to send a message to all your patients if you need to notify them about changes to your schedule.
## Scheduling
### How do I quickly reschedule a patient appointment?
To quickly reschedule a patient’s appointment:
| **1** | Click in the shaded area of the appointment to open the appointment popover box. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Show suggested times** next to Quick Reschedule. |
| **3** | Select a new appointment time from the list of the next six available options, based on the appointment’s **Location** and **Duration** and the Provider’s **Availability**. [Click here for instructions on how to configure Provider Availability](/articles/Calendar-Booking-Site-Guide-Enhanced-Provider-availability-by-Practice-Location-Appointment-Type). |
| **4** | Click **Save new time** . |
![Appointment popover for Carl Jones showing the Quick Reschedule section with six available time slots listed and the "Save new time" button at the bottom.]()
### Where can I see a list of patients with no upcoming scheduled visits?
To see a list of patients with no upcoming scheduled visits:
| **1** | Click **Reports** -> **Patient List** . |
| ----- | --------------------------------------------------------------------------------------------------------- |
| **2** | (Optional) Filter for patients by assigned provider, demographics or clinical data if needed. |
| **3** | Click **Generate List** to see matching patients. |
| **4** | Look at the **Next Appointment** column to see which patients do not have a future appointment scheduled. |
| **5** | Click **Download** -> **Download CSV** to download a spreadsheet for additional filtering if needed. |
## Related Articles
* [Calendar Guide- Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Medication List Management Guide- Documenting, discontinuing or merging medications](/articles/medication-history)
# Questions of the Month - March 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-March-2024
This article houses the most frequently asked questions from Elation customers for March 2024.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from March 2024 can be divided into the following categories:
* [Annotating Documents](#annotating_documents)
* [Chart Management](#chart_management)
* [Direct Messaging](#direct_messaging)
* [Fax Inbox Management](#fax_inbox_management)
## Annotating Documents
### How do I append my signature to a fax I received via the Fax Inbox?
The Annotate and eSign feature allows users at your practice to annotate and electronically sign clinical reports and documents directly in Elation EHR. All users can annotate documents, while Provider Level Users can annotate and electronically sign documents.
[Click here to learn more about the Annotate & eSign feature](/articles/Patient-Chart-Guide-Annotate-and-eSign)
.
### After I annotate or electronically sign a document, can I fax it back to the facility that sent me the document?
Yes, after you sign a document, you can use the Letter to Provider feature to fax it out to any recipient.
[Click here to learn more about the Letter to Provider feature](/articles/letter-and-referral-introduction#Fax)
.
## Chart Management
### How do I merge two charts that belong to the same patient?
To merge two charts that belong to the same patient, first decide which chart you want to keep (we will call this the winning chart) and which chart you want to merge away (we will call this the losing chart). Afterwards:
1. Go to the duplicate patient chart you would like removed (the losing chart).
2. Click on the patient's name to access the patient's demographics.
3. Click on the **Merge Chart** button under Notes & Chart Management.
4. Enter in the name of the original patient chart you want the duplicate chart to merge into (the winning chart).
5. Click **Merge Chart**.
6. Verify the data of the losing chart and winning chart. If you do not want to proceed, click **No**. If you do want to proceed, follow the next step.
7. Click **Yes, merge charts** to complete the merge.
[Click here to learn more about merging charts](/articles/merging-duplicate-charts)
.
## Direct Messaging
### Can I send Direct Messages using Elation?
Yes, you can send Direct Messages via the Letter to Provider feature in Elation EHR, as long as you have the recipient's Direct Address. [Click here to learn more about the Direct Messaging feature](/articles/how-to-use-direct-messaging).
### What is my Direct Address?
Provider Level Users can locate their Direct Address in the EHR under **Settings** --> **Account Details** --> **Direct address**.
[Click here to learn more about the Direct Messaging feature](/articles/how-to-use-direct-messaging)
.
## Fax Inbox Management
### How do I restore a deleted fax?
To restore a fax that was deleted within the last 7 calendar days:
1. Open the Fax Inbox
2. Click on the **Recently Deleted** button at the top of your inbox
3. Select the pages you want to restore & then click **Restore**
Faxes deleted more than 7 days ago cannot be restored.
[Click here to learn more about restoring deleted faxes](/articles/Fax-Inbox-Introduction#restoring_deleted_faxes)
.
# Questions of the Month - March 2025
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-March-2025
This article includes common questions that were asked in March 2025.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Chart management](#chart_management)
* [Patient follow-up](#patient_follow-up)
* [Vitals management](#vitals_management)
## Chart management
### A lab report came in and created a duplicate chart. How do I move the lab report to the patient's existing chart?
If a duplicate chart was created by an interface or integration, we recommend using the **Merge Chart** feature to merge all of the contents of the duplicate chart into the patient's existing chart.
[Click here to learn more about the Merge Chart feature](/articles/merging-duplicate-charts).
## Patient follow-up
### How do I share a Care Plan with my patient via Patient Passport?
If a Care Plan was documented in a visit note, then the Care Plan will automatically be shared with the patient via Patient Passport in the form of a **Visit Summary** once the visit note is signed off.
[Click here to learn more about visit summaries](/articles/elation-patient-passport-an-introduction#visit_summaries).
### How do I search for patients who are due for an annual wellness exam?
There are a couple of ways you can search for patient's who are due for an annual wellness exam:
1. Use the [Patient List report](/articles/find-patients-with-elations-patient-list) and search for patients using the **Last Seen** and **CPT Codes** filters. For example, apply the **Last Seen** filter and search for all patients who had their last visit in 2024, then use the **CPT Code** filter and filter by the CPT codes for annual wellness visits (i.e. 99395, 99396, G0439, etc).
2. Use [Billing Home](/articles/Billing-Home) and search for visits that had annual wellness visit CPT codes and then calculate when the patient is due for their next annual. For example, set the date range for the enter 2024 calendar year and then download the results and filter by the CPT codes for annual wellness visits (i.e. 99395, 99396, G0439, etc).
## Vitals management
### How do I enter the patient's height and weight in metric units?
A patient's height and weight can be entered in metric units but it will be converted to and stored as imperial units. Head circumference can be entered in imperial units and will be converted to and stored in metric (cm).
* To enter the patient's height in metric units, type the number and then 'cm' (e.g. `165cm`). The height will be converted to inches.
* To enter the patient's weight in metric units, type the number and then 'kg' (e.g. `65kg`). The weight will be converted to pounds.
* To enter the patient's head circumference in imperial units, type the number and then 'in' (e.g. `14in`). The value will be converted to centimeters.
In addition to simple metric/imperial entries, the following input formats are also supported:
* **Compound inputs** — e.g. `5'10"` for height or `5 lbs 8 oz` for weight
* **Fractions** — e.g. `5 1/2'` or `13 3/4 in`
* **European-style decimal commas** — e.g. `12,5 kg` (converts to `27.56 lbs`)
* **Case-insensitive units** — `CM`, `Kg`, `LBS`, and other variations all work
If the system cannot recognize the input, the field silently reverts to the last valid value when you click or tab out of the field.
### How do I record historical vitals?
Use a Non-Visit Note to store historical vitals by following these steps:
1. Click **Visit Note** at the top of the patient's chart.
2. Click **Non-Visit Note**.
3. Click **Vitals** to open the **Document Vitals** box.
4. Enter vitals information as needed for the patient and make sure you update the date of the vitals records.
5. Click **Save** to save and close the box or **Save and Add Another** to keep adding more vitals.
6. Click **Sign Note** to save the Non-Visit Note and corresponding historical vitals.
[Click here for additional information](/articles/adding-historic-vitals).
# Questions of the Month - May 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-May-2024
This article houses the most frequently asked questions from Elation customers for May 2024.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from May 2024 can be divided into the following categories:
* [Documenting an encounter](#documenting_encounter)
* [Faxing](#faxing)
* [Managing patient charts](#managing_charts)
* [Scheduling](#scheduling)
## Documenting an encounter
### How can I easily reference active problems in the visit note I am drafting?
As best practice, we recommend storing active problems for patients in the Problem List section of their Clinical Profile. This allows you to easily export the problems to various areas of the visit note (such as the HPI, Review of Systems, Assessment, or Billing sections) when you are documenting an encounter.
[Click here to learn more about the Problem List and how to export problems to your visit note](/articles/managing-your-problem-list).
### How do I copy content from a previous visit note to a new visit note?
To copy content from a previous visit note to a new visit note:
1. Locate the previous visit note you want to copy within the patient's chronological record
2. Click **Actions** --> **New Note** (under the **Export To:** section)
3. This will copy all of the content from the previous visit note (except for vitals or referenced orders) into a new visit note draft.
## Faxing
### How do I send a fax that has more than 40 pages of attachments?
The behavior of a fax with more than 40 pages of attachments depends on the recipient:
* If the recipient is also an Elation EHR user (they will have a logo next to their name), then the Letter/Referral along with its attachments will be sent electronically, directly to their Elation EHR and will not be sent to them via fax.
* ## If the recipient is a secure Provider Portal user (they will have a logo next to their name), then the Letter/Referral along with its attachments will be sent electronically, directly to their secure Provider Portal. By default, if the **Also fax copies of the attachments** box is not checked, then we will fax them the Cover Letter and body of the Letter/Referral along with instructions to retrieve the remaining attachments online.
If the recipient is having trouble accessing their Provider Portal, share [this article](/articles/secure-Provider-Portal) with them.
* If the recipient is a contact in your directory without a Provider Portal or Elation EHR designation (meaning they only have a name and fax number stored), and your attachments exceed the fax page limit, split them across multiple Provider Letters or Referrals and send each as a separate fax, or select **Sign & Download PDF** to download the full packet and send it using a conventional fax machine outside Elation.
* ## If the recipient is a plain 10-digit fax number, they will receive the entire Letter/Referral, including its attachments, as a fax transmission when the packet is within the applicable fax page limit. If the packet exceeds that limit, split the attachments across multiple Provider Letters or Referrals and send each as a separate fax, or select **Sign & Download PDF** to download the full packet and send it using a conventional fax machine outside Elation.
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. The larger the fax transmission, the more likely it may run into interruptions, therefore we recommend keeping your faxes under 40 pages when possible.
Limiting your faxes will also help you save money since each Standard Provider User is only allotted 1,500 free 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.[Click here to learn more about managing your fax usage](/articles/fax-usage).
[Click here to learn more about the various ways to send Letters or Referrals](/articles/letter-and-referral-introduction).
## Managing patient charts
### I have a few patients that have the same first and last name. What should I do to avoid any mix-up or confusion?
We recommend adding a Patient Tag to the patient's chart to alert the different members of your practice that there are patients with the same first and last name. Patient Tags are visible when when you search for patients and are a good way to alert your staff. For example, you can use a Patient Tag called 'Same Name Alert'.
[Click here to learn more about adding Patient Tags to a patient's chart](/articles/adding-patient-tags).
## Scheduling
### How do I send custom visit instructions for in person visits?
To send custom visit instructions for in person visits, enter the text in the **Visit instructions for patient** box in the appointment. The text in the **Visit instructions for patient** box will be sent automatically along with appointment reminders (if the appointment reminders have not been sent already) or you can manually send the instructions by clicking the **Send** button.
![Appointment detail popup for Joan Mack showing the "Visit instructions for patient" section highlighted, containing the text "Please bring your blood pressure monitor to your appointment." with a Send button.]()
### How can I tell who updated the status of an appointment?
To view the edit history of an appointment:
1. Click into the shaded area of the appointment in the Calendar
2. Click **Edit**
3. Scroll down to the **Activity Log** section of the **Edit Patient Appointment** box
![Edit Patient Appointment dialog with the Activity Log section highlighted, showing entries: "6/7/24 1:11pm: Confirmed by Karly Smith, MD" and "6/7/24 1:07pm: Scheduled by Karly Smith, MD"]()
## Related Articles
* [Calendar Guide- Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar)
* [Letters & Referrals Introduction- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Letters & Referrals Guide- How my colleagues can access shared patient information from my faxes and emails](/articles/secure-Provider-Portal)
* [Patient Tags Guide- Classifying patients for administrative efficiency](/articles/adding-patient-tags)
* [Problem List Guide](/articles/managing-your-problem-list)
# Questions of the Month - May 2025
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-May-2025
This article includes common questions that were asked in May 2025.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Medications](#medications)
* [Multi-factor Authentication](#MFA)
* [Training](#Training)
## Medications
### Does the patient receive a notification when I send their prescription to the pharmacy?
Yes, you can send the patients a reminder after sending their prescription(s) to their pharmacy. These reminders can even include education content and cost-saving information. [Click here to learn more about prescription reminders](/articles/prescription-reminders-for-patients).
### I downloaded the patient's recent medication fills to their chart, but they're highlighted in yellow and don’t appear in the medication history. Could you help me understand why?
Downloaded medication fills are highlighted in yellow as a visual cue. They aren’t permanently added to the chart until you **merge** them into the medication list.
Think of it like copying a list of ingredients from a recipe website into a sticky note on your fridge. The sticky note is just a temporary reminder — it’s there for reference, but not yet part of your official shopping list. To make it permanent, you have to copy those ingredients into your actual shopping list.
Similarly, when you download medication fills, Elation highlights them in yellow to show they’re just for reference. They won’t become part of the patient’s official medication history until you take action to merge them into the chart.
[Click here for more information about managing downloaded medication fills](/articles/mergingreconciling-downloaded-meds-with-existing-meds).
## Multi-factor Authentication
### How do I implement multi-factor authentication?
The best way to implement multi-factor authentication (MFA) is to have each team member set up their authentication factors first, then have an Admin-Level User enable MFA for the entire practice. [Reference our Quick Start Guide for additional detailed instructions](/articles/Multi-Factor-Authentication-Quick-Start-Guide).
## Training
**A new employee has joined my practice. Are there any training resources I can share with her to help her learn Elation?**
Yes, Elation’s Training Center is the best resource for new employees. It provides role-specific training materials to help them get started. [Click here to visit our Training Center](https://training.elationhealth.com/).
# Questions of the Month - Oct, Nov, Dec 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-Oct-Nov-Dec-2024
This article includes common questions that were asked in Q4 2024.
Each month, Elation compiles frequently asked questions from our customer interactions and Office Hours and shares the questions and answers through this help center. We hope to broaden our customers' knowledge of our features and best practices.
The topics from this edition include:
* [Patient forms](#forms)
* [Visit note documentation](#vn)
* [Scheduling](#scheduling)
* [Patient Communication](#ptcom)
* [External Communication](#excom)
## Patient forms
### How do we create a form that can be electronically signed by the patient?
You can create a signable form using our [patient forms feature](/articles/Patient-Forms-Guide#patient_signature). As you’re constructing the form, select the **Patient Signature** question type from the dropdown menu.
### Once a patient has filled out the electronic form, how does our office copy their responses into different areas of the chart?
After the patient submits their responses, you will see the form as a report under the Outstanding Items section of their chart. When you click to open this report, you will [have the ability to select responses and export them](/articles/Patient-Forms-Guide#export) to the Clinical Profile and/or a visit note draft.
Note: This export step is NOT required. If you don’t wish to copy their responses anywhere, simply sign off on the report and the form will get filed into the chart’s Chronological Record.
## Visit note documentation
### How do I transfer lab results from a lab report into a visit note?
To export discrete test results from a lab report into a visit note:
1. Open the lab report in the patient’s chart.
2. Hover your mouse of the test name whose results that you want to export.
3. Click the Actions menu that appears to the right of the test name.
4. Select one of the **Export to Note** options.
### How do I create a template for a common procedure that I perform?
You can use our [visit note template feature](/articles/elation-visit-note-templates) to create a template for your procedure. For procedures, practices typically add the procedure’s description and details to the **Data** section of the note. If there are billing codes that you’d like to include, you can add them to the bottom of the template.
Then, when you export the template into your draft note, the content that you built into the template will automatically appear.
### Is it possible to design a template that pulls patient-specific details (like name, DOB, and sex) into the visit note?
No, currently there isn’t a way to create a template with these types of variables. We recommend leaving space in the template with the underscore key (ex. \_\_\_\_\_) or brackets (ex. \[ ]) to remind the user to fill this information in. You can use more general language like “the patient” rather than specific pronouns.
### Is there a way to undo a deletion from my visit note draft if I clicked the X button?
No, if you click the **X** button to remove a section of text from the visit note, there isn’t a way to undo this action.
### How do I attach patient education/a handout to my visit note?
1. Open your visit note.
2. Click the **Handouts** button at the top of the chart.
3. In the pop-up window, select the handout that you would like to include. (If you don’t see a handout that you need but have a file of it on your computer, you can upload the file to Elation so that your practice can access it. To do so, scroll to the bottom of the pop-up window and click **Upload File**)
4. Upon clicking the handout name, a preview of it will open in a new tab. Close this preview tab.
5. In the visit note, you’ll see a link to the handout appear under Care Plan.
## Scheduling
### How do I create two overlapping appointments? (i.e. double book for the same/similar time)
On the right side of each appointment, you’ll see a space on the calendar that you can click to insert another appointment for the same time. Alternatively, you can click the **+ Appointment** button at the top of the calendar and input the date and time for the appointment manually.
### How do I connect my Google calendar with my Elation calendar?
Please [use these instructions](/articles/introduction-to-google-calendar-sync) to set up Google sync.
### Am I able to modify the list of appointment statuses that appear in Elation? (ex. Checked in, In room, Checked out)
No, there isn’t a way to customize appointment statuses at this time.
## Patient communication
### How do I send the patient a copy of something from their chart?
Elation’s Patient Passport feature allows you to send messages and attachments to your patients via a secure portal. [Follow these instructions](/articles/letter-and-referral-introduction#Patient) to learn how to send a letter and attachment to your patient via Patient Passport.
### How do I share a copy of the Elation invoice from a visit with my patient?
The invoice generated from an Elation visit note cannot be directly attached to a Patient Letter. However as a workaround, you can follow the steps below to download the invoice as a PDF and upload it back to the chart as a Report.
1. Locate the visit note in your Chronological Record.
2. In the upper right hand corner, click **Actions** and under the Print section, choose the type of invoice that you’d like to print.
3. When the print preview appears, change the Destination to **Save as PDF** and save the file to your computer.
4. Locate the file on your computer and [click-and-drag the file over the patient’s chart to upload it](/articles/filing-documents-to-a-patient-chart) as a Report.
5. Once the invoice is saved in the chart as a Report, you’ll be able to [attach it to a Patient Letter](/articles/letter-and-referral-introduction#Patient).
### How do I send a mass-message to patients about an upcoming event?
You can use [our bulk letter feature](/articles/introduction-to-bulk-letters) to send the same letter to multiple patients via Patient Passport.
There isn’t a way to send a mass email from Elation because email is not secure.
## External communication
### How do I send a copy of the patient visit to an insurance company for prior authorization?
1. Open the patient’s chart and click **Letter > To Provider**.
2. Type the insurance company’s fax number in the **To** field. If prompted to save the number, you can optionally do so.
3. Type a message to the insurance company in the Body.
4. Towards the bottom of the page, click **Select Chart Items to Attach** and find the visit note that you’re trying to share.
5. Important: In the yellow banner at the bottom of the letter, if you see a checkbox regarding whether you want to fax the attachments, **make sure you select this checkbox**.
6. Click **Sign and Send**.
### How do I prevent recipients of my Referrals and Provider Letters from having full access to the patient’s chart when they sign into Elation Connect?
When someone logs into Elation Connect to view your Referral or Provider Letter, they ONLY see what you’ve attached to the referral/letter that you sent them.
In other words, unless you have attached everything from the patient’s chart to the referral/letter, the recipient will not have access to these records.
# Questions of the Month - September 2024
Source: https://help.elationhealth.com/articles/Questions-of-the-Month-September-2024
This article houses the most frequently asked questions from Elation customers for September 2024.
Each month, Elation will compile the most frequently asked questions from Elation customers through our different customer interactions and Office Hours and share the questions and answers with our customers. We hope to broaden our customers' knowledge of our amazing features and share best practice workflows.
The questions from September 2024 can be divided into the following categories:
* [Patient Appointments](#appointments)
* [Patient Intake](#patient_intake)
* [Bidirectional Lab Interfaces](#BiDi_Labs)
## Patient Appointments
### Can I link my Patient Self-Booking site with Elation to my business website?
Yes, you can link your Patient Self-Booking site with Elation to your business website. To do this:
1. Locate your Booking Site URL by:
2. Log in to Elation EHR.
3. Go to **Settings** -> **Calendar & Booking**.
4. Click **Booking site**.
5. Click **Copy** next to your Booking Site **URL**.
6. Store the Booking Site URL on your business website.
[Click here for more information about the Booking Site](/articles/Patient-Booking-Site)
.
### How do I share my Zoom link with patients?
When an Appointment Type or Appointment is set as Virtual, your virtual visit instructions (including Zoom link) is shared with the patient automatically along with their appointment reminders depending on your appointment reminder settings.
To manually send virtual visit instructions with patients:
1. Go to the patient's appointment in the calendar.
2. Click into the colored area of the appointment.
3. Click **Send** next to the **Virtual Visit Instructions**.
[Click here to learn more about virtual appointments](/articles/Elation-Telehealth-powered-by-Zoom)
.
### Patient intake
#### Can I share the electronic patient form link with my patient while they're in office?
There are a couple of ways to share the electronic patient form link with your patient while they're in office. Here are the two options:
1. Resend the forms to the patient while they're in office. To do so:
2. Go to the patient's appointment in the calendar.
3. Click into the colored area of the appointment.
4. Click **Resend** next to the forms section.
5. Load the forms onto a portable device and have the patient fill it out in office. To do so:
6. Login to your EHR account on the device using the Google Chrome mobile application.
7. Go to the patient's appointment in the calendar.
8. Click into the colored area of the appointment.
9. Click **Copy URL** next to the forms section.
10. Open the URL in a new browser tab.
11. Log out of your EHR account.
12. Hand the device to the patient to fill out their forms.
#### How do I create patient forms with custom questions?
To create patient forms with custom questions:
1. Go to **Settings -> Patient Forms**
2. Click **Create New Form**.
3. Click **Blank**.
4. Give the form a **Form Name** and **Title**.
5. Click **Add question**.
6. Click **Other** to add a custom question.
7. Keep adding additional **Other** question types until you are done adding custom questions.
8. Click **Save form** to save your new form.
[Click here to learn more about Patient Forms](/articles/Patient-Forms-Guide)
.
### Bidirectional Lab Interfaces
#### Can I send lab orders electronically to my local lab facility?
Yes, for certain lab vendors, you can send lab orders electronically to the lab vendor.
[Click here for a comprehensive list of the Bidirectional Lab Interfaces that Elation offers](/articles/Bidirectional-Lab-Interface-Guide)
.
## Related Articles
* [Bidirectional Lab Interface Guide](/articles/Bidirectional-Lab-Interface-Guide)
* [Elation Integrated Video- Connecting with patients using video](/articles/Elation-Telehealth-powered-by-Zoom)
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Patient Forms Guide](/articles/Patient-Forms-Guide)
# Real-time Eligibility Guide - Checking for patient's insurance eligibility in real-time (Paid Add-On)
Source: https://help.elationhealth.com/articles/Real-Time-Eligibility
This guide provides an overview of the insurance eligibility check feature in Elation. The Real-time Eligibility feature is a paid add-on within the EHR.
## Overview
If your practice uses **Elation Billing** (practice management software), eligibility checks are handled differently in the billing system. See the following Elation Billing articles for billing-specific eligibility instructions: [Running Eligibility - Elation Billing](/articles/running-eligibility)
[Troubleshoot Eligibility - Elation Billing](/articles/troubleshoot-eligibility)
### What is Real-time Eligibility?
Real-time Eligibility in Elation EHR enables you to request a patient's primary and secondary insurance eligibility, coverage, and benefits based on the insurance details in their demographics. If the request is successful, the retrieved information will be displayed in the patient's demographics for easy access.
### What are the benefits of the Real-time Eligibility feature?
Real-time Eligibility is valuable because
* it allows you to request updated insurance information from patients if their coverage has lapsed, especially while they are in the office with you.
* the eligibility, coverage and benefits details will allow you to collect any patient responsibility at the point of care, if preferred.
* the eligibility, coverage and benefits details will allow you to inform the patient in advance for any additional responsibility they may have for the services rendered.
## Setup
### Enabling Real-time Eligibility
This Real-time Eligibility feature is a custom add-on product for EHR customers. This feature comes with additional costs. If you would like to use this feature, please reach out to Elation using the **I need help** -> **Contact Elation Support** button and a member of our team will reach out to assist you.
### Completing registration & configuring Settings
**REQUIREMENT** You must follow the instructions in this article to correctly register your practice and set up your Carriers to ensure you successfully receive eligibility information: [Click here for instructions on how to set up your Payers for eligibility checks](/articles/Real-time-Eligibility-Set-Up-Payers) .
In the above article you will find instructions for the following: Reviewing your Insurance Eligibility Settings.
Configuring the **Eligibility Payer ID** and **Submitter Type** for each carrier you want to run eligibility checks for.
Sending credentials and eligibility enrollment details to Elation.
Once you have completed registration and configured your settings, you can start using the Real-time Eligibility feature.
## Workflow Instructions
### Viewing updates to the demographics box
In each patient's Demographics Box, you will see a section at the top of the **Primary Insurance** and **Secondary Insurance** sections for Eligibility Checks.
* If insurance information is empty, you will see text that says *'Enter insurance information to run eligibility check.'*. You must enter insurance information for the patient in order to run an eligibility check.
* If you see text that says *'Payer ID … does not support real-time eligibility. Invalid payer name…'* it means one of three things:
* The Carrier does not offer electronic eligibility checks and they do not have an Eligibility Payer ID.
* The Eligibility Payer ID is not entered in your Insurance Settings for the Carrier.
* The Eligibility Payer ID entered in your Insurance Settings for the Carrier is incorrect.
* If you see a blue **Check Eligibility** button and text that says '**Run eligibility check to view insurance status**', it means eligibility check is available for the Carrier and you can click the **Check Eligibility** button to run an eligibility check.
If the **Check Eligibility** button is disabled, hover your mouse over the button to see why it is disabled and then add/correct the information needed to continue checking eligibility.
### Running manual eligibility checks
There are two ways to manually check insurance eligibility:
1. **From Patient Demographics** - Click the **Check Eligibility** button in the Patient Demographics to run eligibility checks for the patient's **Primary Insurance** and **Secondary Insurance**.
![Patient demographics panel open to Insurance, Payment, & Membership tab, showing the blue Check Eligibility button and "Run eligibility check to view insurance status" message for patient Pat Marzipan with Cigna as primary insurance carrier.]()
1. **From an Appointment** - Click the **Check Eligibility** button in the Create Event dialogue for a new appointment or in any created appointment for a patient to run an eligibility check for the patient's **Primary Insurance**.
![Appointment detail popup for Pat Marzipan showing Primary Insurance section with "Check Eligibility" button and "Run eligibility check to view insurance status" prompt.]()
Eligibility checks may take up to 20 seconds to run. Once the eligibility check is complete, the status of the eligibility check as well as the details of successful eligibility checks will appear in the demographics and/or appointment.
If you see the following error when performing Eligibility Checks - *'Payer ID … does not support real-time eligibility. Invalid payer name…',* this could mean one of three things:
If the **Check Eligibility** button is disabled, hover your mouse over the button to see why it is disabled and then add/correct the information needed to continue checking eligibility.
### Running automated eligibility checks for patients with appointments
Each night at approximately 3:30 AM Eastern, Elation will automatically run an eligibility check for patients who
1. have an appointment in the Elation Calendar for the following day **AND**
2. who have an eligibility enabled Carrier on file
This feature is automatic and does not need to be configured or enabled in any way. This feature cannot be disabled at this time.
### Viewing eligibility status in the patient's demographics
Eligibility response information will display above the **Primary Insurance** and **Secondary Insurance** information. The summarized eligibility details will display the date the insurance eligibility check was run, status of the insurance, Copay, Coinsurance, remaining Deductible and Effective Date as long as the information is made available by the Payer.
This is what the Eligibility response summary information will look like:
![Patient demographics panel showing Primary Insurance eligibility summary for Pat Marzipan: Active Coverage status, 25.00 Copay, 20% Coinsurance, 750.00 Remaining Deductible, last checked 4/5/2022, with Check Eligibility and Open Full Report buttons visible.]()
To view the full details of the Eligibility response, click the **Open Full Report** button under the summary. The full details of the eligibility response can include:
* a breakdown of various coverages & benefits
* coverage level
* prior authorization requirements
* out of pocket costs
* coverage limitations
This is an example of what the full report looks like. You may click on the header of the different objects (ex. Copay, Coinsurance) or Service Type (ex. General, Physical Therapy) to filter for specific details.
![Pat Marzipan's Full Eligibility Report dated 4/5/2022, showing Eligibility Details with Active Coverage, $25 copay entries for Orthopedic and Gastrointestinal service types, individual coverage level, in-network, no auth required.]()
### Viewing eligibility status in the Clinical Profile
New icons have been added to the Clinical Profile next to the patient's Primary Insurance to display the status of the Primary Insurance's eligibility. The Clinical Profile will not display the status of the Secondary Insurance's eligibility.
![Clinical Profile showing Pat Marzipan's demographics with Blue Cross Blue Shield insurance and a tooltip displaying "Active as of 3/17/2022" eligibility status icon.]()
The icon will change to one of the following depending on the status:
| Icon | Status |
| ---- | ---------------------------------------------------------------------------- |
| | Eligibility not run- click into the demographics to run an eligibility check |
| | Active |
| | Inactive |
| | Error - additional or updated information is needed for eligibility check |
### Viewing eligibility status in the Appointment
A new section has been added to the **Create Event** box and **Appointment** details to show the Eligibility status of the the patient's Primary Insurance. The summarized eligibility details will display the date the insurance eligibility check was run, status of the insurance, Copay, Coinsurance, remaining Deductible and Effective Date as long as the information is made available by the Payer. You can click the **Open Full Report** button to view the details of the eligibility response.
![Appointment detail popup for Pat Marzipan showing Primary Insurance eligibility summary with Active Coverage status, 25.00 copay, 20% coinsurance, 750.00 remaining deductible, last checked 4/5/2022, with Check Eligibility and Open Full Report options highlighted.]()
If you do not see any **Primary Insurance** information in the appointment, it means the patient does not have **Primary Insurance** information on file.
### Managing mismatched demographics
If the information returned in the Eligibility response does not match what is on file in the patient's Demographics, a notification will appear in the Demographics or Appointment that says \*'Updated information from ... fields is available from eligibility response.'\*Click the **View** button to view the discrepancies or click the **Dismiss** button to dismiss the notification and view it again the next time you view the patient's Demographics.
* If you click the **View** button to view the discrepancies, Elation will show you the information you have on file alongside the information provided by the Eligibility Report to allow you to compare the information. You can then check off the Demographics fields you want to update using the information from the Eligibility Report and click **Update All Fields** to make use of the new information.
!["Review demographics data" panel showing two mismatched fields: Middle Name (on file: blank, eligibility report: E) and Address (on file: blank, eligibility report: 123 Main St., Suite C, Springfield, CA 90002), both checked for update, with "Update All Fields" button available. An arrow highlights the "View" button in the eligibility mismatch notification that opened this panel.]()
Eligibility checks for a patient with Primary and Secondary Insurance may yield conflicting suggestions (ex: the Carrier for Primary Insurance says the patient’s address should be **123 Main St.** while the Carrier for the Secondary Insurance says the patient’s address should be **456 Index Ave.**). In these cases, it may be best to have the patient correct their information with their insurance carrier(s).
If a carrier returns the **Patient relation to policyholder** field value as **Other**, it means it did not match any of the existing relationship options offered by Elation (**Child**, **Self** or **Spouse**).
### Documenting eligibility checks when real-time eligibility is unavailable
Some payers do not support real-time eligibility checks, or you may need to verify eligibility outside of Elation (for example, by calling the payer or checking their online portal). In these cases, use the Notes field in the patient's insurance section to document your manual verification.
To record a manual eligibility verification:
| 1 | Open the patient's chart and click on the patient's name to open their demographics. |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Scroll to the Insurance, Payment & Membership section and locate the relevant insurance record (Primary, Secondary, or Tertiary). |
| 3 | In the Notes field, enter details about your verification, such as: Date and time of verification • Method used (phone call, payer portal, etc.) • Key financial details confirmed (deductible remaining, copay amount, coinsurance percentage, etc.) • Name of representative spoken to (if applicable) |
| 4 | Click Save & Close . |
**Example note:** *Verified via BlueCross portal on 1/23/2026. Active coverage confirmed. Deductible: $500 remaining. Copay: $25 for office visit. - JSmith*
For per-visit context, you can also add notes in the Billing notes field within the appointment. To do this, click on the appointment, click Edit , and enter details in the Billing notes field.
## Frequently Asked Questions (FAQ)
##### Why is the "Check Eligibility" button disabled for a patient?
The **Check Eligibility** button will be disabled if Elation receives a certain error when trying to run an eligibility check for a patient. If the **Check Eligibility** button is disabled, hover your mouse over the button to see why it is disabled and then add/correct the information needed to continue checking eligibility.
##### How long will it take to receive results after requesting an eligibility check?
It may take 10-20 seconds to receive results after requesting an eligibility check.
##### When will automatic eligibility checks be run? Can I configure when automatic eligibility checks will be run?
An automatic job will run nightly (around 3:30am Eastern) to perform eligibility checks for all patients with appointments scheduled for the following day. This functionality cannot be configured at this time.
##### How are the summarized copay, coinsurance, and remaining deductible amounts in Demographics, Appointment Details, and Create an Event selected?
Elation will attempt to find values for copay, coinsurance, and remaining deductible for each combination below. If a value is not found for a combination, the next combination will be tried.
If multiple matching values are returned for a given category in a combination (ex: 2 'In Network' \$25 copays for 'Individual' coverage level for service type code 98), then that value will be displayed.
If multiple different values are returned for a given category in a combination (ex: 1 $25 copay and 1 $50 copay that are both 'In Network' for 'Individual' coverage level for service type code 98), then a **See Full Report** message will display.
The sequence and combinations below may be refined over time
| **Sequence** | **Service Type Code** | **Coverage Level** | **In-Network** |
| ------------ | ---------------------------------------- | ------------------ | ------------------------------- |
| 1 | 30 - Health Benefit Plan Coverage | Individual | Yes, Not Applicable, or (blank) |
| 2 | 30 - Health Benefit Plan Coverage | Employee | Yes, Not Applicable, or (blank) |
| 3 | 30 - Health Benefit Plan Coverage | (Any) | Yes, Not Applicable, or (blank) |
| 4 | 98 - Professional Physician Office Visit | Individual | Yes, Not Applicable, or (blank) |
| 5 | 98 - Professional Physician Office Visit | Employee | Yes, Not Applicable, or (blank) |
| 6 | 98 - Professional Physician Office Visit | (Any) | Yes, Not Applicable, or (blank) |
| 7 | 96 - Professional Physician | Individual | Yes, Not Applicable, or (blank) |
| 8 | 96 - Professional Physician | Employee | Yes, Not Applicable, or (blank) |
| 9 | 96 - Professional Physician | (Any) | Yes, Not Applicable, or (blank) |
| 10 | BZ - Physician Visit Well | Individual | Yes, Not Applicable, or (blank) |
| 11 | BZ - Physician Visit Well | Employee | Yes, Not Applicable, or (blank) |
| 12 | BZ - Physician Visit Well | (Any) | Yes, Not Applicable, or (blank) |
| 13 | BY - Physician Visit Sick | Individual | Yes, Not Applicable, or (blank) |
| 14 | BY - Physician Visit Sick | Employee | Yes, Not Applicable, or (blank) |
| 15 | BY - Physician Visit Sick | (Any) | Yes, Not Applicable, or (blank) |
##### What should I do if the eligibility check results in an error?
Details on the cause of the error should be displayed in Elation. Please use the available information to resolve any data issues. You can then click the **Check Eligibility** button after updating the information to re-run the eligibility check.
For example, if you see the error ***Payer ID … does not support real-time eligibility. Invalid payer name…***, double check that the correct **Eligibility Payer ID** is added to the Carrier in Elation.
##### What NPI information is used for an eligibility check?
The NPI information used for an eligibility check will depend on the following:
* If a patient’s insurance carrier has **Credentialed as a group** listed under **Submitter Type**, then the **Group name** and **Group NPI** configured in the Insurance Settings will be used for both manual and automatic eligibility checks.
* If a patient’s insurance carrier has **Credentialed as individual providers** listed under **Submitter Type**, then the name and NPI of the patient’s **Provider assigned in practice** will be used for both manual and automatic eligibility checks.
📖
**RECOMMENDED READING**
[Click here for instructions on how to set up your Payers for eligibility checks](/articles/Real-time-Eligibility-Set-Up-Payers).
**I have a Clearinghouse through my billing software. Is Elation connected to my Clearinghouse?**
Elation's Real-time Eligibility feature is powered by Elation's connection to ClaimMD. Elation is not connected to your Clearinghouse, even if your Clearinghouse is also ClaimMD.
##### Is there a manual "eligibility confirmed" toggle?
Elation does not currently have a dedicated toggle or button to manually mark eligibility as confirmed. The eligibility status icon in the Clinical Profile and Demographics reflects the most recent successful automated or manual real-time eligibility check run through Elation.
For payers that do not support real-time eligibility, or when you verify eligibility outside of Elation (via phone or payer portal), record your verification details in the Notes field within the patient's insurance record in Demographics. You can also use the Billing notes field in the appointment for visit-specific context.
##### What if my payer doesn't support real-time eligibility?
If you see the message ***Payer ID … does not support real-time eligibility. Invalid payer name…*** it means one of the following:
* The Carrier does not offer electronic eligibility checks.
* The Eligibility Payer ID is not entered in your Insurance Settings for the Carrier.
* The Eligibility Payer ID entered in your Insurance Settings for the Carrier is incorrect.
*
**If the payer does not support electronic eligibility checks:**
| 1 | **Verify eligibility directly** - Contact the payer by phone or through their online portal. |
| - | ---------------------------------------------------------------------------------------------------------------------------- |
| 2 | **Document your verification** - [Click here for full instructions](#document_eligibility) . |
| 3 | **Add visit-specific notes (optional)** - Add notes in the Billing notes field within the appointment for per-visit context. |
**I** f you believe the payer should support eligibility checks:\*\*
Verify the Eligibility Payer ID is correctly configured in your Insurance Settings. Reference the [Real-time Eligibility Guide - Setting up Payers for eligibility checks](/articles/Real-time-Eligibility-Set-Up-Payers) for instructions on how to add or correct the Eligibility Payer ID.
## Related Articles
* [Real-time Eligibility Guide - Setting up Payers for eligibility checks](/articles/Real-time-Eligibility-Set-Up-Payers)
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
# Real-time Eligibility Guide - Setting up Payers for eligibility checks (Paid Add-On)
Source: https://help.elationhealth.com/articles/Real-time-Eligibility-Set-Up-Payers
This article explains how to configure Carriers (Payers) in your EHR to ensure you receive insurance eligibility and benefits information.
## Overview
If your practice uses **Elation Billing** (practice management software), payer enrollment for eligibility and ERA is handled through a separate process. See [Enrolling for Claims Submission, ERA, and Real-Time Eligibility (EDI) - Elation Billing](/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi) for billing-specific enrollment instructions.
### What is Real-time Eligibility?
Real-time Eligibility (RTE) in Elation EHR enables you to request a patient's primary and secondary insurance eligibility, coverage, and benefits based on the insurance details in their demographics. This article explains how to configure Carriers (Payers) in your EHR to ensure you receive insurance eligibility and benefits information.
📖
**RECOMMENDED READING**
[Click here to learn more about Elation's Real-time Eligibility feature and how to use it](/articles/Real-Time-Eligibility)
.
## Setup
**REQUIREMENT** The following actions must be completed to start using the Real-time Eligibility feature. Follow the detailed instructions below for guidance. [Send credentials and eligibility enrollment details to Elation](#complete_registration) **after** completing the following Settings configurations:
Wait for approval from ClaimMD (Elations' Clearinghouse for RTE).
### Sending credentials & eligibility enrollment details to Elation
Elation must assist with completing Provider registration and eligibility enrollments before you can start using the Real-Time Eligibility feature. To begin this process:
| **1** | Download [this file](/files/eligibility-enrollment-spreadsheet.zip) and fill out the following two tabs of the spreadsheet: **Group info**: Enter all the Provider or Group NPIs associated with your practice and their TINs. • **Special enrollment**: Enter the following information into each row for **each Payer** that requires eligibility enrollment. To find the Payers that need eligibility enrollment, go through the exercise of [updating your Carrier Settings](#Carrier_Settings) (instructions below). |
| ------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Once your file is complete and ready, click **I need help** -> **Contact Elation Support** . |
| **3** | Choose **Something else** under **Select an issue** . |
| **4** | Enter the following information in the **Details** box: *Please help me complete Provider registration and submit Payer enrollments for RTE. Details are in the attached file.* |
| **5** | Click **Next** to continue to the next step of the contact Support process. |
| **6** | Click **No, I still need help** . |
| **7** | Confirm the **Details** & click **Add Attachment** to attach the filled out spreadsheet. |
| **8** | Click **Next** . |
| **9** | Click **Submit** after confirming the name and email we should contact once the enrollment is completed. |
| **10** | Enrollments will be completed within two business days, after which you will begin receiving eligibility responses for that payer. |
### Updating Insurance Eligibility Settings
By default, the Real-time Eligibility feature uses the NPI of the **Provider assigned in practice** to run eligibility checks. If your practice is contracted with any payers using a Group NPI then you must add those Group NPI(s) to the **Insurance Eligibility Settings** to configure running eligibility checks using the Group NPI. You can add as many Group NPIs as needed.
![Add New Group dialog showing Group name "Horizon Medical" and Group NPI "1068874295" filled in, with an arrow pointing from the "+ Add New Group" button that opened it.]()
To add Group NPI information for eligibility checks:
| **1** | Go to **Settings** -> **Insurance** . |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **+ Add New Group** under **Insurance Eligibility Settings** . |
| **3** | Enter the **Group Details**: **Group name**\*\*\*:\*\* Name of your group as associated with Payer contracts. • \*\* Group nickname\*\*: Any preferred names the group goes by. • \*\* Group NPI\*\*\*: NPI of the group associated with Payer contracts. |
| **4** | Click **Save** . |
### Updating Carrier Settings
Two fields in the Insurance Carrier details are required for eligibility checks: **Eligibility Payer ID** and **Submitter Type**. Please review these fields for each Carrier and make appropriate changes as needed to ensure successful eligibility responses.
* *Additional Details* - **Eligibility Payer ID**
* The **Eligibility Payer ID** field stores the ID required (as designated by the Payer) to run eligibility checks for a specific payer. [Click here to find the Eligibility Payer ID for a Payer](https://www.claim.md/payer-list).
* *Credentialing & Enrollment*\*\*- Submitter Type\*\*
* The **Submitter Type** allows you to specify whether an Individual Provider NPI will be used to run eligibility checks or whether one of the [Group NPIs](#insurance_eligibility_settings) will be used to run eligibility checks.
* If **Credentialed as a group** is selected and you have multiple Groups, an additional dropdown will appear to allow you to select which **Group** will be submitted for eligibility checks.
#### Adding Eligibility Payer ID and setting Submitter Type for each Payer
Follow the steps outlined in the quick video below to add the **Eligibility Payer ID** and set the **Submitter Type** for each Payer. You will need to have two windows or two tabs open in your web browser- one for Elation EHR and the other for [ClaimMD's Payer List](https://www.claim.md/payer-list) (ClaimMD is the Clearinghouse Elation uses for eligibility checks).
You can also follow the steps below, as demonstrated in the video above.
| **1** | Open the **Insurance** Settings page in Elation. |
| ------ | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Open this list of Payers from ClaimMD in another tab or window of your browser: [https://www.claim.md/payer-list](https://www.claim.md/payer-list) |
| **3** | Search for the Payer you want to run eligibility checks for in the ClaimMD Payer List and see if they have **Prime Eligibility** listed in the Services column. If they do, this means they offer eligibility/benefits information and you can run an eligibility check for them via Elation. • If they do not then you cannot run eligibility checks for this Payer via Elation. |
| **4** | If the Payer has **Prime Eligibility** listed in the Services column, copy the Payer ID under the **Payer ID** column and then go back to Elation. ![ClaimMD payer detail page for AARP showing Payer ID 36273 highlighted, with Eligibility / Benefits row confirming "Enrollment" is required.]()
|
| **5** | Click the **Edit** (pencil) button next to a Payer's name. |
| **6** | Paste the Payer ID you copied into the **Eligibility Payer ID** field. ![Insurance carrier edit modal for AARP showing the Eligibility Payer ID field highlighted with value "36273" entered under Additional Details.]()
|
| **7** | Scroll down to the **Credentialing and Enrollment** section and specify under **Submitter Type** whether the Providers in your practice are **Credentialed as individual providers** or **Credentialed as a group** for this payer. This is important to guarantee a successful eligibility check. If **Credentialed as a group** is selected and you have multiple Groups, an additional dropdown will appear to allow you to select which **Group** will be submitted for eligibility checks. |
| **8** | Click **Save** in the Insurance details in Elation to save your edits. |
| **9** | Return to the ClaimMD tab in your browser and click **View Payer** . Check the **Eligibility / Benefits** row for the word "Enrollment." If it appears, a special enrollment process must be completed by Elation on your behalf. Notify Elation immediately by following the [steps outlined in the 'Sending credentials & eligibility enrollment details to Elation' section above](#complete_registration) . |
| **10** | Repeats steps 3-9 for each Payer you want to run eligibility checks for. |
### Checking for eligibility enrollment requirements
Certain payers require you to complete a special enrollment process in order to obtain eligibility information.
![ClaimMD Payer Information page for CA Medicare North (Payer ID 01102) with Eligibility/Benefits row highlighted, showing "Enrollment Required" — indicating special enrollment is needed.]()
To verify whether a payer requires eligibility enrollments:
| **1** | Open this list of Payers from ClaimMD in another tab or window of your browser: [https://www.claim.md/payer-list](https://www.claim.md/payer-list) |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Search for the Payer you want to run eligibility checks for in the ClaimMD Payer List and see if they have **Prime Eligibility** listed in the Services column. If they do, this means they offer eligibility/benefits information and you can run an eligibility check for them via Elation. • If they do not then you cannot run eligibility checks for this Payer via Elation. |
| **3** | Click **View Payer** if the payer offers eligibility checks. |
| **4** | Check the **Eligibility / Benefits** row for the word "Enrollment." If it appears, a special enrollment process must be completed by Elation on your behalf. |
| **5** | Download [this file](/files/eligibility-enrollment-spreadsheet.zip) and fill out the following two tabs of the spreadsheet: **Group info**: Enter all the Provider or Group NPIs associated with your practice and their TINs. • **Special enrollment**: Enter the following information into each row for **each Payer** that requires enrollment: |
| **6** | Notify Elation immediately by following the [steps outlined in the 'Sending credentials & eligibility enrollment details to Elation' section above](#complete_registration) . |
## Workflow Instructions
### Maintaining your Carrier list
Depending on how your organize your Carriers, you may have multiple entries for the same Carrier. Make sure the **Eligibility Payer ID** is populated for all entries of the same Carrier in order for eligibility checks to run properly.
Here is an example of a list of Aetna Carriers and how the Eligibility ID field may look:
| **Payer Name** | **Eligibility Payer ID** |
| ------------------------------- | ------------------------ |
| Aetna PPO | 60054 |
| Aetna Affordable Health Choices | 60054 |
| Aetna HMO | 66054 |
### Adding new Carriers
When you are about to add a new Carrier to your Carrier list:
| **1** | Review your existing list of Carriers to make sure a new Carrier is needed. [Click here for instructions on how to add a new Carrier](/articles/Managing-Carriers-and-Plans#add_carrier_or_plan) . |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | [Add the Eligibility Payer ID and set the Submitter Type for the Payer](#add_eligibility_payer_ID) . |
| **3** | [Send eligibility enrollment details to Elation as needed](#complete_enrollments) . |
If you add the correct **Eligibility Payer ID** from ClaimMD but are still unable to receive eligibility checks for that Payer, notify Elation with the following details: Payer Name
Payer ID
NPI(s) associated with the Payer contract
Name(s) associated with the NPI(s)
### Adding new Providers
When adding a new Provider to your practice, you must notify Elation to complete their registration process so eligibility checks can be run for that Provider's patients. To notify Elation:
| **1** | Download [this file](/files/eligibility-enrollment-spreadsheet.zip) and fill out the following two tabs of the spreadsheet: **Group info**: Enter all the Provider or Group NPIs associated with your practice and their TINs. • **Special enrollment**: Enter the following information into each row for **each Payer** that [requires enrollment:](#add_eligibility_payer_ID) |
| ------ | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **I need help** -> **Contact Elation Support** . |
| **3** | Choose **Something else** under **Select an issue** . |
| **4** | Enter the following information in the **Details** box: *Please help me complete Provider registration and submit Payer enrollments for RTE. Details are in the attached file.* |
| **5** | Click **Next** to continue to the next step of the contact Support process. |
| **6** | Click **No, I still need help** . |
| **7** | Confirm the **Details** & click **Add Attachment** to attach the filled out spreadsheet. |
| **8** | Click **Next** . |
| **9** | Click **Submit** after confirming the name and email we should contact once the registration is completed. |
| **10** | Enrollments will be completed within two business days, after which you will begin receiving eligibility responses for that payer. |
## Troubleshooting Common Errors
### Incorrect Payer ID selection
Selecting the wrong Eligibility Payer ID is a common cause of eligibility check failures.
* **Using a commercial payer ID for a Medicare product:** Some payers use different Payer IDs for their commercial plans versus their Medicare Advantage products.
* For example, UnitedHealthcare's commercial plans may have a different Eligibility Payer ID than AARP-branded Medicare Advantage plans offered through UnitedHealthcare. Always confirm the correct Payer ID for the specific product your patient is enrolled in.
* **Using a generic payer ID when the payer has distinct IDs for eligibility versus claims:** Some payers have separate Payer IDs for eligibility checks and claims submission. The Eligibility Payer ID stored in your Carrier record must match the ID designated for eligibility, not claims.
### Patient has active coverage but the eligibility response says 'inactive' or 'invalid'
| **1** | Look up the payer's Eligibility Payer ID on the [ClaimMD Payer List](https://www.claim.md/payer-list). |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Compare the Payer ID listed on ClaimMD with the **Eligibility Payer ID** stored in the corresponding Carrier record in Elation. |
| **3** | If the IDs do not match, click the **Edit** (pencil) button next to the Carrier name in your **Insurance Settings** and update the **Eligibility Payer ID** field with the correct value from ClaimMD. |
| **4** | Click **Save**. |
#### If eligibility checks still fail after updating the Payer ID
If you continue to see failures after confirming and updating the Eligibility Payer ID, contact Elation Support and include the following details:
* Payer name
* Payer ID currently configured in Elation
* Example Patient IDs and dates of failed eligibility checks
### Provider NPI has not been enrolled for eligibility with payer
If you see the following error when performing Eligibility checks- ‘*Provider NPI \[] has not been enrolled for eligibility with payer \[]*’, this could mean one of the following:
| **Issue** | **Solution** |
| ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------- |
| The Provider/Group did not complete eligibility enrollment for the Payer and will not be able to receive eligibility information until enrollment is completed and approved. | [Notifying Elation about eligibility enrollments](#notify_enrollments) . |
| The Provider/Group completed enrollments but the incorrect **Submitter Type** is associated with the Carrier. | Check the **Submitter Type** setting for that Carrier and select the correct type. |
**Payer ID does not support real-time eligibility. Invalid payer name...**
If you see the following error when performing Eligibility checks - ‘*Payer ID … does not support real-time eligibility. Invalid payer name…*’, this could mean one of the following:
| **Issue** | **Solution** |
| ------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------- |
| The Carrier does not support electronic eligibility checks through ClaimMD. | Verify patient's eligibility via other means. |
| The **Eligibility Payer ID** is not stored in the Insurance Settings for the Carrier. | [Add the Eligibility Payer ID to the Carrier](#add_eligibility_payer_ID) . |
| The **Eligibility Payer ID** stored in the Insurance Settings for the Carrier is incorrect. | [Verify the Eligibility Payer ID for the Carrier and update the Eligibility Payer ID to the correct one](#add_eligibility_payer_ID) . |
## Frequently Asked Questions
**What NPI information is used for an eligibility check?**
The NPI information used for an eligibility check will depend on the following:
* If a patient’s insurance carrier has **Credentialed as a group** listed under **Submitter Type**, then the **Group name** and **Group NPI** configured in the Insurance Settings will be used for both manual and automatic eligibility checks.
* If a patient’s insurance carrier has **Credentialed as individual providers** listed under **Submitter Type**, then the name and NPI of the patient’s **Provider assigned in practice** will be used for both manual and automatic eligibility checks.
##### How often do I need to update Carrier Settings?
The
**Eligibility Payer ID**
rarely changes for a Payer. If you are notified of a change in the Payer's Eligibility ID then
[update the Eligibility Payer ID in Carrier Settings](#add_eligibility_payer_ID)
.
The
**Submitter Type**
typically only changes when you change how you are contracted with a Payer. You can update the Submitter Type as needed.
**I have a Clearinghouse through my billing software. Is Elation connected to my Clearinghouse?**
Elation's Real-time Eligibility feature is powered by Elation's connection to ClaimMD. Elation is not connected to your Clearinghouse, even if your Clearinghouse is also ClaimMD.
## Related Articles
* [Real-time Eligibility Guide - Checking for patient's insurance eligibility in real-time](/articles/Real-Time-Eligibility)
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
# Patient Forms Guide - Receiving and filling out forms as a patient
Source: https://help.elationhealth.com/articles/Receiving-and-filling-out-forms-as-a-patient
## Content
* [Overview](#overview)
* [How do patients complete forms?](#summary)
* [Workflow Instructions (Patient’s Perspective)](#workflows)
* [Opening the forms link from an email](#email)
* [Completing forms](#complete_forms)
* [Uploading insurance card images](#uploading_insurance_cards)
* [Applying an eSignature](#eSignature)
* [Sample Forms](#sample_forms)
## Overview
### How do patients complete forms?
Patients can access their assigned forms in two ways:
* **Email** — An email from [reminders@elationemr.com](mailto:reminders@elationemr.com) arrives with a secure link to open their forms.
* **Patient Passport** — If the patient has a Passport account, forms attached to their upcoming appointments appear directly in the appointment details view. They can open and complete forms from there without needing the email link.
* Each form must be completed in a single session—responses cannot be saved and resumed later.
* If multiple forms are sent, patients can complete and submit them one at a time. They may return to the original link later to complete any remaining forms.
* Once a form is submitted, it is considered final and cannot be edited or re-submitted.
## Workflow Instructions (Patient’s Perspective)
### Completing forms from Patient Passport
Patients with a Patient Passport account can access and complete their forms directly from their appointment.
1. Log in to **Patient Passport** at [app.elationpassport.com](https://app.elationpassport.com).
2. Go to **Appointments** and open the upcoming appointment.
3. Find the **Complete patient forms** link and click it to complete any incomplete forms.
If the appointment is a virtual visit, your meeting join link also appears in the appointment details in this same view.
![Visit Note Instructions And Forms Attached To Appointments]()
**Image needed:** Screenshot of the Patient Passport appointment detail card showing visit instructions and the patient forms section with completion status indicators.
### Opening the forms link from an email
Patients will receive an email from [reminders@elationemr.com](mailto:reminders@elationemr.com) with the subject line **"Fill out forms for upcoming appointment with \[Provider's Name]"** whenever Patient Forms are sent to them. The Provider's name will help inform them where the request is coming from.
To get started, patients can click the **Fill out forms** button in the email to open and complete their forms.
### Completing forms
When a patient opens their electronic forms, the progress bar at the top will show the total number of forms included. As each form is completed, the corresponding bar will turn green to indicate progress.
Patients can complete each form at their convenience, but each form must be finished in a single session. Responses cannot be saved and resumed later, so patients must click **Submit and continue** before exiting the form.
For questions that allow multiple responses, patients can click **+ Add Another** to include additional entries.
#### Uploading insurance card images
When a patient receives a form with an insurance card upload question, they can click the upload icon to attach an image from their computer or mobile device. If using a mobile device with a camera, they can take a photo in real time. Patients can preview uploaded images and replace them if the quality isn’t clear.
#### Applying an eSignature
When patients receive a form that requires an electronic signature, they’ll be asked to review the information, indicate their agreement or disagreement, and sign using their cursor. Both a response and a signature are required to submit the form.
If they need to make changes, patients can click **Clear Signature** to redraw their signature before submitting.
## Sample Forms
![Follow-up Intake form showing address, phone, email fields, insurance card front and back upload areas, and a medications field with Submit and continue button.]()
![Follow-up PHQ-9 form with the fourth question's dropdown open, showing four frequency options: Not at all, Several Days, More than half the days, Nearly every day.]()
![Consent for Treatment form with "I agree" selected, a handwritten signature drawn in the signature field, and the "Submit and continue" button visible at the bottom.]()
## Related Articles
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Patient Forms Guide - Creating and managing Patient Forms](/articles/Patient-Forms-Guide)
* [Patient Forms Guide - Sending forms to patients](/articles/Sending-forms-to-patients)
* [Patient Forms Guide - Managing forms responses](/articles/Managing-forms-responses)
# Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox
Source: https://help.elationhealth.com/articles/Receiving-faxes-in-your-Elation-Fax-Inbox
This article describes how you can ensure all your faxes appear as electronic records in Elation.
This article describes how you can ensure all your faxes appear as electronic records in Elation. This includes instructions on how to port your fax number to Elation or forward faxes from an existing fax number you own to the electronic number provided to you by Elation.
📖
**RECOMMENDED READING**
[Click here for an introduction to the Fax Inbox feature in the EHR](/articles/Fax-Inbox-Introduction)
.
## Overview
### How do I obtain an electronic fax number from Elation and what is it for?
Elation provides each practice with a unique electronic Elation fax number when they begin using Elation EHR. This fax number allows you to receive faxes directly in Elation EHR. This fax number can be one of the following:
* a brand new fax number that Elation obtains from our fax provider.
* a fax number that you previously owned, which we [port](#fax_port_details) to our fax provider (per your authorization) and assign to your practice.
If you requested a brand new fax number, watch for an email, within 10 days of signing up with Elation, notifying your practice that an electronic Elation fax number has been assigned to your practice.
#### Can I change my Elation fax number after it's been assigned?
Elation's fax vendor provisions your Elation fax number, so you cannot change it yourself from within Elation EHR. To request a different Elation fax number, click **I need help** → **Contact Elation Support**.
#### How can I keep my existing fax number?
To retain your fax number when switching from one EHR to another and continue receiving faxes as electronic records, you can choose from the following options:
1. [Port the fax number](#fax_port_details) you want to retain to Elation to make that fax number your Elation fax number.
2. Retain ownership of the fax number while simultaneously having a new fax number with Elation and then [forward faxes](#fax_forward_details) received by that number to your Elation fax number.
##### How do I choose between porting my fax number and fax forwarding?
Here is how you would choose between porting your fax number or forwarding faxes:
* If you are fine with not being able to send faxes from the fax number you want to retain, opt for the [fax port option](#fax_port_details).
* If you need to retain the ability to send faxes from the fax number you want to retain, select the [fax forward option](#fax_forward_details).
#### What can I do with the electronic fax number provided by Elation?
With the electronic fax number provided by Elation:
* all inbound patient paperwork received will automatically be converted into electronic records.
* you can [forward faxes](#fax_forward_details) from a landline fax number to your Elation fax number.
### What does it mean to 'port' a fax number?
A fax port is the process of transferring ownership of a fax number from your existing fax carrier to Elation's fax carrier. Afterwards Elation will assign this fax number to you as your Elation fax number.
There are two types of fax ports and you would usually pick one of the two when you are asked which type of fax port you would like to proceed with:
* To port only a subset of your fax numbers from your existing fax carrier to Elation's fax carrier, choose a **partial fax port**.
* To port all your fax numbers from your existing fax carrier to Elation's fax carrier, choose a **full fax port**.
Porting an existing fax number under Elation's ownership means you cannot fax out from your fax machine (or electronic fax account) from this existing fax number because you no longer own this number. You can use Elation's [Letter feature](/articles/letter-and-referral-introduction#Fax) to send faxes from your Elation account. Faxes sent from your Elation account will not be sent from your Elation fax number. Faxes will be sent from a set of fax numbers with California area codes.
### What are the benefits of porting a fax number I previously owned to Elation?
Porting a fax number you previously owned to Elation allows you to maintain your correspondences with external collaborators that already have your existing fax number. You will not need to update any business materials because your fax number remains the same.
### What is fax forwarding?
Fax forwarding is the process of transferring faxes from one fax device/number to your Elation fax number. One fax device/number receives the fax first and then **forwards** a copy of that fax to your Elation fax number. You can forward faxes using one of these options:
* Forward faxes manually by taking a fax you received and then faxing those pages to your Elation fax number.
* Ask your landline fax provider to automatically forward any fax your fax number receives to your Elation fax number.
* Program a physical fax machine to automatically forward any fax it receives to your Elation fax number.
Fax-forwarding will only work with **landline** fax numbers. If you had an existing **electronic** fax number prior to using Elation, we recommend [porting that number over to Elation's ownership](#fax_port_details) . Elation can also port your existing landline fax number to Elation's ownership so that your existing landline fax number becomes your Elation fax number.
### What are the benefits of fax forwarding?
Forwarding all your faxes to your Elation fax number allows you to manage all patient records electronically in Elation. Additionally,
* automatic fax forwarding allows you to receive all inbound faxes in Elation while still being able to send outbound faxes from the existing fax number you are forwarding faxes from.
* manual fax forwarding allows you to choose which inbound faxes to store in Elation while still being able to send outbound faxes from the existing fax number you are forwarding faxes from.
## Workflow Instructions
### Porting an existing fax number you own to Elation
To port an existing fax number you own to Elation
1. Call and confirm with your existing fax number carrier that your fax number can be ported
2. Send the following to your Elation contact:
* The date you want the fax port to take place.
* A completed [Letter of Authorization form](/files/fax-letter-of-authorization.pdf).
* A copy of the first page of your current bill for the fax number; the bill must have the Lead Billing Number on it.
3. Once we receive this paperwork, we submit a request to our fax provider to begin the fax port process.
* This process can take up to 20 business days depending on how quickly your existing fax carrier processes our request.
4. You will receive an email from Elation once your existing fax number has been ported to Elation.
### Manually forwarding faxes to your Elation fax number
To manually forward faxes received through a fax number you own, if they are printed from a physical fax machine, follow these steps:
1. Take the pages you received and put the pages back into your fax machine.
2. Enter your Elation fax number into the fax machine and send the pages to your Elation fax number.
If you have an electronic fax number and receive faxes in an external electronic fax inbox: Download the fax file from your external electronic fax inbox to your computer.
[Upload the file to your Elation Fax Inbox](/articles/Uploading-documents-to-the-Fax-Inbox).
### Automatically forwarding faxes from your landline fax number to your Elation fax number
To automatically forward faxes from your landline fax number to your Elation fax number, choose one of the following options:
* Ask your landline fax provider to automatically forward any fax your fax number receives to your Elation fax number.
* Program a physical fax machine to automatically forward any fax it receives to your Elation fax number.
#### Asking your fax provider to automatically forward faxes to your Elation fax number
Some landline fax providers (i.e., your local phone company) offer a service to automatically forward received faxes to another fax number. To request this service, contact your landline fax provider and inquire about the availability and setup process. This service may incur additional costs.
#### Programming a fax machine to automatically forward faxes to your Elation fax number
Most physical fax machines allow you to program automatic forwarding of received faxes to another fax number. Refer to your fax machine's User Manual and follow the provided instructions to set up fax forwarding to your Elation fax number.
## Frequently Asked Questions
### Can I port my Elation fax number to a new carrier if I'm closing my practice or switching EHRs?
Yes. If you want to keep using your Elation fax number after you close your practice or move to a different EHR, you can port that number to your new fax carrier. Contact Elation Support to request a proof-of-ownership document confirming Elation's carrier holds the number; your new carrier uses this document to complete the port on their end. Request this document before your Elation account is deactivated, since Elation cannot generate it after the account has closed.
## Recommended Reading
* [Fax Inbox Introduction](/articles/Fax-Inbox-Introduction)
* [Fax Usage - Frequently Asked Questions](/articles/fax-usage)
* [Practice Home Introduction- A hub for managing your practice](/articles/practice-home-introduction)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
* [Letters & Referrals Guide- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
# Medication List Management Guide - Reconciling active medications
Source: https://help.elationhealth.com/articles/Reconciling-active-medications
## Overview
### What is the medication reconciliation feature?
The Medication Reconciliation feature displays all active medications for a patient and provides a streamlined workflow to document adherence and discontinue inactive medications.
AI-powered algorithms analyze patient, medication, and fill data to identify drugs that are likely no longer being taken. The data referenced by AI includes:
* Patient's problem list
* Patient risk factors (e.g. age)
* Prescription/dispensing history
### What are the benefits of the medication reconciliation feature?
The Medication Reconciliation feature streamlines the process of reviewing and updating a patient’s active medication list by consolidating all current medications into a single, easy-to-navigate workflow allowing you to make real-time updates during patient encounters, including discontinuing medications in bulk. AI-powered suggestions highlight medications that the patient may no longer be taking based on prescription fill patterns and clinical history, allowing you to make faster, more informed decisions. This improves the accuracy of the patient’s chart, supports safer prescribing, and enhances the overall quality of care.
## Workflow Instructions
### Reconciling active medications
![Reconcile Active Medications dialog showing Hydromet 5/1.5 mg/5ML Syrup and HYDROmorphone 2 mg Tab flagged as "Likely Not Taking" with AI-generated explanations, alongside the Doc D/C checkboxes and Patient Adherence columns.]()
| **1** | Open the medication reconciliation window using one of these workflows: Click **Reconcile Meds** at the top of the Permanent Rx Meds section of the Clinical Profile. • Click **MedsHx** -> **Reconcile Medications**. • Click **MedsHx** -> **Medication History** -> **Reconcile Active Medications**. • Open a legacy visit note and click **Reconcile Meds**. • Open an [Elation Note](/articles/Elation-Note) and click the **Medication Reconciliation** icon in the Reconciled Medications block. |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Elation AI will quickly analyze the patient’s chart to identify medications the patient may no longer be taking. Any such medications will be flagged with a **Likely Not Taking** label, accompanied by context or notes explaining why the medication was flagged. If you would like to share your feedback about the AI suggestions with Elation, click on the rating scale at the bottom of the form and provide any additional context as needed. |
| **3** | Add patient adherence notes to the **Patient Adherence** column as needed. |
| **4** | Click on the **Sig** to add, edit or remove the sig as needed. This option will not be available if the **Cancel Request** box is checked. |
| **5** | To add additional medications to the medication list, click \*\*+ Document Med \*\* at the top of the window. |
| **6** | To discontinue inactive medications, check the **Document Discontinue** box for each medication you want to continue. You can also check the box at the top of the **Doc D/C** column to select/unselect all medications at once. Select the reason for discontinuing the medication in the **Discontinue Reason** dropdown that appears. • Check the **Cancel Request** box if you want to send a cancellation request to the pharmacy — this option is only available when the following is true: |
| **7** | Click the **Complete Med Rec..** button to proceed with your changes OR **Complete Med Rec Without Changes** if no changes are needed. |
| 8 | A **Last Reconciled** date will display at the top of the Medication History section to indicate when the medication list was last reviewed and updated. ![]()
|
### What happens after completing medication reconciliation?
When you click **Complete Med Rec**, all changes you made during reconciliation are applied immediately to the patient's permanent medication list:
* Sig edits update the corresponding medication in the permanent medication list right away.
* New medications added via **+ Document Med** appear in the **Permanent Rx Meds** or **Permanent OTC Meds** section of the Clinical Profile.
* Discontinued medications move to the **Discontinued** section of the Medication History with the reason you selected. Discontinuing a medication discontinues the entire [medication thread](/articles/medication-history#anatomy-of-a-medication-thread), which includes all medications in that thread — including any records later documented for that same medication.
* The **Last Reconciled** date updates at the top of the Medication History section, showing when the list was last reviewed.
* If you complete medication reconciliation while a visit note is open, the MIPS toggle to confirm a patient's active medications are documented is toggled **On**.
#### Example: Before and after medication reconciliation
| Stage | What you see |
| ------------------------------------ | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Before medication reconciliation** | *Metformin 500 mg BID* appears in **Permanent Rx Meds** in the Clinical Profile. |
| **During medication reconciliation** | You check the **Document Discontinue** box for **Metformin** and select **Patient is not taking the medication** as the reason. |
| **After medication reconciliation** | *Metformin* no longer appears in **Permanent Rx Meds** . It now appears in the **Discontinued** section of the Medication History with the reason **Patient is not taking the medication** . |
## Frequently Asked Questions
### How does the AI decide which medications to flag?
The AI flags “likely not taking” medications by reviewing medication duration, fill patterns, the problem list, and the patient's age, providing an explanation for each suggestion.
### Can I bulk discontinue medications?
Yes, select multiple active medications to apply discontinue actions in bulk. Alternatively, you can also check the box at the top of the Doc D/C column to select all medications at once.
### Can I document patient-reported adherence?
Yes, each medication thread has a free-text note field for adherence.
### Is documentation visible for audits, MIPS, or billing?
If medication reconciliation is completed while a visit note is open, the MIPS toggle to confirm a patient's active medications are documented is toggled on.
### Who can use the Medication Reconciliation feature?
Any user in the practice can complete the medication reconciliation.
### Can I open the Medication Reconciliation window from the visit note?
You can only open the Medication Reconciliation window from\*\* an [Elation Note](/articles/Elation-Note).
### Does completing medication reconciliation update the permanent medication list immediately?
Yes. When you click **Complete Med Rec**, all changes—including sig edits, new medications, and discontinuations—are saved to the patient's permanent medication list immediately. You do not need to take any additional steps for these changes to take effect.
### Why did a newly documented medication get discontinued when I completed medication reconciliation?
If you [document a medication](/articles/medication-history#documenting-medications-a-patient-is-already-taking) that matches an existing active medication, Elation adds the new record to that [medication thread](/articles/medication-history#anatomy-of-a-medication-thread). Completing medication reconciliation with **Document Discontinue** checked for that medication discontinues the medication thread, which includes all medications in that thread — including the newly documented record.
**Related Articles**
* [Decision Support Interventions Regulatory Documentation](/articles/Decision-Support-Interventions-Regulatory-Documentation)
* [Medication List Management Guide- Documenting, discontinuing or merging medications](/articles/medication-history)
* [Elation Health - Building Clinical-First AI](/articles/Building-Clinical-First-AI)
# Billing Guide- Recording payments from patients
Source: https://help.elationhealth.com/articles/Recording-Payments-from-Patients
This article describes the different features and workflows that your practice can utilize for recording payments from patients.
### What does it mean to record payments from patients?
Practices collect payment from patients for services rendered during different points in the patient visit lifecycle. Elation offers different features for recording payment collected:
* Using Elation’s Patient Payments feature
* During patient check in
* After the encounter
### How can Elation’s features make recording payments efficient?
Collecting and recording payments from patients is an essential part of running a practice. Payment and billing features in Elation are designed to ensure your practice has multiple options for collecting and tracking these payments.
You can use Elation to store patient payment information collected via an integrated solution like the Patient Payments feature as well as payments collected via other external solutions/methods, and have a designated source of truth for your payment collection workflows.
* The Patient Payments feature is an integrated solution that will increase your collection rate, provide an easier way for your patients to pay your practice, and save your practice time.
* If you collect payments during check in, you can utilize the Patient Payments feature to record payments or tie the payment to the appointment for reporting for an external system.
* Recording payments directly in the visit note after the patient encounter enables your practice to generate detailed invoices and/or receipts for your patients.
If your practice uses **Elation Billing** , patient payment workflows are managed through the Elation Billing PMS. See the Elation Billing payment articles linked in Related Articles below.
### What payment recording features does Elation offer?
Elation offers multiple payment recording features, which can be used in combination with each other, or separately, depending on your practice’s needs. These include Elation’s Patient Payment feature, the ability to record payments directly in the check-in window, and the ability to document billing information directly in a visit note and generate patient invoices.
#### Elation’s Patient Payment feature
It is easy to request a payment from a patient using Elation’s Patient Payment feature with just a few simple steps detailed in our [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments) . Once a payment is completed, the payment is automatically recorded and stored in the Patient Payment Report for records. You can also reprint receipts for patients from the Patient Payment Report.
Elation partnered with Stripe, a secure, Payment Card Industry (PCI) compliant, digital, payment processing platform, to provide you with the ability to collect payments from your patients directly within Elation. Using Elation’s Patient Payments feature, your practice can collect payments for any services you offer, at any time during the day, and manage your full transaction history directly within Elation.
#### Record payment during check in
**Note:** If you are utilizing the Patient Payment feature, please reference the section above for steps on how you can send a request to the patient upon check in, or charge their card on file.
When a patient arrives for their appointment, you are able to record a payment upon check in. Changing their appointment status to **Checked In** will open the check in window that asks you to confirm their Patient Details. If your practice uses the Patient Payment feature, you can reference the patient’s copay and deductible from the check in window, and open the Patient Payment window to send a charge to the patient.
![Patient check-in window for Katie Williams showing 25.00 copay highlighted, alongside the Patient Payment Request panel with amount 25, reason "Copay," and the "Send request" button highlighted.]()
If your practice does **not** use Patient Payments and uses a third party billing system, you can document that a payment was collected from the check in window by selecting **Save & Record Payment** and recording the payment amount in the **Patient Payment** box. You can also select **Edit** directly on the appointment and record a payment if you did not document this with the initial check in window open.
![Edit Patient Appointment dialog for Katie Williams showing the Patient Payment field highlighted in red with value "25" entered, next to Advantage Insurance Copay of $25.00.]()
You can reference the payments collected at check in and track the payments for this workflow through Elation’s [Billing Home](/articles/Billing-Home) .
#### Patient invoicing and visit note documentation
You can document payment information and generate an invoice and/or receipt directly within a visit note in the **Billing Information** window. Here you can add detailed payment information such as CPT codes with their associated charges and quantities as well as the related Dx codes. With information documented here, your billing team can determine how much to charge the patient for the visit.
![Billing Information window for Kathryn Williams showing procedure 99213 with amount 100.00, quantity 1, Patient Payment field highlighted at 25.00, and an arrow pointing to the "+ Add Billing Information" button in the visit note.]()
You have the option to print an invoice and/or receipt for the patient directly from the visit note. When printing an invoice and/or receipt, you have the option to print a Simple Invoice (no Dx), Claims Invoice (ICD-10), or a Claims Invoice (ICD-9). You can print a claims invoice if the patient needs to submit a receipt to their insurance for reimbursement.
![Visit note Billing Information section showing a red arrow pointing to the "Print Invoice" dropdown button, with billing code 99213 [I10] at 100.00 and patient payment of 25.00 recorded.]()
### Benefits of utilizing Billing Home
Practices that use the Patient Payments feature can most effectively track payments in the [Patient Payment Report](/articles/using-elation-to-securely-collect-patient-payments#managing_payments) .
[Billing Home](/articles/Billing-Home) in Elation allows your practice to track payments that were collected as cash, check or through a third party system. You can enter payment information for any bill from [Billing Home](/articles/Billing-Home) as well as print patient invoices.
## Related Articles
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Billing Home Guide- A dashboard for managing your bills](/articles/Billing-Home)
* [Billing Guide- Frequently Asked Questions](/articles/Billing-Guide-Frequently-Asked-Questions)
* [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
* [Collecting a Patient Payment in Elation Billing](/articles/elation-ehr-billing-collecting-a-patient-payment-in-elation-billing)
* [Manually Record Patient Payment in Elation Billing](/articles/manually-applying-a-patient-payment)
* [Integrated Refunds (Elation Billing)](/articles/elation-ehr-billing-integrated-refunds)
* [Self Pay Patients (Elation Billing)](/articles/elation-ehr-billing-self-pay-patients)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
# Lab Orders & Results - Using the regular Lab Order Form
Source: https://help.elationhealth.com/articles/Regular-Lab-Order-Form
## Overview
Use this article to learn how to create and transmit lab orders for the following lab interface scenarios:
* Lab vendors without an interface.
* Lab Vendors with a live or pending results-only interface.
* Lab Vendors with a pending bidirectional lab interface.
Here is an example of what the regular version of Elation’s Lab Order Form looks like in these situations. The buttons that allow you to complete the order will include:
* **Print & Close**
* **Sign & Close**
* (if applicable) **Sign & Hold**
![Lab requisition form showing empty required fields (Lab, Tests, Dx for All) and the Print & Close, Sign & Close, Sign & Hold, Save as Draft, and Discard buttons at the bottom.]()
**BIDIRECTIONAL LAB INTERFACES** [Click here for instructions on how to complete lab orders if you have a live bidirectional lab interface with the vendor](/articles/Electronic-Lab-Order-Form) .
## Workflow Instructions
### Creating a lab order
**1**
Create a lab order use any of the the following options:
1. At the top of the patient's chart, click **Orders** -> **Lab Order**.
2. In any visit note or non-visit note draft, click **Lab**.
3. In an existing signed Lab Order, click **Actions** -> **Reorder** to re-order the same tests as the signed Lab Order.
**2**
Type the first few letters of the lab vendor's name to filter your list of lab vendors.
If you've already entered diagnoses in the patient's \*\* Problem List or visit note, these diagnoses will automatically appear in the dropdown menu for you to select. Use the [Problem List Guide](/articles/managing-your-problem-list) to learn more about this feature.
Fill out the Lab Order Form. Fields with an asterisk are required. The chart below explains the core fields in the form. [Click here to see definitions for the remaining fields and buttons](#glossary).
**Field / Button**
**Instructions**
\***Lab**
Type the first few letters of the lab vendor's name to filter your list of lab vendors.
Select the vendor with whom you are placing the order.
* Use the Labs Settings page to add additional vendors if needed.
**Site**
Designate whether the specimen will be collected at any vendor patient service center, a specific vendor patient service center, or in-house.
* Additional location details can be set on the Labs Settings page, if needed.
\***Tests**
Enter the test(s) you want the patient to complete. [Click here for instructions on how to create your own lab tests](/articles/Creating-tests-for-Order-Forms).
**Add Dx**
If there are diagnoses that need to be associated with a specific test, use this field to add those diagnoses. Test-level diagnosis codes will take precedence over order-level diagnosis codes.
\***Dx for All**
If you've already entered diagnoses in the patient's \*\* Problem List or visit note, these diagnoses will automatically appear in the dropdown menu for you to select. Use the [Problem List Guide](/articles/managing-your-problem-list) to learn more about this feature.
Add diagnoses that are relevant to all the test(s) in the order. Order-level diagnosis codes are secondary to test-level diagnosis codes.
**Coll**
**If you selected \*\* Any site** or a specific vendor patient service center for the Site\*\*, optionally specify when the test should be performed in the **Schedule Collection** **Date** field. **If you selected \*\* In-house draw** for the Site\*\*, specify the **Document Collection** date and time that the specimen collection was completed. [Click here to learn about placing a lab order on hold until specimens collection is completed](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection).
\***Patient Condition**
Specify fasting requirements, if any, for the test(s).
**Bill Type**
Specify whom to bill for the lab test(s). As a best practice, ensure the patient's demographic and insurance details in the chart are as comprehensive as possible, as this information will be printed on the lab order. If you would like to specify a default **Bill Type** for all of your lab orders:
1. Go to **Settings** -> **Lab Orders**.
2. Go to the **Lab Order Settings** section.
3. Use the **Default Bill Type** dropdown to select the default bill type. Your selection will be automatically saved.
**Field / Button**
**Instructions**
\***Lab**
Type the first few letters of the lab vendor's name to filter your list of lab vendors.
Select the vendor with whom you are placing the order.
* Use the Labs Settings page to add additional vendors if needed.
**Site**
Designate whether the specimen will be collected at any vendor patient service center, a specific vendor patient service center, or in-house.
* Additional location details can be set on the Labs Settings page, if needed.
\***Tests**
Enter the test(s) you want the patient to complete. [Click here for instructions on how to create your own lab tests](/articles/Creating-tests-for-Order-Forms).
**Add Dx**
If there are diagnoses that need to be associated with a specific test, use this field to add those diagnoses. Test-level diagnosis codes will take precedence over order-level diagnosis codes.
\***Dx for All**
If you've already entered diagnoses in the patient's \*\* Problem List or visit note, these diagnoses will automatically appear in the dropdown menu for you to select. Use the [Problem List Guide](/articles/managing-your-problem-list) to learn more about this feature.
Add diagnoses that are relevant to all the test(s) in the order. Order-level diagnosis codes are secondary to test-level diagnosis codes.
**Coll**
**If you selected \*\* Any site** or a specific vendor patient service center for the Site\*\*, optionally specify when the test should be performed in the **Schedule Collection** **Date** field. **If you selected \*\* In-house draw** for the Site\*\*, specify the **Document Collection** date and time that the specimen collection was completed. [Click here to learn about placing a lab order on hold until specimens collection is completed](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection).
\***Patient Condition**
Specify fasting requirements, if any, for the test(s).
**Bill Type**
Specify whom to bill for the lab test(s). As a best practice, ensure the patient's demographic and insurance details in the chart are as comprehensive as possible, as this information will be printed on the lab order. If you would like to specify a default **Bill Type** for all of your lab orders:
1. Go to **Settings** -> **Lab Orders**.
2. Go to the **Lab Order Settings** section.
3. Use the **Default Bill Type** dropdown to select the default bill type. Your selection will be automatically saved.
**3**
Use any of the options below to sign the lab order.
* **Print & Close**
* **Sign & Close**
* **Sign & Hold**
Once a lab order is signed, it cannot be edited.
### Transmitting the lab order
#### Transmitting the lab order to the lab vendor via Elation fax
Attach a signed lab order to a Provider Letter to fax the lab order to the lab vendor. [Click here for full instructions](/articles/efaxing-lab-and-radiology-orders).
#### Transmitting the lab order to a patient
Attach a signed lab order to a Patient Letter to send a copy of the lab order to the patient via Patient Passport. [Click here for full instructions](/articles/elation-patient-passport-an-introduction#write_message).
### Printing specimen labels
To print specimen labels for the lab order:
1. Locate the order in the **Chronological Record** or under the **Reports** -> **Lab Reports** tab.
2. Click **Actions**
* To [print labels with a Dymo printer](/articles/Orders-Guide-DYMO-printer), select **Print DYMO Specimen Labels**.
* To print labels at the bottom of a regular sheet of paper (compatible with Labcorp forms), select **Print Specimen Labels**.
Below is an example of a specimen label printout for a Labcorp order.
![Printed LabCorp requisition form for Patient Sick (Male, DOB 01/01/1977) showing four ordered tests, diagnosis codes E11.9 and Z34.90, Bill Type of Patient, and specimen label strip at the bottom.]()
### Printing a lab order
To print a lab order (without specimen labels):
1. Locate the order in the **Chronological Record** or under the **Reports** -> **Lab Reports** tab.
2. Click **Actions** -> **Print**.
## Resources
### Glossary of Lab Order Form fields and buttons
**Field / Button**
**Explanation**
**View Order Sets**
View and apply commonly used [Lab Order Sets](/articles/Managing-lab-order-sets) to the lab order.
**Send STAT via Phone**
Check this box if you want to instruct the lab to share results with you urgently by phone.
**Send STAT via Fax**
Check this box if you want to instruct the lab to share results with you urgently by fax.
**Show and print dual codes**
Show both ICD-9 and ICD-10 codes for selected diagnoses.
**Save as Order Set**
Save the tests, test-level diagnosis codes and order-level diagnosis codes listed as a new Order Set.
**Lab Instructions**
List any additional notes or instructions you want to share with the lab here.
**Notify via**
Add an internal note about how your practice should notify the patient about their lab results.
**Send a copy of test results to…**
**REMINDER** Labs are not obligated to share the results with the providers listed. This instruction is a courtesy request.
List the name(s) of provider(s) to whom the lab vendor should send a copy of the results.
**St. Order**
Indicate the testing frequency and, if applicable, specify an **End date** for the standing order.
**RMDR**
Specify who to send an Elation alert to if results are not received by a specified date. The **Reminder date** is the date the reminder will be sent.
**Keep this confidential**
If you mark a record as confidential, that record will always have a special indicator that can be seen when this order is shown in the patient's chart. This indicator will prompt members of your practice to take caution when printing or sharing the record. Learn more about confidential records in the [Patient Chart Guide- Managing confidential records](https://elation.lightning.force.com/articles/Knowledge/confidential-items-in-your-patient-chart) article.
Check the **Keep this confidential** box to mark the order as a confidential record in the patient’s chart.
**Print & Close**
Simultaneously sign and print the lab order and close the lab order window.
**Sign & Close**
Simultaneously sign the lab order and close the lab order window.
**Sign & Hold**
Simultaneously sign the lab order and put the lab order on hold so that specimen collection at your practice can occur later. This option will only be active if you selected “in-house lab” as the Site and left the **Document collection** date blank. [Click here to learn about placing a lab order on hold until specimen collection is completed](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection).
**Save as Draft**
Save the lab order as a draft and close the lab order window. The lab order draft will remain in the **Requiring Action** section of the patient’s chart until it is signed or discarded.
**Discard**
Delete the lab order draft.
**X**
Save the lab order as a draft and close the lab order window. The lab order draft will remain in the **Requiring Action** section of the patient’s chart until it is signed or discarded.
## Frequently Asked Questions
### How many lab tests can I add to a single lab order?
You can add up to 40 lab tests per lab order.
### How many diagnosis codes can I add to a single lab order?
You can add up to 120 unique diagnosis codes per lab order.
### Do I need to add a test-level diagnosis code to every test in the lab order?
No, adding a test-level diagnosis code to every test in the lab order is not required. Tests without a test-level diagnosis code will automatically be linked to the order-level diagnosis codes.
### Do I need to add order-level diagnosis codes to a lab order if it already has test-level diagnosis codes?
No, order-level diagnosis codes are not required if each test has an associated test-level diagnosis code. However, if any test lacks a test-level diagnosis code, you must either assign a test-level diagnosis code to that test or add an order-level diagnosis code.
### How does the lab interpret test-level diagnosis codes versus order-level diagnosis codes?
Test-level diagnosis codes precede order-level diagnosis codes. See the example below:
![Lab requisition form showing CBC w/Plts and BMP tests, with BMP having test-level diagnosis codes C22.1 and H40.1190, and E11.9 Type 2 diabetes as the order-level "Dx for All" code. Lab is LabCorp, Patient Condition is Fasting - 12 hours, with Print & Close, Sign & Close, Sign & Hold, Save as Draft, and Discard buttons visible.]()
* The CBC test was not assigned any test-level diagnosis codes, so it will be linked only to the order-level diagnosis code E11.9, which will be treated as the primary diagnosis code for the CBC test.
* The BMP test was assigned two test-level diagnosis codes and is also linked to the order-level diagnosis code E11.9:
* C22.1 will be treated as the primary diagnosis code since it is the first test-level diagnosis code.
* H40.1190 will be treated as the secondary diagnosis code as it is the second test-level diagnosis code.
* E11.9 will be treated as the tertiary diagnosis code because it is associated at the order-level.
### Can I move a diagnosis code from the test-level to the order-level or vice versa?
Diagnosis codes cannot be dragged-and-dropped to relocate them. To change their placement, delete the code from the current location and re-add it to the desired one.
### What do the different Bill Types mean?
* **Third Party** = Bill the Patient's insurance information on file
* **Patient** = Bill the Patient directly
* **Client** = Bill my practice
* **Worker's Comp** = Bill the patient's workers’ compensation payer
* **Special Billing** = Allows you to designate that you have a special code that you would like to associate with this order.
### How can I create a lab order for patients without insurance?
If you choose **Patient** as the **Bill Type** then you do not have to enter insurance information for the patient. The patient would then be expected to pay at the lab center.
### How do I create a standing order for a patient that needs to get the same tests done on a periodic basis?
To specify a standing order for a patient requiring periodic testing, create the lab order as usual. Be sure to complete the **St. Order** fields to indicate the desired testing frequency and, if applicable, specify an **End date** for the order.
**REMINDER** Some lab vendors may still require you to send a new lab order for each recurring test. If a new lab order will be needed, use the [Post-Date Office Message](/articles/post-date-a-message-to-yourself-or-a-colleague) feature to set a reminder for yourself to generate the order at the appropriate time.
### Can staff members help me create lab orders?
Yes! Staff Level Users can draft lab orders for any patient. Once they are done drafting an order, Staff Level Users can click **Save as Draft & Close** to keep the lab order in the Requiring Action section of the patient's chart for providers to complete and sign off. When Staff Level Users draft lab orders, the orders are always assigned to the Provider Assigned in Practice that's designated in the patient's demographics.
If you would like to allow staff members to **sign** lab orders on your behalf, you can assign them as a delegate. [Click here to learn more about staff delegates](/articles/staff-permissions--staff-delegates).
Once assigned, the staff member will see the **Ordering on behalf of** field on the Lab Order Form. The order records the provider shown in this field as the ordering provider.
* If the staff member is a delegate for a **single** provider, that provider is shown in the **Ordering on behalf of** field and is used automatically.
* If the staff member is a delegate for **multiple** providers, the **Ordering on behalf of** field is a dropdown. Providers are listed **alphabetically by last name**. If the patient's assigned primary physician is one of the staff member's providers, that physician is selected by default; otherwise the field is left blank and the staff member must select a provider before signing.
When a staff member is a delegate for multiple providers, always confirm the **Ordering on behalf of** field shows the correct provider before signing. The default selection is based on the patient's assigned primary physician and may not be the intended ordering provider.
### Does Elation have any integrations with lab centers?
Yes, Elation has integrations with many lab centers to receive electronic lab results. For a subset of these lab vendors, we can also send orders electronically from the Lab Order Form. You can always view the latest list of integrated partners and their integration type on our [Partners](https://www.elationhealth.com/integrations/) page. To request an integration with one of our integrated partners, click the **I need help** -> **Contact Elation Support** button at the top of your Elation account and send the following information to our Support Team:
1. Name of the lab center
2. Full name of your lab center representative
3. Email and phone number of your lab center representative
### Can I order other medical tests in Elation?
Yes! You can also order imaging (radiology), cardiac, pulmonary, and sleep tests in Elation. Find out more about the different medical tests forms in the [Order Forms Introduction](/articles/Order-Forms-Introduction-Ordering-medical-tests-for-your-patients) article.
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Managing lab vendors](/articles/Managing-lab-vendors)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Lab Orders & Results - Managing lab order sets](/articles/Managing-lab-order-sets)
* [Orders Guide - Creating tests for Order Forms](/articles/Creating-tests-for-Order-Forms)
* [Orders Guide- Following up on outstanding orders & referrals](/articles/follow-up-outstanding-orders-referrals)
# Reporting Guide - Built-in appointment and visit note productivity reporting (Premium)
Source: https://help.elationhealth.com/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting
This article describes the following productivity reports and dashboards available to Premium EHR users: Appointment Dashboard, Appointment List, Visit Notes Dashboard and Visit Notes List.
## What is built-in productivity reporting in the EHR?
Premium EHR users have access to built-in reporting around appointments and visit notes in Elation EHR. With four new dashboards and reports, you will be able to see the performance metrics for patient appointments and visit notes for certain periods of time. The new reporting options are as follows:
* Appointment Dashboard
* Appointment List
* Visit Notes Dashboard
* Visit Notes List
## What are the benefits of built-in productivity reporting?
The built-in reporting options around your appointments and visit notes data allows you to
* Track the performance and productivity of your practice.
* Easily scan your data to assist with administrative workflows such as ensuring data is complete for appointments and patient demographics.
* Visualize your performance and measure efficiency.
## How to access built-in productivity reports
Premium EHR users can access the Appointment Dashboard, Appointment List, Visit Note Dashboard and Visit Note List by clicking the **Reports** button in the blue navigation bar at the top of any page in Elation EHR and then clicking on the name of the dashboard or report to open it in a new tab in your browser.
![Reports menu expanded in the top navigation bar, with Appointment Dashboard, Appointment List, Visit Note Dashboard, and Visit Note List highlighted in a red box.]()
If you are interested in upgrading to the Premium EHR subscription to use this feature, click the **I need help** button to notify Elation and a member of the Elation Team will reach out to assist you.
## Appointment Dashboard
### Appointment Dashboard Overview
The Appointment Dashboard is divided into 3 main sections:
* (Top) A graph of ‘Total Appointments by Type’ (Appointment Type)
* (Center) A graph of **Appointments by Status** along with a quick view count of
* Total Appointments
* Canceled Appointments
* No Show Appointments
* Canceled Ratio
* No-Show Ratio
* (Bottom) Quick-view tables that show:
* Scheduled Appointments by Patient Status
* Scheduled Appointments by Note Type
* Past Appointment Statuses
The **time to sign** calculation begins when the visit note is created.
### How to use the Appointment Dashboard
![Appointment Dashboard with filter row highlighted, showing Appt Date set to "Last 30 Days" and all other filters (Appointment Status, In-Person or Virtual, Visit Provider, Appt Type, Insurance Company, Practice Location) set to "is any value"]()
The Appointment Dashboard shows you visuals and graphs around the following details of the Appointment data, if available. You can apply these filters to the Dashboard to customize your view of the Dashboard. After applying filters, click the
![Refresh button icon used to apply selected filters and update report results]()
**Refresh** button to see the results based on your selections.
* **Appointment Date**
* Filter by the date of the appointment. By default, the Dashboard will show you Appointment data for the last 30 calendar days.
* **Appointment Status**
* **In-person or Virtual**
* **Visit Provider**
* **Appointment Type**
* **Insurance Company**
* **Practice Location**
You can also click on any Appointment Type label at the bottom of the **Total Appointments by Type** graph to hide that Appointment Type from the graph.
![Animated demonstration of the Appointment Dashboard showing how clicking an appointment type legend label hides or shows that type in the Total Appointments By Type bar chart.]()
To download or print a copy of the entire dashboard, click on the
![Actions button]()
**Actions** button as shown in the image below and then click **Download** to save a PDF copy of the dashboard to your computer for records or for printing.
![Visit Notes Dashboard with the three-dot Actions menu open, showing the Download option highlighted, used to save a PDF copy of the dashboard.]()
Click on the
![Actions button]()
**Actions** button within individual visuals (as shown below) to:
* Download the data
* Expand the visuals
* Refresh the data
![The three-dot Actions menu open on the Total Appointments By Type chart, showing options: Download data, View, and Clear cache & refresh.]()
## Appointment List
### Appointment List Overview
![Appointment List report showing 12 patient rows with columns for Patient ID, Name, DOB, Visit Provider, Appt Date, Start/End Time, Appointment Status, Appt Type, Patient Form Completed, Reason for Visit, Insurance Carrier, and Phone Number. Filters at top include Appt Date set to "Last 30 Days" with all other filters set to "is any value."]()
The Appointment List allows you to see a tabular view of the appointment data in the Appointment Dashboard with extra granularity. The following columns are available in the Appointment List. You can hover your cursor over each column name to see additional column options or the sort option.
* **Patient ID**
* **Patient Name**
* **Patient Date of Birth**
* **Attribute Physician (Provider Assigned in Practice)**
* **Visit Provider**
* **Appointment Date**
* **Appointment Start Time**
* **Appointment End Time**
* **Appointment Status**
* **Appointment Type**
* **Patient Form Completed**
* **Reason for Visit (Description- Chief Complaint)**
* **Insurance Carrier (Primary Insurance)**
* **Phone Number (Phone number in the first phone field)**
### How to use the Appointment List
The following filters are available in the Appointment List. After applying filters, click the
![Refresh button icon used to apply selected filters and update dashboard results]()
**Refresh** button to see the results based on your selections.
* **Appointment Date**
* Filter by the date of the appointment. By default the Dashboard will show you Appointment data for the last 30 calendar days.
* **Appointment Status**
* **In-person or Virtual**
* **Visit Provider**
* **Appointment Type**
* **Insurance Company**
* **Practice Location**
* **Visit Note Type**
To download or print a copy of the Appointment List, click on the
![Actions button]()
**Actions** button (as shown in the image below) and then click **Download**. You can view the downloaded report in any spreadsheet software on your computer/laptop such as Microsoft Excel.
![Appointment List report with the Actions menu open, highlighting the Download option to save the report as a spreadsheet file.]()
Click on the
![Actions button]()
**Actions** button within the table (as shown below) to:
* Download the data
* Adjust column widths
* Expand the table
* Refresh the data
![Appointment List table with the three-dot Actions menu open, showing options: Download data, Autosize all columns, Reset all column widths, View, and Clear cache & refresh.]()
## Visit Note Dashboard
### Visit Note Dashboard Overview
The Visit Note Dashboard is divided into 3 main sections:
* (Top) A graph of **Total Visit Notes - Signed vs Unsigned** along with a quick view count of
* % signed within 48 hours
* % signed same day
* Avg days to sign
* (Bottom Left) A graph of ‘Unsigned Notes by Provider’
* (Bottom Right) A graph of ‘Unsigned Notes by Appointment Type’
### How to use the Visit Note Dashboard
![Visit Notes Dashboard showing 5 signed and 6 unsigned notes over the last 30 days, with 45.5% signed within 48 hours, 18.2% signed same day, and 3.2 average days to sign, including bar charts for unsigned notes by provider and appointment type.]()
![Visit Notes Dashboard with filter bar highlighted, showing Appt Date set to "Last 30 Days" and Appt Type, Practice Location, Attributed Physician, and Visit Provider each set to "is any value."]()
The Visit Note Dashboard shows you visuals and graphs around the following visit note data. You can apply these filters to the Dashboard to customize your view. After applying filters, click the
![Refresh button icon used to apply selected filter changes to the dashboard or report]()
**Refresh** button to see the results based on your selections.
* **Appointment Date**
* **Appointment Type**
* **Practice Location**
* **Attributed Physician**(Provider Assigned in Practice)
* **Visit Provider**
You can also click on the **Unsigned** or **Signed** label at the bottom of the graph to hide visit notes with that status from the graph.
![Visit Notes Dashboard showing the filter bar with Appt Date set to "Last 30 Days" and all other filters set to "is any value," used to customize the dashboard view.]()
To download or print a copy of the entire dashboard, click on the
![Actions button]()
**Actions** button (as shown in the image below) and then click **Download** to save a PDF copy of the dashboard to your computer for records or for printing.
![Visit Notes Dashboard with the Actions menu open, showing the Download option highlighted, used to save a PDF copy of the dashboard.]()
Click on the
![Actions button]()
**Actions** button within visuals (as shown below) to:
* Download the data
* Expand the visual
* Refresh the data
![Visit Notes Dashboard with the three-dot Actions menu open on the "Total Visit Notes - Signed vs. Unsigned" chart, showing Download data, View, and Clear cache & refresh options. An arrow points to the menu.]()
## Visit Note List
### Visit Note List Overview
The Visit Notes List allows you to see a tabular view of the visit note data in the Visit Notes Dashboard with extra granularity. The following columns are available in the Visit Notes List. You can hover your cursor over each column name to see additional column options or the sort option.
* **Patient Name**
* **Patient Date of Birth**
* **Attribute Physician**(Provider Assigned in Practice)
* **Visit Provider**
* **Appointment Date**
* **Appointment Type**
* **Visit Note Template**
* **Is Signed (Yes/No)**
* **Signed Date**
* **Days to Sign**
* **Billing Status**
* **Appointment Status**
### How to use the Visit Note List
The following filters are available in the Visit Notes List. After applying filters, click the
![Refresh button icon used to apply selected filters and update dashboard results]()
**Refresh** button to see the results based on your filters.
* **Appointment Date**
* Filter by the date of the appointment. By default the Dashboard will show you Appointment data for the last 30 calendar days.
* **Appointment Type**
* **Practice Location**
* **Is Signed (Yes/No)**
* **Attributed Physician (Provider Assigned in Practice)**
* **Visit Provider**
To download or print a copy of the Visit Notes List, click on the
![Actions button]()
**Actions** button (as shown in the image below) and then click **Download**. You can view the downloaded report in any spreadsheet software on your computer/laptop, such as Microsoft Excel.
![Visit Notes List with the Actions menu open, showing the Download option highlighted, used to export the report as a spreadsheet file.]()
Click on the
![Actions button]()
**Actions** button within the table itself (as shown below) to:
* Download the data
* Adjust column widths
* Expand the table
* Refresh the data
![Visit Notes List table with the three-dot Actions menu open, showing options: Download data, Autosize all columns, Reset all column widths, View, and Clear cache & refresh.]()
## Frequently Asked Questions
### How often is data refreshed?
Data in the reports and dashboards are refreshed every hour.
### What is the difference between the Appointment Report and the Appointment List?
The Appointment Report will continue to show you appointment data during a select period of time with pre-defined data fields. The new Appointment List provides more detailed appointment data and enhanced filtering options.
The Appointment Report will be deprecated once all customers are accustomed to the new Appointment List.
### Can I save my filter preferences?
Filters cannot be saved at this time. We will update you if this feature becomes available.
### Can I add or remove columns in the reports?
Data columns cannot be adjusted at this time. We will update you if this feature becomes available.
### Can I add or request additional automatic calculations in the dashboards?
We do not offer any additional automatic calculation options in the dashboards at this time. We will update you if this option becomes available.
### Can I print the dashboards?
Yes, you can print the dashboards by clicking on the **Actions** button in the dashboards, and then clicking **Download** to save a PDF copy of the dashboard to your computer. Afterwards open the PDF and then print the PDF to print a copy of the dashboard.
### Can I download the graphs or tables?
Yes, you can download all of the visuals, graphs and tables in the dashboards and reports.
To download a PDF version of the entire dashboard, Click on the
![Actions button]()
**Actions** button (as shown in the image below) and then click **Download** to save a PDF copy of the dashboard to your computer.
![Visit Notes Dashboard with the three-dot Actions menu open, showing the Download option highlighted, used to save a PDF of the full dashboard.]()
To download a copy of a specific graph or visual, click on the
![Actions button]()
**Actions** button within the graph or visual (as shown below) and then click **Download data**.
![Visit Notes Dashboard with the three-dot Actions menu open inside the "Total Visit Notes - Signed vs. Unsigned" chart, showing options: Download data, View, and Clear cache & refresh.]()
### What data is available within the Appointment List?
The following data is available in the Appointment List:
| Column Header | Description | Notes |
| ---------------------- | ------------------------------------------------------ | --------------------------------------------------------------------------------------------------------------------------------- |
| Patient ID | The Elation Patient ID | Links to the Patient Chart |
| Patient Name | The name of the patient | |
| Patient Date of Birth | The DOB for the patient | |
| Patient Age | The current age of the patient | |
| Attributed Physician | The primary provider attributed to the patient | |
| Visit Provider | The provider the patient was scheduled to see | |
| Appt Date | The date of the appointment | |
| Start Time | The start time of the appointment | |
| End Time | The end time of the appointment | |
| Appointment Status | The current status of the appointment | Statuses: Billed, Canceled, Checked In, Checked Out, Confirmed, In Room, Not Seen, Scheduled, Vitals Taken |
| Appt Type | The type of appointment | Any existing or custom created Appointment Types such as: Follow-Up, Office Visit, Physical Exam, Walk-In, New Patient, Procedure |
| Patient Form Completed | Whether the patient has already filled out their forms | Yes / No |
| Reason for Visit | The stated reason for the appointment | |
| Insurance Carrier | The insurance carrier listed for the appointment | |
| Phone Number | The patient's phone number | |
### What data is available within the Visit Note List?
The following data is available in the Visit Note List:
| Column Header | Description | Notes |
| --------------------- | --------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------- |
| Patient ID | The Elation Patient ID | Links to the Patient Chart |
| Patient Name | The name of the patient | |
| Patient Date of Birth | The DOB for the patient | |
| Patient Age | The current age of the patient | |
| Attributed Physician | The primary provider attributed to the patient | |
| Visit Provider | The provider the patient was scheduled to see | |
| Appt Date | The date of the appointment | |
| Appt Type | The type of appointment | Any existing or custom created Appointment Types such as: Follow-Up, Office Visit, Physical Exam, Walk-In, New Patient, Procedure |
| Visit Note Template | Which of the selected templates was used for the visit note | |
| Is Signed | Whether or not the note has been signed | Yes / No |
| Signed Date | The date the visit note was signed | |
| Days to sign | The number of days that it took the user to sign the visit note | |
| Billing Status | The current status of billing (where applicable) | |
| Appointment Status | The current status of the appointment | Statuses: Billed, Canceled, Checked In, Checked Out, Confirmed, In Room, Not Seen, Scheduled, Vitals Taken |
## Related Articles
* [Blue Navigation Bar Guide](/articles/Blue-Navigation-Bar)
* [Calendar Guide- Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar)
* [Visit Note Documentation Introduction](/articles/Visit-Note-Documentation-Introduction)
# Multi-Factor Authentication - Resetting authentication factors
Source: https://help.elationhealth.com/articles/Resetting-authentication-factors-for-MFA
All Elation users are **required** to use multi-factor authentication for security and compliance purposes.
## Overview
If you are blocked from signing in (for example, you were disconnected from your authentication factor or you changed mobile devices or computers), you have two options to reset your MFA factors:
* **Ask an Admin Level User in your practice to reset your factors** from the [Manage Accounts](https://app.elationemr.com/settings/allaccounts/) settings page. This is the fastest path for most users.
* **Reset your factors yourself** using the [MFA self-service reset page](https://app.elationemr.com/mfa/reset). Self-service requires a **government-issued photo ID** and a selfie to verify your identity.
Once your factors are reset, you will be prompted to set up a new authentication factor the next time you sign in to Elation.
For security reasons, Elation Support will not reset authentication factors on a user's behalf except in limited cases (for example, if you are the sole administrator of your practice). Safely resetting factors requires high confidence that the person making the request is the actual user. Your practice admin is usually in the best position to verify your identity, which is why admin-initiated resets are the fastest option. If you cannot reach an admin, use the self-service reset flow described below.
## Workflow Instructions
### Option 1: Ask an Admin Level User to reset your factors (fastest)
Admin Level Users can follow these instructions to reset a user's authentication factors:
| **1** | Go to **Settings** -> **Manage Accounts** . |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Locate the account that needs their authentication factors reset. |
| **3** | Click **Reset Multi-factor** ; this will reset all of the user's authentication factors. |
| **4** | The user will be required to set up at least one authentication factor the next time they attempt to sign in to their Elation account. |
### Option 2: Reset your own factors with self-service MFA reset
If you cannot reach a practice admin, you can reset your own MFA factors at [https://app.elationemr.com/mfa/reset](https://app.elationemr.com/mfa/reset).
#### What you'll need
Before you start, make sure you have:
* Access to the **email address** associated with your Elation account.
* A **government-issued photo ID** (for example, a driver's license, state ID, or passport). The name on your ID must match the name on your Elation account.
* A device with a **camera** so you can take a selfie during identity verification.
* Your current **Elation password**.
Identity verification is handled by Stripe Identity. The name on your verified ID is automatically compared to the name on your Elation account. Minor differences (such as nicknames, middle names, or transliteration) are tolerated, but a significant mismatch will cause the reset to fail.
#### Steps
| **1** | Go to [https://app.elationemr.com/mfa/reset](https://app.elationemr.com/mfa/reset) and enter the email address associated with your Elation account. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Check your email for a message from Elation and click the link to begin identity verification. |
| **3** | Complete the Stripe Identity verification flow by photographing your government-issued photo ID and taking a selfie. |
| **4** | Once your identity is verified, check your email for a short-lived reset link and click it to continue. |
| **5** | Confirm your Elation password to complete the reset. All of your MFA factors will be removed and your account will be unlocked. |
| **6** | Sign in to Elation. You will be prompted to set up at least one authentication factor before you can continue. |
Whenever a user on your practice completes a self-service MFA reset, practice admins are automatically notified by email so they have visibility into the change.
## Frequently Asked Questions (FAQ)
[Click here for answers to common MFA questions—including troubleshooting login issues, choosing authentication factors, and more](/articles/Multi-Factor-Authentication-FAQ).
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication Guide - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Updating authentication factors](/articles/Updating-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Frequently Asked Questions](/articles/Multi-Factor-Authentication-FAQ)
* [User Accounts Guide- Administrative privileges](/articles/administrative-privileges)
# Fax Inbox Guide - Restoring documents deleted from the Fax Inbox
Source: https://help.elationhealth.com/articles/Restoring-documents-deleted-from-the-Fax-Inbox
This article describes how to restore documents deleted from the Fax Inbox.
This article describes how to restore documents deleted from the Fax Inbox.
📖
**RECOMMENDED READING**
[Click here for details on how to delete documents from the Fax Inbox](/articles/Actioning-on-documents-within-the-Fax-Inbox#delete_documents)
.
## Overview
### How do I restore documents deleted from the Fax Inbox?
Documents deleted within the past 7 calendar days can be restored directly from the **Recently Deleted** feature within the Fax Inbox.
[See the below for instructions](#restore_documents)
.
Documents deleted more than 7 calendar days ago can only be restored by Elation. To restore documents deleted more than 7 calendar days ago, click
**I need help -> Contact Elation Support**
and provide the following details to our Support Team:
* The date (and approximate time if available) the document or pages was deleted.
* The number of pages that were deleted.
* Who deleted the pages.
## Workflow Instructions
### Restoring documents deleted from the Fax Inbox
To restore documents deleted from the Fax Inbox within the past 7 calendar days:
1. Click the **Recently Deleted** button at the top of the Fax Inbox to see all the recently deleted faxes.
2. Once you find the pages you want to restore, select all the pages and then click the **Restore** button at the top of the listing.
3. Click the **Recently Deleted** button again to return to the main Fax Inbox to see the restored documents.
## Related Articles
* [Fax Inbox Introduction](/articles/Fax-Inbox-Introduction)
* [Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox)
* [Fax Inbox Guide - Actioning on documents within the Fax Inbox](/articles/Actioning-on-documents-within-the-Fax-Inbox)
# Rhode Island - KIDSNET/RICAIR - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Rhode-Island-KIDSNET-RICAIR-Immunization-Registry-Interface-User-Guide
This article describes how you can submit vaccination data to the Rhode Island Child and Adult Immunization Registry [RICAIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Rhode Island State Immunization Registry known as RICAIR or KIDSNET.
## What is the RICAIR Immunization Registry Interface?
The RICAIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to RICAIR, the Rhode Island Child and Adult Immunization Registry, sometimes known as KIDSNET. Practices can also query RICAIR for vaccination history or forecast.
## Why is the RICAIR Immunization Registry Interface valuable?
With the RICAIR Immunization Registry Interface, practices no longer need to separately log in to RICAIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to RICAIR. You can also pull vaccination history for specific patients from RICAIR to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & RICAIR
The Elation Team will assist you with initiating an interface with RICAIR. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry would you like to connect to?
If you do not administer vaccines and would like to only query for vaccination history/forecast, please specify this in the **Details** field.
* Who will be the main point of contact for RICAIR interface setup
* What age range of patients (from minimum to maximum) does your practice care for?
* Are vaccinations administered at your practice?
* If yes, what type of vaccines are administered?: routine, travel, influenza, COVID
* If yes, what is your weekly average of vaccines administered?
* If yes, is your practice enrolled in VFC (Vaccines for Children)? What is your VFC pin?
* If yes, do you have publicly- and/or privately-funded vaccine stock? If public, is it a publicly-funded pediatric and/or adult vaccine stock?
* Is your organization current enrolled in RICAIR? If so, what is your organizational IIS ID?
* Does your practice administer vaccinations at more than one site? If so, how many sites?
* Do you already have a live RICAIR interface through another EMR?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to RICAIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to RICAIR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using RICAIR
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# SMS (Text message) Opt-In Guide
Source: https://help.elationhealth.com/articles/SMS-Text-Message-Opt-In-Guide
Learn about the SMS (text message) opt-in feature to help patients subscribe to text message reminders and notifications.
## Overview
**Full name (a.k.a.) preferred name used on the SMS opt-in page.** When a patient has a Full Name (preferred/actual name) set in their demographics, that name—not their legal name—is shown on the SMS opt-in page they see when subscribing. See the [Patient Demographics Guide](/articles/Patient-Demographics-Guide) for more on the Legal Name vs. Full Name fields.
### What is SMS (text message) Opt-In?
SMS (text message) Opt-In is a feature that allows you to send a request to a patient to have them subscribe to text messages from your practice for reminders and notifications from various Elation features including Appointment Reminders, Virtual Visit instructions, and Patient Passport notifications.
For patients who Opt-In to SMS (text message), messages and data rates may apply. For more information, please see [Terms of Service](https://www.elationhealth.com/passport-terms-of-service/) and the Elation Health [Privacy Policy](https://www.elationhealth.com/privacy-policy/).
### Why is SMS (text message) Opt-In useful?
The Telephone Consumer Protection Act requires that businesses and organizations receive express consent from individuals before sending automated SMS messages. The SMS Opt-In feature allows you to receive this consent from your patients.
**Opting in is required for patients to receive:**
* **SMS appointment reminders** — Patients who have not opted in will receive a phone call instead of a text message, even if they have a mobile number on file.
* **Virtual visit instructions via text** — For telehealth appointments, patients need to opt in to SMS to receive their video visit link and instructions by text message.
* **Patient Passport notifications via text** — SMS opt-in is also required for text-based notifications from Passport.
If a patient previously unsubscribed from text messages, you can prompt them to subscribe again. Patients sometimes unsubscribe when they don't recognize the context of the message. With guidance from your practice about the importance of text communication, you can help patients re-subscribe using the steps below.
## Workflow Instructions
### Requesting patients opt-in to SMS
You can ask the patient to text "START" to the number 36331 to subscribe to text messages from your office again or follow the steps below to send them an email request to subscribe online.
1. Open the Patient's chart and click on their name to open the Demographics box.
2. Click on the **Request Opt-In** box and click **Email Opt-In Request**.
![Patient chart for Daisy Jones showing the Contact Information tab with the "Request Opt-In for SMS" popup open, with the "Email Opt-In Request" button highlighted.]()
Once the patient has completed the steps to subscribe, the status will updated in the patient's Demographics.
![Patient Demographics Contact Information panel showing "666-879-8799 is opted in to text messages" highlighted with a red border under Text Message Opt-In.]()
#### What patients see when prompted to opt-in to SMS
1. Patients will receive an email from your office with instructions for how to subscribe to text messages again.
![Elation Health opt-in email sent to patient Daisy Jones from Kary Jones, MD, showing a "Set up text reminders" button and instructions to text START to 36331.]()
1. If the patient clicks **Set up text reminders**, they will be brought to a page for them to subscribe to text messages again if they select **Yes, send me text message notifications...**
![Patient SMS opt-in page for Elation Demo Practice showing two unselected options: "Yes, send me text message notifications to 666-879-8799" and "No, I do not want text message notifications," with a Save button.]()
1. Once the patient clicks **Save**, they will see a confirmation page that tells them they have successfully subscribed to text message notifications again.
![Success confirmation page showing phone number (666) 879-8799 is now subscribed to text message notifications from Elation Demo Practice.]()
### How patients can opt-in to SMS on their own
#### Patient Passport
If the patient has a Patient Passport account, they can update their SMS (text message) preference directly from the Settings page of their Passport account by clicking **Update Preferences**.
![Patient Passport Settings page showing the user menu open (step 1), Settings option highlighted (step 2), and Update Preferences button highlighted (step 3) to update SMS preferences.]()
#### Appointment Reminders
If the patient receives any appointment reminder or appointment confirmation emails from Elation, they will see instructions in the email about how to subscribe to SMS (text message) notifications. The patient can click **Opt in to SMS notifications** to update their preferences.
### How patients can unsubscribe (opt-out) from SMS
Patients can opt-out of or unsubscribe from SMS (text message) by:
1. sending a text message with the word "STOP" to the number 36331
2. updating their SMS (text message) preference directly from the Settings page of their Passport account by clicking **Update Preferences**.
## Frequently Asked Questions (FAQ)
### Which patients will need to subscribe to text messages on their own?
Patients who have never received text message reminders or notifications from Elation prior to December 21, 2021 must Opt-In via one of the methods described above.
### Can patients unsubscribe from text messages at any time?
Yes, patients can unsubscribe from text messages at any time. If they unsubscribe, they must subscribe again using the same Opt-In steps above.
## Related Articles
* [Automated Appointment Reminders](/articles/appointment-reminders)
* [How to set up Elation Integrated Video](/articles/Elation-Telehealth-powered-by-Zoom)
* [What Elation Passport looks like for your patients](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
# Scheduling Capabilities Overview
Source: https://help.elationhealth.com/articles/Scheduling-capabilities
This article provides an overview of Elation's scheduling capabilities, helping you understand the available tools for managing appointments and provider schedules.
## Overview
### What are Elation's scheduling capabilities?
Elation offers a comprehensive suite of scheduling tools designed to help practices efficiently manage patient appointments, provider availability, and patient self-scheduling. These tools work together to streamline scheduling workflows, reduce administrative burden, and improve patient access to care.
### Why are scheduling capabilities important?
Effective scheduling capabilities help practices:
* **Reduce administrative workload** - Automate appointment booking and reminders to free up staff time.
* **Improve patient access** - Allow patients to self-schedule appointments online at their convenience.
* **Optimize provider time** - Manage availability across multiple locations and appointment types.
* **Minimize no-shows** - Send automated reminders to confirm appointments.
* **Support care continuity** - Schedule recurring appointments for patients who need ongoing care.
## Key Scheduling Features
### Calendar
The Calendar is the central scheduling tool in Elation, used to manage provider availability and patient appointments.
| **Feature** | **Description** |
| -------------------------- | ------------------------------------------------------------------ |
| **Standard View** | View a single provider's daily schedule. |
| **Expanded View** | View multiple days or multiple providers side by side. |
| **Appointment Management** | Create, edit, and delete appointments. |
| **Patient Check-in** | Update appointment status as patients arrive. |
| **Virtual Visit Support** | Distinguish virtual from in-person appointments with a video icon. |
For detailed instructions, see the [Calendar Guide - Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar) article.
### Resource or Team Calendars
In addition to individual provider calendars, Elation Support can set up a resource or team calendar for scheduling that isn't tied to a specific provider — for example, a shared calendar for nurse visits, lab draws, or other team-based appointments.
A resource or team calendar:
* Isn't a login-based user account. No one signs in to it directly.
* Can't sign clinical documentation, such as visit notes, orders, or prescriptions.
* Can't serve as the billing or rendering provider on a claim. Any billing, orders, or clinical documentation for appointments booked on a resource or team calendar must still be associated with a Provider Level User in the chart.
* Is available at no additional cost.
To set up a resource or team calendar, have an Admin Level User use **I need help** → **Contact Elation Support**.
### Patient Booking Site
The Patient Booking Site is a personalized web page where patients can self-schedule appointments based on provider availability.
| **Feature** | **Description** |
| ----------------------------- | ----------------------------------------------------------- |
| **Online Self-Scheduling** | Patients can book appointments 24/7 from any device. |
| **Real-Time Availability** | Shows only available time slots based on provider settings. |
| **Customizable URL** | Personalize your booking site link for your practice. |
| **Multi-Location Support** | Patients can select their preferred practice location. |
| **Patient Forms Integration** | Automatically send intake forms when patients book. |
To enable the Booking Site, each provider must configure their availability in the **Calendar & Booking** settings.
For setup instructions, see the [Patient Booking Site Guide](/articles/Patient-Booking-Site) article.
### Provider Availability
The Provider Availability settings allow you to define when each provider is available for appointments, by practice location and appointment type.
| **Feature** | **Description** |
| ---------------------------------- | ---------------------------------------------------------------------------------------------- |
| **Location-Specific Availability** | Set different hours for each practice location. |
| **Appointment Type Filtering** | Specify which appointment types are available during each time block. |
| **Time Zone Management** | Assign time zones to each location for accurate patient communication. |
| **Visual Indicators** | Gray vertical bars on the calendar show availability; diagonal stripes show unavailable times. |
For configuration instructions, see the [Calendar & Booking Site Guide - Enhanced Provider availability by Practice Location & Appointment Type](/articles/Calendar-Booking-Site-Guide-Enhanced-Provider-availability-by-Practice-Location-Appointment-Type) article.
### Appointment Types
Appointment Types define the different kinds of appointments your practice offers, such as office visits, physicals, or telehealth consultations.
| Setting | Description |
| --------------------------- | --------------------------------------------------------------------- |
| **Name & Color** | Customize the name and color for easy identification on the calendar. |
| **Default Duration** | Set how long each appointment type typically lasts. |
| **Visit Note Template** | Automatically apply templates when starting a visit note. |
| **Patient Forms** | Link forms to send to patients when they book. |
| **Booking Site Visibility** | Choose which appointment types appear on your Patient Booking Site. |
For setup instructions, see the [Calendar Guide - How to set up the provider calendar](/articles/calendar-and-booking-settings) article.
### Recurring Appointments
The Recurring Appointments feature lets you schedule a series of ongoing patient visits in a few steps, ideal for patients who need regular care.
| **Feature** | **Description** |
| ------------------------ | ----------------------------------------------------------------------------------------------------- |
| **Flexible Intervals** | Schedule weekly or monthly recurring appointments. |
| **Up to 52 Recurrences** | Create a series up to 18 months in advance. |
| **Conflict Detection** | Review scheduling conflict alerts when creating a series of recurring appointments. |
| **Individual Editing** | Edit or delete individual appointments without affecting the entire series of recurring appointments. |
Patients cannot book recurring appointments through the Booking Site. Only staff can create recurring appointments.
For detailed instructions, see the [Calendar Guide - Scheduling recurring patient appointments](/articles/recurring-patient-appointments) article.
### Quick Reschedule
Quick Reschedule lets you instantly move an appointment to a new time slot based on provider availability.
| **Feature** | **Description** |
| ---------------------------- | ------------------------------------------------------------------------------------ |
| **Suggested Times** | Displays the next six available slots based on location, duration, and availability. |
| **One-Click Rescheduling** | Select a new time and save without leaving your workflow. |
| **Single Appointments Only** | Works on individual appointments, not a series of recurring appointments as a whole. |
**Exception:** The appointment must have a **Location** assigned to use Quick Reschedule.
For instructions, see the [Calendar Guide - Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar#quick-reschedule) article.
### Calendar Blocks and Non-Blocking Events
Elation offers two types of events to help manage your schedule:
| **Event Type** | **Blocks Calendar?** | **Blocks Booking Site?** | **Use Case** |
| ------------------------------- | -------------------- | ------------------------ | -------------------------------------- |
| **Calendar Block** | Yes | Yes | Lunch breaks, meetings, time off |
| **Non-Blocking Calendar Event** | No | No | Scheduling preferences, internal notes |
Calendar Blocks prevent appointments from being scheduled during that time, both in the EHR and on the Booking Site. Non-Blocking Calendar Events (also called non-blocking placeholders) display preferences on the calendar without restricting scheduling.
For detailed instructions, see the [Calendar Guide - Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar#blocks-vs-nonblocking) article.
### Automated Appointment Reminders
Automated Appointment Reminders help reduce no-shows by notifying patients about their upcoming appointments.
| **Feature** | **Description** |
| ------------------------------ | ----------------------------------------------------------------- |
| **Up to 3 Reminders** | Send multiple reminders before each appointment. |
| **Multi-Channel Delivery** | Send via text, email, or phone call based on patient preferences. |
| **Patient Confirmation** | Patients can confirm or cancel directly from the reminder. |
| **Virtual Visit Instructions** | Include video visit details for virtual/telehealth appointments. |
For setup instructions, see the [Calendar Guide - Using automated appointment reminders](/articles/appointment-reminders) article.
## Feature Comparison
| **Feature** | **Staff Can Use** | **Patients Can Use** | **Requires Setup** |
| ---------------------- | ----------------- | -------------------- | -------------------------------------------- |
| Calendar | Yes | No | Appointment Types, Display Settings |
| Patient Booking Site | Yes | Yes | Provider Availability, Booking Site Settings |
| Recurring Appointments | Yes | No | Provider Availability (recommended) |
| Quick Reschedule | Yes | No | Location assigned to appointment |
| Calendar Blocks | Yes | No | None |
| Non-Blocking Events | Yes | No | None |
| Appointment Reminders | Automatic | Receives | Reminder Settings |
## Getting Started
To set up scheduling for your practice, follow these steps:
| 1 | **Configure Practice Locations** - Add your practice locations and assign time zones. See the [Practice Locations Guide](/articles/adding-a-second-practice-location) article. |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | **Set Up Appointment Types** - Create the appointment types your practice offers. See the [Calendar Guide - How to set up the provider calendar](/articles/calendar-and-booking-settings) article. |
| 3 | **Configure Provider Availability** - Define when each provider is available for appointments. See the [Calendar & Booking Site Guide - Enhanced Provider availability](/articles/Calendar-Booking-Site-Guide-Enhanced-Provider-availability-by-Practice-Location-Appointment-Type) article. |
| 4 | **Enable the Patient Booking Site** (optional) - Allow patients to self-schedule appointments online. See the [Patient Booking Site Guide](/articles/Patient-Booking-Site) article. |
| 5 | **Set Up Appointment Reminders** - Configure automated reminders to reduce no-shows. See the [Automated Appointment Reminders Guide](/articles/appointment-reminders) article. |
## Frequently Asked Questions (FAQ)
### Can patients book recurring appointments online?
No, patients cannot book recurring appointments through the Booking Site. Only staff can create a series of recurring appointment in Elation.
### Can I double-book appointments?
Yes, staff can book multiple appointments in the same time slot when needed. However, the Booking Site does not allow patients to double-book the same time slot.
### How do Calendar Blocks differ from Non-Blocking Events?
Calendar Blocks remove time from availability on both the calendar and the Booking Site. Non-Blocking Calendar Events display scheduling preferences without blocking availability—patients can still book during those times via the Booking Site if provider availability allows. [Click here for more information about these two features](/articles/how-to-use-elation-calendar#calendar_block_vs_placeholder).
### Can I use the Calendar without the Patient Booking Site?
Yes, you can use the Elation Calendar without enabling the Patient Booking Site. The Calendar functions independently for internal scheduling.
### How far in advance can I schedule recurring appointments?
The latest possible end date for a recurring appointment series is **18 months** from the date it is created, or a maximum of **52 recurrences**.
### Do appointment reminders work for all appointments?
Yes, appointment reminders are sent for all scheduled appointments, whether booked through the Booking Site or manually by staff.
## Related Articles
* [Calendar Guide - Using the Calendar for appointments & events](/articles/how-to-use-elation-calendar)
* [Calendar Guide - How to set up the provider calendar](/articles/calendar-and-booking-settings)
* [Calendar Guide - Scheduling recurring patient appointments](/articles/recurring-patient-appointments)
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Calendar & Booking Site Guide - Enhanced Provider availability by Practice Location & Appointment Type](/articles/Calendar-Booking-Site-Guide-Enhanced-Provider-availability-by-Practice-Location-Appointment-Type)
* [Calendar Guide - Using automated appointment reminders](/articles/appointment-reminders)
* [Practice Locations Guide - Listing your service locations](/articles/adding-a-second-practice-location)
* [Calendar Guide - Setting practice location for appointment reminders](/articles/using-multi-location-scheduling)
# Security & Privacy Settings Overview
Source: https://help.elationhealth.com/articles/Security-and-Privacy-Settings-Overview
Summary of the settings available on the Security & Privacy Settings page, with links to detailed guides for each.
The **Security & Privacy** Settings page is where Admin users configure practice-wide security, patient data sharing, and privacy controls. This article summarizes the settings available there and links to the detailed guide for each.
## Who can access these settings
Only Admin users can view and edit **Security & Privacy** Settings. Go to **Settings** > **Security & Privacy** to open the page.
For more on which settings are Admin-only, see [User Accounts Guide — Administrative privileges](/articles/administrative-privileges).
## Settings on this page
### Multi-Factor Authentication
Require a second authentication factor (authenticator app, SMS, or email code) for users signing in to your practice's Elation account. Admins enable MFA at the practice level, and each user then sets up their own factors.
See [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA) for setup instructions and supported factors.
### Patient Data Sharing with Outside Care (Carequality)
Opt your practice in to Carequality so you can securely query and share patient records with other networks and EHRs via the Outside Care workflow. Toggling this on requires agreeing to the compliance terms.
See [Elation-Carequality Integration Introduction](/articles/Carequality-Integration-Introduction) for details.
### RxInform prescription reminders
Enable RxInform, a free service that sends prescription reminders to patients on your practice's behalf. Patients can opt out at any time, and clinicians or staff can manage opt-outs per patient in demographics or per prescription.
See [RxInform prescription reminders for patients](/articles/prescription-reminders-for-patients) for the enablement steps and workflow.
### Sensitive chart access rules (Premium)
Premium EHR Users can separately configure how Elation handles unauthorized access to sensitive charts, choosing between a warning and a hard block for:
* **Patient Cohorts** — restrict charts by patient criteria such as age or tag.
* **VIP charts** — restrict individual charts marked as VIP.
See [Patient Chart Guide — Restricting access to patient charts based on patient criteria](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria) and [Patient Chart Guide — Marking charts as VIP for restricting access (Premium)](/articles/vip-chart-feature).
### Demographics Notes
**Beta feature:** The feature described in this section is part of a beta release and is only available to a select number of practices.
The **Demographics Notes** card has a single toggle: **Share demographics notes with providers** (default: **On**).
* **On** — when a provider-facing letter or printout includes a demographics page, the patient **Notes** field from **Notes & Chart Management** is included on it.
* **Off** — the **Notes** field is suppressed from provider-facing letters and printouts that include a demographics page. Letters or printouts that do not include a demographics page are unaffected.
The setting applies only to provider-facing output. It does not change these behaviors:
* **Patient-facing letters** always exclude the **Notes** field.
* **Printing a patient's own chart** always includes the **Notes** field when the demographics page is part of the printout.
* **EHI exports and patient record exports** always include the **Notes** field, because those are the patient's complete record.
## Related Articles
* [User Accounts Guide — Administrative privileges](/articles/administrative-privileges)
* [User Accounts Guide — Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure)
* [Elation features for Privacy Requirements](/articles/Features-for-Privacy-Requirements)
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
# Patient Forms Guide - Sending forms to patients
Source: https://help.elationhealth.com/articles/Sending-forms-to-patients
## Content
* [Overview](#overview)
* [Who can receive Patient Forms?](#qualifications)
* [How do I send forms to patients?](#send_forms)
* [Setup](#setup)
* [Creating & managing Patient Forms](#creating_forms)
* [Linking Patient Forms to specific Appointment Types to be sent with appointments](#link_to_appointments)
* [Unlinking forms from Appointment Types](#unlink_forms)
* [Workflow Instructions](#workflow_instructions)
* [Send Patient Forms via appointments](#send_with_appointments)
* [Automate sending Patient Forms via appointments](#automate_with_appointments)
* [Manually sending Patient Forms via appointments](#manual_send_via_appointments)
* [Managing the status of automated forms](#manage_forms_status)
* [Sending Patient Forms from the patient’s chart](#send_forms_from_chart)
* [Following up on notifications about incomplete Patient Forms](#forms_notifications)
* [Frequently Asked Questions (FAQ)](#faq)
## Overview
### Who can receive Patient Forms?
Patients can receive Patient Forms if:
1. They have a valid email address on file.
2. They book an appointment through the Booking Site and select an Appointment Type that has forms attached.
### How do I send forms to patients?
There are two ways to send forms to patients:
1. Automate sending forms to patients when they schedule an appointment. This includes appointments you add to your Elation Calendar and appointments added via the Booking Site.
2. Manually send forms to patients from their chart.
If multiple forms are sent at the same time, the patient will complete them one after the other in a single session.
## Setup
### Creating & managing Patient Forms
[Click here for step-by-step instructions about creating and managing Patient Forms.](/articles/Patient-Forms-Guide)
### Linking Patient Forms to specific Appointment Types to be sent with appointments
To automate sending Patient Forms to patients when they schedule an appointment, attach the forms you want patients to receive to each applicable appointment type.
| **1** | Go to **Settings** -> **Calendar and Booking** -> **Appointments** . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Find the Appointment Type you are linking forms to and click **Edit** . |
| **3** | Under the **Linked Forms** section, click the dropdown menu and select the form you want to link. You can link multiple forms. • Use the Grid icon to reorder the forms and control the order in which they appear to the patient. |
| **4** | Under **Sending Forms**, specify when you want the forms to be automatically delivered to your patient. **immediately upon booking** - forms will be delivered when an appointment is created. • **days before appointment** - forms will be delivered ahead of the appointment based on the number of days specified in the numbers box that appears. |
| **5** | Click **Save** . |
#### Unlinking forms from Appointment Types
| **1** | Go to Settings -> **Calendar and Booking** -> **Appointments** . |
| ----- | --------------------------------------------------------------------------- |
| **2** | Find the Appointment Type you are unlinking forms from and click **Edit** . |
| **3** | Under the **Linked Forms** section, locate the form you want to unlink. |
| **4** | Click **X** to unlink the form. |
| **5** | Click **Save** . |
Once a form is unlinked, it will no longer be sent to patients for any future forms requests for that type of appointment.
## Workflow Instructions
### Send Patient Forms via appointments
#### Automate sending Patient Forms via appointments
If you attach Patient Forms to specific [Appointment Types](/articles/calendar-and-booking-settings#Appointment_Types), Elation will automatically send the Patient Forms to the patient via email if they have an appointment for the corresponding Appointment Type. When the forms are sent will depend on which timing preference you selected when attaching Patient Forms to Appointment Types.
| **1** | Go to your Calendar & add an appointment to the calendar. Choose the Appointment Type that has Patient Forms attached. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Once the appointment is saved, the Patient Forms will be delivered to the patient based on the timing preferences that you defined under the Appointment Type Settings page. |
Patient Forms sent automatically based on Appointment Type do **not** create a Patient Forms request item in the patient's Chronological Record, Requiring Action, or Outstanding Items queue. Track the status of these forms from the appointment itself — see [Managing the status of automated forms](#managing-the-status-of-automated-forms) below. Once a patient submits a form, the completed form appears as a report under **Outstanding Items** in the patient's chart, and is filed into the Chronological Record once it is signed off. See [Reviewing and exporting responses to the chart](/articles/Managing-forms-responses#reviewing-and-exporting-responses-to-the-chart).
#### Manually sending Patient Forms via appointments
If for any reason you need to resend forms to a scheduled patient, click into the white space of the appointment to open the appointment popover and then click **Resend** in the **Forms** section.
#### Managing the status of automated forms
You will see a forms status indicator on appointments that have forms. Click into the appointment details to view specifically which forms are complete versus outstanding.
* A **clock** icon indicates there are forms that are incomplete
* A **green check mark** icon indicates all forms are completed.
If any forms were submitted to your practice outside of Elation (e.g., faxed or via paper), you can manually mark the form as completed by following these steps:
| **1** | Click into the white space of the appointment to open the appointment popover. |
| ----- | ------------------------------------------------------------------------------ |
| **2** | Click **Edit** . |
| **3** | Go to the **Forms** section. |
| **4** | Check off the form(s) that were completed. |
| **5** | Click **Save** . |
### Sending Patient Forms from the patient’s chart
If you want to send Patient Forms independent of a patient appointment, you can use the **Forms** feature at the top of the patient’s chart.
To send Patient Forms from the patient’s chart:
| **1** | Open the patient’s chart. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click the **Forms** button in the gray navigation bar. |
| **3** | Verify the email you are sending the forms to, if applicable. Click **Update** to update the patient’s email if needed as it is required to send forms. |
| **4** | Under **Select Forms** , click the **+Add Forms** to select which forms you want to send to the patient. |
| **5** | Under **Notify Me if Incomplete**, choose if and when you want to be alerted when a patient hasn’t completed the Patient Forms you sent by a certain date or within a set timeframe. Patients will still have access to their forms after the notification date. |
| **6** | Click the **Send** button to immediately send the selected Patient Forms to the patient. |
When you send Patient Forms from the patient's chart, a Patient Forms request item is added to the patient's chart and remains visible until either all sent Patient Forms are completed by the patient or the request is removed. Once the patient submits the forms, the request item is automatically removed and each completed form appears as a report under **Outstanding Items** for review and sign-off.
The Patient Forms request item described here is only created when forms are sent manually from the patient's chart. Forms that are sent automatically via Appointment Type do not generate a request item in the chart — track those from the appointment itself.
You can also take the following actions on the request:
* **Copy URL** - Copy the URL of the Patient Forms and share it with the patient via alternative means such as Patient Passport.
* **Resend** - Send the Patient Forms to the patient again. You will be able to select new notifications preferences when resending Patient Forms.
* **Remove Request** - Delete the Patient Forms request.
Deleting Patient Forms requests will make the request inactive for the patient. Delete Patient Forms requests with caution.
#### Following up on notifications about incomplete Patient Forms
Once Patient Forms are sent from the Patient Chart and the due date is reached
* The notification will appear in the **Requiring Action** section of the patient chart and Practice Home for the sender once it reaches the due date.
* The notification will appear in the **Outstanding Items** section of the patient chart for all other users (besides the sender).
From these reminders, users can take one of the following actions:
* **Copy URL** - Copy the URL of the Patient Forms and share it with the patient via alternative means such as Patient Passport.
* **Resend** - Send the Patient Forms to the patient again. You will be able to select new notifications preferences when resending Patient Forms.
* **Remove Request** - Delete the Patient Forms request.
Deleting Patient Forms requests will make the request inactive for the patient. Delete Patient Forms requests with caution.
## Frequently Asked Questions
### Sending Patient Forms
#### Does the patient need to have a Patient Passport account in order to receive and fill out forms?
The patient doesn't need to have a Patient Passport to receive forms. They only need to have their email address saved in Elation.
#### Will the patient be invited to Patient Passport when we send them their forms?
The patient will not be invited to Patient Passport when Elation sends them the forms.
#### Do I need to enable the booking site to send forms?
The Booking Site does not need to be enabled.
#### Can you send forms without scheduling a visit for the patient?
Currently, an appointment must be created to send forms to a patient.
#### Can I change the timing of when forms are automatically sent to the patient?
Yes, under **Calendar and Booking > Appointment Types**, click **Edit** for the Appointment Type you'd like to customize. In the edit panel, you'll be able to configure forms to be sent to the patient upon creating their appointment, or X number of days prior to the appointment.
#### Can the same form be sent to the patient more than once?
Yes, patients can receive the same form multiple times via different appointments. Patients will be able to fill out patient forms each time they receive them.
#### If two patients have the same email, will they both be able to receive patient forms?
Yes, if multiple patient charts share the same email, each **chart** will receive a copy of any patient forms attached to corresponding appointments they are scheduled for.
#### If we schedule patients through our Practice Management System (PMS), can we still send forms to patients?
As long as the appointment created in your PMS synchronizes to the Elation calendar, the patient will receive the forms that are linked to the appointment type. Please check that any Elation appointment types with forms are mapped to the appointment types in your PMS.
#### Can the forms link be sent to the patient via SMS?
Not at this time — forms are only delivered via email.
#### Can you send a form to a patient if the form hasn't been added to the appointment type of their scheduled appointment?
Right now, only the forms that are associated with the appointment type can be delivered to the patient.
#### If an appointment is canceled, will the forms link become invalid?
Yes, if an appointment is canceled/deleted from Elation, the patient will no longer be able to fill out forms for that encounter.
#### Does the Patient Forms request appear in the Chronological Record when forms are sent automatically via Appointment Type?
No. Forms that are sent automatically based on Appointment Type do **not** create a Patient Forms request item in the Chronological Record, Requiring Action, or Outstanding Items queue. Track the status of these forms directly from the appointment. A Patient Forms request item is only created when forms are sent manually from the patient's chart, and that item is removed once the patient submits the forms.
#### Where do completed forms appear regardless of how they were sent?
Once a patient submits a form, it appears as a report under **Outstanding Items** in the patient's chart for review, export, and sign-off. After sign-off, the completed form is filed into the patient's Chronological Record.
#### Is there a practice-wide notification or queue when a patient completes a form?
No, there is currently no email or in-app notification triggered when a patient completes a form, and completed forms do not appear in any Practice Home queue. Check the individual patient's chart under **Outstanding Items** (see above) to see whether a form has been completed.
#### Can I send a Patient Form that requires a signature to all patients at once?
No. Each **Patient Signature** question generates a unique, patient-specific link, so forms that require a signature must be sent individually or automated through an Appointment Type — they cannot be shared as a single bulk link or message. To reach your full patient panel with an informational update instead (for example, notifying patients that a form has changed), send a [Bulk Letter](/articles/introduction-to-bulk-letters) and have patients complete the signature form individually at their next appointment.
### Patient Forms and the Booking Site
#### Can we list just the URL for the Telehealth appointment scheduling on our websites?
Yes, you can use the direct URL for the telemedicine appointment type and your patients will be directed right to this appointment type.
#### Does the patient information have to match when booking the appointment?
The information goes through a matching algorithm to identify whether or not the patient exists in our system or is a new patient. If the information entered passes our checks as existing patient, we'll add the appointment to that chart. If the patient information does not pass our check, but looks like it could be a duplicate, we'll create a new chart and notify you that it could be a duplicate. If the patient information entered does not match, we'll create a new chart.
#### Can you tell if an appointment was self-scheduled or scheduled by the practice?
The appointments will appear identical on your Elation Calendar, but you can turn on a setting that will send you an email each time an appointment is booked through the Booking Site. Please find this under **Settings > Calendar & Booking > Booking Site**, and scroll down to **Preferences**.
## Related Articles
* [Patient Forms Introduction](/articles/Getting-Started-with-Patient-Forms)
* [Patient Forms Guide - Creating and managing Patient Forms](/articles/Patient-Forms-Guide)
* [Patient Forms Guide - Managing forms responses](/articles/Managing-forms-responses)
* [Patient Forms Guide - Receiving and filling out forms as a patient](/articles/Receiving-and-filling-out-forms-as-a-patient)
# Elation Patient Passport Guide - Setting up Patient Passport
Source: https://help.elationhealth.com/articles/Setting-up-Patient-Passport
## Setup
Prior to using Patient Passport, make sure the correct Settings and workflows are in place by following the setup instructions below.
## Basic Configurations
### Customizing default sharing preferences for your assigned patients
As a Provider Level User, you can control what Clinical Profile information is automatically shared with your patients through their Passport accounts. The following Clinical Profile information is always shared automatically with patients. This is known as the **Objective Data Only** category:
* **Allergies**
* **Drug Intolerances**
* **Medications**
* **Vaccines**
Other Clinical Profile data points that can be shared automatically are categorized into three additional levels. Use the table below to determine which level you want to set as your default and then review and adjust your preferences under **Settings**→**User Settings**→**Patient Sharing Defaults**→**Sections of the clinical profile to share through Passport**. These defaults apply to patients who have you listed as their Provider Assigned in Practice under their demographics.
Changes to your sharing defaults only apply to patients who register for Passport **after** the update. For patients already registered, adjust sharing settings individually in their chart under **Passport Sharing Options** .
| | **Objective Data Only** | **Objective Data & Problem List** | **Clinical Profile, excludes Confidential** | **Clinical Profile, Expanded Summary** |
| -------------------------------------------- | ----------------------- | --------------------------------- | ------------------------------------------- | -------------------------------------- |
| Satisfies MIPS requirements | **X** | ✅ | ✅ | ✅ |
| Allergies | ✅ | ✅ | ✅ | ✅ |
| Drug Intolerances | ✅ | ✅ | ✅ | ✅ |
| Medications | ✅ | ✅ | ✅ | ✅ |
| Vaccines | ✅ | ✅ | ✅ | ✅ |
| Problem List | **X** | ✅ | ✅ | ✅ |
| History | **X** | **X** | ✅ | ✅ |
| Legal Reports | **X** | **X** | ✅ | ✅ |
| Provider List | **X** | **X** | ✅ | ✅ |
| Confidential | **X** | **X** | **X** | **X** |
| Expanded Summary, Implantable Devices (CCDA) | **X** | **X** | **X** | ✅ |
### Specifying messaging preferences
By default, patients cannot initiate messages to you from their Passport account. To allow patients to send messages to your practice:
Go to **Settings** → **Admin Users Only** → **Patient Passport Messages**.
Change the **Allow patients to send messages to the practice** toggle to Yes to enable patient-initiated messages.
Afterwards, scroll down the page to review your routing preferences to ensure patients’ messages are routed to the correct person/team in your practice. Adjust as needed:
Adjust routing preferences **For all providers at the same time** in the **Routing for All Providers** section by clicking **Update Routing for all Providers**. • **For individual providers** under the **Routing per Provider** section by clicking **Change Routing for …**.
Type the name of the recipient(s) or User Group(s) in the **Route To:** fields next to each Message Category. To add a recipient, type the recipient’s name in the **Add provider, staff or group in practice…** field and then select a match from the search results. • To remove specific recipients, hover over their name and click **X**. • To remove all users click **Clear All**.
Click **Update Provider’s Routes** to save your changes.
All newly received patient messages will follow the updated routing preferences.
If a Message Category is routed to a User Group, any action taken by one member (viewing or acknowledging the message) clears it from every other group member's Requiring Action queue, even if they never personally opened it. If you need to guarantee that specific staff each see every message, route the category to those individuals instead of a User Group.
Routing is evaluated at the time a message is sent, based on the message's subject/category and the patient's **Provider Assigned in Practice** at that moment. If you change a patient's assigned provider afterward, messages the patient already sent stay with the original routing — they don't retroactively move to the new provider's queue. You do not need to cancel and re-invite the patient to Passport to fix this.
### Controlling patient profile photo uploads
Practice admins can decide whether patients can upload or change their profile photo from Patient Passport. This is useful if you want the profile photo on file to come only from the practice.
Go to **Settings** → **Patient Passport Settings**.
Toggle **Allow patients to upload a profile photo from Patient Passport** on or off.
Photo uploads are allowed by default.
When the setting is off:
* The edit photo button is hidden on the patient's **Profile**, **Demographics**, and **Clinical Profile** pages in Patient Passport, so patients cannot add or replace a profile photo from the portal.
* Any profile photo already on file stays in place, and patients can still see it.
* Staff can still upload or update a patient's profile photo from the chart.
This setting only controls profile photo uploads from Patient Passport. Photos and other attachments patients send through **Messages** are controlled separately under **Settings** → **Admin Users Only** → **Patient Passport Messages**.
### Educating patients about Patient Passport
Educating patients (and/or their caretakers) on the benefits and usage of the Patient Passport can help boost adoption, especially as different use cases will require different ways of setting up their Passport account.
[Click here for a patient facing article about Passport setup and features](/articles/what-patient-passport-messaging-looks-like-to-a-patient). Feel free to include it in your communications with them.
## Advanced Configurations
### Customizing Clinical Profile sharing settings for individual patients
As needed, adjust what’s shared for each patient to override the default.
In the patient’s chart, click the passport button (a globe) at the corner of the patient’s profile picture.
Go to the **Passport Sharing Options** section and choose the level of sharing you want.
Save your changes by clicking the appropriate button based on the patient’s account status: If the patient hasn’t been invited yet or they haven’t registered yet, click **Send Invitation & Close**. This will also send the patient an invitation, even if they’ve already received one. • If the patient is a registered user, click **Save Settings Changes & Close**.
The changes will take effect the next time the patient signs in to their Passport account.
Provider Level Users configure the practice's default **Passport Sharing Options**. Any user can override this default for an individual patient from the chart by following the steps above.
### Enabling notifications about unopened Patient Letters
As a Provider Level User, you can specify a default notification preference for when patients don’t open/read the Patient Letters you send them. This includes [Patient Passport invitations of any kind](https://docs.google.com/document/d/1Nk38K6UkfP-cCdKrWoGvhRj6hWYk7Mhb4odGpP1ByqU/edit?tab=t.99ih9hgc9jlk#heading=h.9xw2jed7wz7f) .
Go to **Settings** → **User Settings** → **Patient Sharing Defaults** → **Notifications**.
Use the dropdown to choose how long to wait before receiving a notification.
[Click here for more information about receiving notifications](/articles/Passport--Communicating-with-patients#reviewing-notifications-about-unread-messages).
### Training staff - Best practice workflows
To maximize Patient Passport adoption:
1. Train your staff on the common scenarios they may encounter when inviting patients to create a Passport account. Use the scenario cards in the [Managing Passport Invitations](/articles/Managing-Passport-invitations) article to find the workflow that matches each situation.
2. **Collecting a patient’s email address:**
3. **Before you collect a patient’s email address**, here are some important questions to ask:
4. *Do you have a Patient Passport account with other practices, whether it be for yourself or someone else? If so, what is the email address associated with that account?*
5. *Do you plan to use this email address for multiple Passport accounts? (E.g. for your child or someone else in your care).*
6. *Does anyone else have access to this email address?*
7. Have staff [educate patients](#educating-patients-about-patient-passport) (and/or their caretakers) on the benefits of using Patient Passport.
8. Have the front office:
* Collect & store an **email address** for each patient in their Patient Demographics for Patient Passport account invitation.
* Invite all patients to Patient Passport.
For a full breakdown of invitation scenarios — including patients with existing accounts, family members, and caregivers — see the [Managing Passport Invitations](/articles/Managing-Passport-invitations) article.
### Setting up the Patient Booking Site
If you allow patients to book appointments through your [Elation Booking Site](/articles/Patient-Booking-Site), you can enable a setting to automatically send them a Patient Passport invitation after they book an appointment if they don’t already have an account.
To turn this on, go to **Settings** → **Calendar and Booking** → **Booking Site** → **Preferences**→ **Automatically send patients an email invitation to join Elation Patient Passport after they book online (if they don't already have a Passport account)**.
If many of your patients plan to use one Patient Passport account to access multiple charts—such as parents managing children’s records or caregivers managing relatives’ charts—we recommend leaving this setting off so that your staff can confirm the use case for the account with the patients before sending an invitation.
## Related Articles
* [Elation Patient Passport Introduction](/articles/elation-patient-passport-an-introduction)
* [Elation Patient Passport Guide - Managing Passport invitations](/articles/Managing-Passport-invitations)
* [Elation Patient Passport Guide - Communicating with patients & sharing records](/articles/Passport--Communicating-with-patients)
* [Elation Patient Passport Guide - Helping patients troubleshoot Passport issues](/articles/troubleshooting-passport-with-patients)
* [Elation Patient Passport Guide - Patient's Point of View](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
# Multi-Factor Authentication Guide - Setting up authentication factors
Source: https://help.elationhealth.com/articles/Setting-up-authentication-factors-for-MFA
This article will guide you through setting up the various types of authentication factors for multi-factor authentication.
📖
**RECOMMENDED READING**
[Click here to learn about the different types of authentication factors and what to consider before choosing and setting one up](/articles/Multifactor-Authentication-MFA#options)
.
All Elation users are **required** to use multi-factor authentication for security and compliance purposes.
## Overview
With multi-factor authentication, every active user in the practice is required to set up at least one authentication factor by their next attempt to sign in to their Elation account.
* Users still logged in at the time MFA is enabled can set up an authentication factor by going to **Settings** -> **Account Details** and then clicking **Setup** next to **No active multi-factor authentication**.
* If you already have an authentication factor set up, this button will be called **Edit factors**.
* Users who are not logged in at the time MFA is enabled will be prompted to set up an authentication factor during their next login.
You cannot share accounts while using multi-factor authentication. Shared, or generic, user accounts or passwords are strictly prohibited by [Elation's Terms of Use](https://www.elationhealth.com/terms-of-use/) and security policies. Individuals who use the EHR must log in using their own, unique account.
## Workflow Instructions
### Setting up an Authenticator App (i.e. Google Authenticator)
#### Setting up an Authenticator App by scanning a QR code
To use an Authenticator App such as Google Authenticator as your authentication factor, link the app to your Elation account by following the steps below. The setup process is generally the same for most authenticator apps. We'll use Google Authenticator as an example.
| **1** | Click **Setup** next to the Authenticator App option in Elation. A QR Code will appear for you to use in Step #3. If you are setting up Google Authenticator from the Elation login screen, click **Setup** and then select your device type by clicking either **iPhone** or **Android**. • Click **Next**. A QR Code will appear. Keep this screen on and QR code visible for Step #3. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | **(As needed)** Install/download the Google Authenticator app on your mobile device if you do not have the app yet. Proceed to step #3 if you already have the app installed. Install via the App Store if you are using an iPhone. • Install via the Google Play Store if you are using an Android device. |
| **3** | Link your Elation account to the Google Authenticator app by using your device’s camera to scan the QR Code on your Elation screen. Open the Google Authenticator app on your mobile device. • Press **Get started**. • Specify if you want to use Google Authenticator with your Google account or without an account. • Press the **+** button at the bottom right of the Google Authenticator app to add a new software application. • Press **Scan a QR Code** and then point your device’s camera at the QR Code that appears in Elation to scan it. • Your Elation account will now appear in Google Authenticator. • Go back to your Elation screen and click **Next**. • In the **Enter Code** box on your Elation screen, enter the **6 digit number** from your Google Authenticator app and then click **Verify**. |
| **4** | You have successfully set up Google Authenticator for multi-factor authentication. If you are completing the setup while logging in to Elation, click **Finish** to proceed to the Practice Home. |
#### Setting up an Authentication App by entering a Key instead of scanning a QR code
Click here for instructions on how to set up an Authentication App without using a QR code.
This option is only available when completing the Authentication App set up from the login screen.
| **1** | Login to Elation. |
| ------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Setup** next to the Google Authenticator option. |
| **3** | A QR Code will appear. Click **Can’t scan?** to see a Key instead. |
| **4** | Open the Google Authenticator app on your mobile device. |
| **5** | Press **Get started** . |
| **6** | Specify if you want to use Google Authenticator with your Google account or without an account. Press **Continue as …** if you want to use your Google account. • Press **Use without an account** if you don’t want to use your Google account. |
| **7** | Press the **+** button at the bottom right of the Google Authenticator app to add a new software application. |
| **8** | Press **Enter a setup key** . |
| **9** | Enter an **Account name** that will help you identify the account (i.e. **Elation**). |
| **10** | Enter the series of letters and numbers that you see on your Elation screen in the **Your key** field. |
| **11** | Leave the **Type of key** field as **Time based** . |
| **12** | Press **Add** . |
| **13** | Your Elation account will now appear in Google Authenticator. |
| **14** | Go back to your Elation screen and click **Next** . |
| **15** | In the **Enter Code** box on your Elation screen, enter the **6 digit number** from your Google Authenticator app and then click **Verify**. The 6 digit number will change every 30 seconds. Always enter the numbers that appear most recently in the Google Authenticator app. |
| **16** | You have successfully set up Google Authenticator for multi-factor authentication. Click **Finish** to proceed to the Practice Home. |
### Setting up Okta Verify
#### Setting up Okta Verify by scanning a QR Code
| **1** | Click **Setup** next to the Okta Verify option. A QR Code will appear for you to use in Step #3. If you are setting up Okta Verify from the Elation login screen, click **Setup** and then select your device type by clicking either **iPhone** or **Android**. • Click **Next**. A QR Code will appear. Keep this screen on and QR code visible for Step #3. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | **(As needed)** Install/download the Okta Verify app on your mobile device if you do not have the app yet. Proceed to step #3 if you already have the app installed. Install via the App Store if you are using an iPhone. • Install via the Google Play Store if you are using an Android device. |
| **3** | Link your Elation account to the Okta Verify app by using your device’s camera to scan the QR Code on your Elation screen. Open the Okta Verify app on your mobile device. • Press **Add Account** in your Okta Verify app. • Press **Other**. • Press **Scan QR Code** and then point your device’s camera at the QR Code that appears in Elation to scan it. • You will see a confirmation on your screen that says **Account Added**. Click **Done** to close the notification. |
| **4** | You have successfully set up Okta Verify for multi-factor authentication. If you are completing the setup while logging in to Elation, click **Finish** to proceed to the Practice Home. |
#### Setting up Okta Verify without scanning a QR code
Click here for instructions on how to set up Okta Verify without using a QR code.
This option is only available when completing the Okta Verify set up from the login screen.
| 1 | Login to Elation. |
| - | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Click **Setup** next to the Okta Verify option. |
| 3 | A QR Code will appear. Click **Can’t scan?** . |
| 4 | Choose the technique you want to use to set up Okta Verify: Use an activation link sent via SMS to a specified mobile phone number. • Select **Send activation link via email**. • Use a Key that you manually input in the Okta Verify App. |
| 5 | You have successfully set up Okta Verify for multi-factor authentication. Click **Finish** to proceed to the Practice Home. |
### Setting up a Security Key or Biometrics Authenticator
Only use a Security Key or Biometric Authenticator as your authentication factor if you use a single, personal device to access Elation. We recommend setting up a second authentication factor as backup in case you may need to access Elation on a secondary device.
To set up a Security Key or Biometric Authenticator (i.e. password manager, Windows Hello, Face ID, Touch ID, etc):
| **1** | Go to **Settings** -> **Account Details** |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Click **Setup** next to **No active multi-factor authentication**. If you already have an authentication factor set up then this button will be called **Edit factors**. |
| **3** | Click **Setup** next to the Security Key or Biometric Authenticator option. |
| **4** | Click **Enroll** . |
| **5** | Follow the on-screen prompts to set up a Security Key or Biometric Authenticator. |
Detailed instructions are unavailable for this setup process as the exact workflows depend on your browser, enabled browser extensions, your computer’s operating system, and available hardware keys. For this reason, Elation will not be able to troubleshoot issues around this authentication factor. Only select this authentication option if you are familiar with this type of authentication factor and are comfortable resolving potential issues on your own.
### Setting up Email Authentication
**Email Authentication can only be set from the Elation login screen AND if you don’t have any other types of factors set up yet.**
Email Authentication is the least secure authentication factor. Only use Email Authentication if you are unable to use other authentication factors.
To set up Email Authentication:
| **1** | Login to Elation. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Setup** next to the Email Authentication option. |
| **3** | Click **Send me a code** . Elation will send a verification code to the email address you use to log in to Elation. |
| **4** | Look for an email with the subject line **Confirm your email address** . |
| **5** | Enter the **6 digit number** from the email into the **Verification code** box on your Elation screen. |
| **6** | Click **Verify** . |
| **7** | You have successfully set up Email Authentication for multi-factor authentication. If you are completing the setup while logging in to Elation, click **Finish** to proceed to the Practice Home. |
## Frequently Asked Questions (FAQ)
[Click here for answers to common MFA questions—including troubleshooting login issues, choosing authentication factors, and more](/articles/Multi-Factor-Authentication-FAQ).
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication Guide - Updating authentication factors](/articles/Updating-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Resetting authentication factors](/articles/Resetting-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Frequently Asked Questions](/articles/Multi-Factor-Authentication-FAQ)
# Telehealth Guide- Setting up your integrated practice management system for telehealth
Source: https://help.elationhealth.com/articles/Setting-up-your-Elation-account-for-telehealth
This article walks you through setting up your integrated practice management/billing system to administer telehealth care.
## Why is it important to configure telehealth billing for Elation & my PMS?
Teleheath workflows and coding allows providers to care for patients and get paid for their work during the COVID-19 public health emergency. This article also applies to providers who normally offer telehealth services. If you are using an integrated practice management/billing system (PMS) alongside Elation, you will want to make sure Elation and your PMS are set up to allow you to successfully get paid for telehealth services rendered in a streamlined fashion.
Our team has created this resource to guide you through the necessary settings updates to bill for telehealth services rendered to patients. Each section linked below provides detailed step-by-step instructions to ensure that your practice can successfully send telehealth charges from Elation to your integrated practice management/billing system (PMS).
The instructions on Elation's end will always remain the same for any PMS and can be seen in the [general Elation instructions](#general) section. Please click on the link below to view instructions relevant to your PMS if you need to make any adjustments in your PMS:
* [Tebra](#Tebra)
* [Akamai](#Akamai)
* [CollaborateMD](#CollaborateMD)
* [PracticeSuite](#PracticeSuite)
* [ConnxtMD](#ConnxtMD)
* [AdvancedMD](#AdvancedMD)
## General information
Telehealth coding regulations can change from time to time and may be different for each payer. For tips on which Place of Service (POS) and CPT Codes to use for telehealth, see our
[Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations)
guide. We recommend consulting with your payer's coding guidelines for the most up to date information.
## General Elation instructions
These instructions apply to any Elation customer using any integrated practice management/billing system (PMS) with Elation. For tips on which Place of Service (POS) and CPT Codes to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
### Adjusting the Place of Service (POS) in Elation
1. In Elation, go to **Settings** >> **Practice Location**
2. Click **+ Add Practice Location** to add a new location where you would like to bill from
3. Fill out the information for the new service location including the relevant POS code. For example, for **Telehealth**, that code is (02).
4. Click **Save** to save your new Practice Location in Elation
5. Look at the relevant practice management/billing system (PMS) instructions below to create a corresponding Practice Location in your PMS.
If you are providing in person and telehealth services from your office, you can have the same Practice Location but different Place of Service codes to designate the type of service being rendered.
### Adjusting CPT Codes in Elation
1. In Elation, go to **Settings** >> **Billing**
2. Click **+Add CPT code**
3. Enter the desired telehealth related CPT codes and corresponding descriptions
* User Tip: Popular telehealth codes can be found here: [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations)
4. Click **Create**
5. Look at the relevant practice management/billing system (PMS) instructions below to create a corresponding CPT Code in your PMS as needed.
## Tebra
Tebra® was previously known as Kareo®.
These instructions can be used alongside the
[general instructions](#general)
above for any customer using the Elation-Tebra integration. For tips on which Place of Service (POS) and CPT Codes to use for telehealth, see our
[Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations)
guide.
### Tebra- Adjusting the Place of Service (POS)
Navigate to Tebra's **Setup** page and add a service location for **telehealth - (02)**
### Tebra- Adjusting CPT® Codes
1. Click **Settings** >> **Codes** >> **Find Procedures** on the top menu.
* **User Tip**: To avoid duplication, best practice is to first search the database to see if the procedure code already exists in the system
2. If the procedure code is not in the system, click **New** at the bottom
3. Enter the required information.
4. When finished, click **Save**
5. Log out of Tebra and log back in to utilize the new code
### Elation- Important Place of Service (POS) steps
After following the [general instructions](#adjusting-the-place-of-service-pos-in-elation) above, you must select the matching Tebra service location name from the drop down menu for any matching Elation Service Location under **Settings** >> **Practice Location**.
### Elation- Important CPT Code information
If you are adding CPT Codes in Elation using the [general instructions](#adjusting-cpt-codes-in-elation) above, please be sure that the CPT code you add to Elation matches exactly to the CPT code in Tebra. Without an exact match, the bills containing the CPT code will fail.
## Akamai
These instructions can be used alongside the [general instructions](#general) above for any customer using the Elation-Akamai integration. For tips on which Place of Service (POS) and CPT Codes to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
### Akamai- Adjusting the Place of Service (POS) & CPT Codes
Navigate to the Akamai **Settings** page and add the service location and CPT codes there.
* Please note that the service location name must match exactly to what is listed as the Practice Location name in Elation
* Please do not hesitate to contact Akamai Support ([support@akamaipm.com](mailto:support@akamaipm.com)) for assistance with updating the billing codes and/or service location.
### Elation- Important Place of Service (POS) and CPT Code steps
Please be sure that the CPT codes and service location that you add to Akamai match exactly to the service location and CPT codes in Elation. Without an exact match, the corresponding bills will fail.
## CollaborateMD
These instructions can be used alongside the
[general instructions](#general)
above for any customer using the Elation-CollaborateMD integration. For tips on which Place of Service (POS) and CPT Codes to use for telehealth, see our
[Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations)
guide.
### CollaborateMD- Adjusting the Place of Service (POS)
1. In CollaborateMD, go to **Customer Setup** >> **Facilities**
2. Click **+New Facility** >> **Add Manually**
* You can also choose **Add via NPI Registry** if you want to add your service location using a unique NPI number
3. Fill in the all of the details and most importantly enter a **Place of Service** under **Claim Defaults**
* For tips on which Place of Service (POS) to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
4. Click **Save** to save the new Facility
### CollaborateMD- Adjusting CPT® Codes
1. In CollaborateMD, go to **Customer Setup** >> **Codes...** >> **Procedure**
2. Click **+ New CPT/HCPCS**
3. Enter the code, description and other required fields
* For tips on which CPT Codes to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
4. Click **Save** to save the new Procedure Code.
### Elation- Important Place of Service (POS) and CPT Code steps
Please be sure that the CPT codes that you add to Elation match exactly to the Procedure codes in CollaborateMD. Please also make sure the Practice Location you add to Elation matches the Facility you add to CollaborateMD. Without an exact match, the corresponding bills will fail.
## PracticeSuite
These instructions can be used alongside the [general instructions](#general) above for any customer using the Elation-PracticeSuite integration. For tips on which Place of Service (POS) and CPT Codes to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
### PracticeSuite- Adjusting the Place of Service (POS)
1. In PracticeSuite, go to **Master Setup** >> **Service Location**
2. Click **+ Add Service Location**
3. Fill in the all of the details and most importantly enter a Place of Service Code in the **POS** field
* For tips on which Place of Service (POS) to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
4. Click **Save** to save the new Service Location
### PracticeSuite- Adjusting CPT® Codes
1. In PracticeSuite, go to **Billing Setup** >> **Fee Schedule**
2. Click **+Add CPT**
3. Enter the code, description and other required fields. Make sure you keep the **Active** checkbox checked.
* \*\*For tips on which CPT Codes to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
4. Click **Save** to save the new CPT Code
### Elation- Important Place of Service (POS) and CPT Code steps
Please be sure that the CPT codes that you add to Elation match exactly to the CPT codes in PracticeSuite. Please also make sure the Practice Location you add to Elation matches the Service Location you add to PracticeSuite. Without an exact match, the corresponding bills will fail.
## ConnxtMD
These instructions can be used alongside the [general instructions](#general) above for any customer using the Elation-ConnxtMD integration. For tips on which Place of Service (POS) and CPT Codes to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
### ConnxtMD- Adjusting the Place of Service (POS) & CPT Codes
1. In ConnxtMD, go to the **Practice Setup** page
2. Add CPT Codes and charge amounts to the Fee Schedule
3. Add a new Facility for teleheath if needed
**Important Note**: Schedule appointments in ConnxtMD using the **Telehealth** facility. The interface links Elation charges to existing ConnxtMD appointments resulting in charges that use the appointment’s chosen facility.
### Elation- Important Place of Service (POS) and CPT Code steps
Please be sure that the CPT codes that you add to Elation match exactly to the CPT codes in PracticeSuite. Please also make sure the Practice Location you add to Elation matches the Service Location you add to PracticeSuite. Without an exact match, the corresponding bills will fail.
## AdvancedMD
### AdvancedMD- Adjusting the Place of Service (POS)
1. In AdvancedMD, go to **System Settings** >> **Facilities**
2. Do not click on any existing Facility to the left, just enter the data for the new facility in the form
3. Make sure you select a **Place of Service**
4. Click **Save**
### AdvancedMD- Adjusting CPT® Codes
1. In AdvancedMD, go to **System Settings** >> **Transaction Codes** >> **Charge Codes**
2. Fill in the code, description and other desired fields.
* \*\*For tips on which CPT Codes to use for telehealth, see our [Telehealth Billing Workflow](/articles/Telehealth-Coding-and-Workflows-Recommendations) guide.
3. Click **Save**
### Elation- Important Place of Service (POS) and CPT Code steps
Please be sure that the CPT codes that you add to Elation match exactly to the CPT codes in AdvancedMD. Without an exact match, the corresponding bills will fail.
After adding a new Facility to AdvancedMD and Practice Location to Elation, contact Elation using the **I need help** >> **I need help from Elation Team Member** button and notify us of the AdvancedMD Facility Code (in the **Code** field of the Facility you added) and we will work with AdvancedMD to map your new Place of Service for billing. You will not see this mapping for bills created via the Elation-AdvancedMD integration until this mapping step is complete and the bills sent from Elation will default to your primary Facility in AdvancedMD.
*CPT copyright 2022 American Medical Association. All rights reserved.*
## Related Articles
* [Telehealth: Billing & Workflow Recommendations](/articles/Telehealth-Coding-and-Workflows-Recommendations)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Practice Locations Guide- Listing your service locations](/articles/adding-a-second-practice-location)
* [Billing Guide- Setting up CPT Codes and Place of Service](/articles/billing-settings---service-locations--procedure-codes)
# Data Sharing Guide - Sharing data outside Elation via CCDA, Carequality, Direct messaging, Connect and Patient Passport
Source: https://help.elationhealth.com/articles/Sharing-data-outside-Elation
This article explains how patient data flows out of and into Elation across CCDA exports/imports, Carequality (Outside Care), Direct messaging & Elation Connect, and Patient Passport.
## Overview
### What is external data sharing?
External data sharing refers to how patient data flows out of and into Elation across four main channels:
* C-CDA (CCDA) exports/imports
* Carequality (Outside Care)
* Direct messaging & Elation Connect (secure provider portal)
* Elation Patient Passport (patient portal)
### Why is understanding external data sharing important?
Clinicians and admins frequently ask two key questions:
* What exactly leaves my chart, and who can see it?
* When I "view" outside records vs import them, where do those records live in Elation?
Understanding these data flows helps you maintain patient privacy, ensure continuity of care, and properly manage incoming records.
### Quick comparison: external data channels
| Data channel | Primary audience | Direction | What they can see | View vs import in Elation | Who initiates? |
| ---------------------------------------------------------------------- | -------------------------------------------------- | ---------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **CCDA export/import** | Other EHRs, registries, HIEs, patients | Outbound & inbound | Standard clinical summary (problems, medications, allergies, encounters, labs, care plan, etc.), optionally scoped to a specific use case (referral, complete record, care plan only). | [Inbound CCD/CCDA files](/articles/import-patient-information-from-another-ehr-c-cda-format) always create a **Patient Summary** report. Only demographics, allergies, problems, immunizations, and medications can be imported as structured data; all other sections remain view-only in the **Patient Summary** unless manually transcribed. | You initiate [CCDA exports](/articles/Supported-Elation-CCDA-types) from the chart or **Patient List** report; outside organizations initiate inbound CCD/CCDA sends. |
| **[Carequality](/articles/Carequality-Integration-Introduction)** | Carequality-enabled clinicians, HIEs, and EHRs | Bi-directional (outbound and inbound) | Outbound: a CCDA summary for matched, consented patients. Inbound: CCDs plus other document types (e.g., PDFs, images) depending on the trading partner. | Inbound CCDs appear in the **Outside Care** viewer and can be filed and (optionally) imported into structured sections. Other document types are view-only in the viewer; to retain them you must download and upload them as Reports. | You initiate queries via the **Outside Care** button; external organizations initiate pulls of your CCDA data when they query Carequality and a match is found. |
| **Direct messaging & Elation Connect** | External clinicians, facilities, and organizations | Outbound and inbound for Direct messaging; mainly outbound for Connect | [Direct messages](/articles/how-to-use-direct-messaging): the Letter/Referral body, attachments you choose, plus an automatically attached CCDA file for the patient when supported. Elation [Connect](/articles/secure-Provider-Portal): a secure, read-only snapshot of the exact documents you attached—never a live copy of your chart. | Inbound Direct CCD/CCDA attachments become **Patient Summary** reports. For new auto-created charts, compatible sections can auto-populate; for existing charts, you choose what to import, exactly like other CCD/CCDA imports. | You initiate outbound messages via **Provider Letters** and **Referrals** ; external systems initiate inbound Direct messages to your Direct address. Connect invitations are triggered when you address a Letter/Referral to a non-Elation contact with fax or email. |
| [Patient Passport](/articles/elation-patient-passport-an-introduction) | Patients and patient-authorized delegates | Mainly outbound from Elation to patients | By default: Clinical Profile (except records marked confidential), visit summaries for signed visit notes, **Patient Letters** , and any attachments you choose to send (e.g., labs, imaging, handouts). | Patient-visible data is read-only from the patient's perspective and **does** **not** change your internal structured chart. You control additional sharing (e.g., lab reports, orders) by attaching records to **Patient Letters** . | You invite patients and send messages/records from within the chart or via [Bulk Letters](/articles/introduction-to-bulk-letters) ; patients and delegates can message or reply if you allow messaging. |
## External data channels
### CCDA exports/imports
#### What leaves Elation in CCDA exports
When you export a CCDA for a single patient or a cohort, Elation generates a structured clinical summary that can include (depending on the export type):
* Reason for referral
* Allergies, adverse reactions, alerts
* Medication history
* Problem list
* Encounters
* Immunizations
* Vital signs
* Social history
* History of procedures and implantable devices
* Relevant diagnostic tests and/or laboratory data (all structured values from signed lab results)
* Functional and mental status
* Assessments, plan of care, goals, and health concerns
You can control the scope by choosing:
* Complete Record (all available data, excluding confidential records)
* Customized Record (manually pick sections such as labs only, or medications & problems)
* Referral Record (referral-oriented subset)
* Progress Notes or Care Plan exports for more focused use cases
CCDA files are meant to be imported into another electronic health records system — they aren't in a human-readable format and won't open properly in a standard document viewer. If a recipient needs a copy of the records in a format anyone can open and read (for example, to share with an attorney or a patient directly), request a PDF export from the practice instead.
#### What you can import from inbound CCD/CCDA files
When another EHR, registry, or HIE sends you a CCD/CCDA file (whether via Direct, Carequality, or manual upload):
* Elation converts the file into a **Patient Summary** report in the patient's chart.
* From that **Patient Summary**, you can import **only** the following sections as structured data into the Clinical Profile:
* Demographics
* Allergies
* Problems
* Immunizations
* Medications
Other sections—such as lab results, imaging reports, visit notes, and discharge summaries—remain part of the read-only **Patient Summary**. You can reference them any time but they **are** **not** merged into Elation's structured fields automatically.
#### "View only" vs import for CCDA
* View only: If you simply open and sign off a **Patient Summary** without importing any sections, the CCD/CCDA stays as an attachment in the chart. It **does** **not** alter the Clinical Profile or other structured areas of the chart.
* View & import: If you choose **Import All** or **Import & Reconcile** for specific sections, Elation pulls demographics, allergies, problems, immunizations, and medications into the appropriate structured sections. All other sections remain view-only inside the **Patient Summary**.
This is true whether the CCD/CCDA arrived as a bulk migration file, a Direct message attachment, or through Carequality.
### Carequality (Outside Care)
#### What Carequality is doing with your data
When your practice enables **Patient Data Sharing with Outside Care** and records patient consent, Elation participates in the national Carequality framework:
* Other Carequality-enabled organizations can query for your mutual patients.
* When there is a qualified match and consent, Carequality pulls a CCDA file of your patient's data from Elation and shares it with the querying organization.
* Elation **does** **not** share images or other non-CCDA document types through Carequality; we share CCDA-formatted data only.
The CCDA content we expose via Carequality matches the CCDA sections listed in the CCDA export guide (problems, medications, allergies, encounters, labs, care plan, goals, etc.).
#### What you see when you query Carequality
When you click **Outside Care** in the Clinical Profile and the patient has granted consent:
* Elation queries the Carequality network using the patient's demographics.
* Any matched outside records appear in the **Outside Care** document viewer.
* You may see multiple document types:
* CCDs/CCDAs – structured clinical summaries.
* PDFs, images (PNG, TIFF, etc.) – scanned notes, results, or other unstructured content.
Labs and notes may be available as documents depending on trading partner capabilities. Elation can only return what other Carequality-enabled organizations choose to share and what their patients have consented to share.
#### Viewing vs importing Carequality documents into the chart
Carequality documents **do not** automatically merge into your chart:
* For CCDs/CCDAs in the **Outside Care** viewer:
* **Sign Off**: files the document into the patient's chart as a report, without importing discrete data.
* **Sign Off & Import**: files the document and allows you to select and import discrete data (demographics, allergies, problems, immunizations, medications) into the Clinical Profile, just like other CCD/CCDA imports.
* For PDFs and images in the **Outside Care** viewer:
* These are view-only in the viewer.
* To retain them in the chart, you must download the file and drag-and-drop it into the chart to file it as a **Report**.
Elation has no control over gaps or omissions in what other organizations share.
### Direct messaging & Elation Connect
#### What's in an outbound Direct message
When you send a Provider Letter or Referral and the yellow banner indicates Direct messaging, Elation transmits a secure Direct message that typically includes:
* The **Letter**/**Referral** body text.
* Any attached chart records that are supported for Direct (e.g., visit notes, reports, labs, summaries).
* An automatically attached CCDA file for the patient's data, when supported by the recipient.
The receiving EHR decides:
* Whether to show the message body as a note, inbox item, or both.
* Whether to store attachments as scanned documents.
* Whether and how to parse the CCDA into their structured chart.
#### What you see for inbound Direct messages
When you receive a Direct message in Elation:
* Incoming messages appear in:
* **Provider Letters inbox** on Practice Home; and/or
* **Requiring Action** in the patient's chart.
* Any attached CCD/CCDA file appears as a **Patient Summary** above the Direct message.
* Behavior differs by chart status:
* No existing chart – Elation creates a new chart and can automatically populate the Clinical Profile from the CCD/CCDA.
* Existing chart – Elation keeps the CCD/CCDA as a **Patient Summary**; you choose whether to import structured sections.
You can always:
* Open the Direct message to see exactly what text and attachments were received.
* Open the associated **Patient Summary** to see what was shared in the CCD/CCDA, and optionally import sections.
#### What Elation Connect recipients can see
When you address a Provider Letter or Referral to a non-Elation contact with fax and/or email, Elation can invite that contact to Elation Connect, our secure provider portal:
* Connect is a read-only portal: it stores patient charts that contain only the records you sent from Elation, not your full internal chart.
* A Connect user can:
* View the **Letter**/**Referral** and its attachments.
* Download those records to transfer into their own system.
* Reply back to you; replies come into your **Provider Letters inbox** and the patient's chart.
Connect users never receive live access to your Elation chart. They only see the specific snapshot (Letter & attachments) that you chose to send for that patient.
### Elation Patient Passport (patient portal)
#### Default patient-visible data
Once a patient registers for Elation Patient Passport, they see:
* Practice contact information.
* Last and next appointment dates.
* Key demographics and contact preferences.
* The Clinical Profile (problems, allergies, medications, immunizations, history, etc.), excluding items marked as confidential.
* A visit summary for every signed visit note, which includes vitals, procedures, tests/treatments (including referrals, medications, and diagnostic test orders), care plan/instructions, and follow-up details.
* Any **Patient Letters** and attachments you send them (e.g., lab reports, imaging reports, handouts).
Visit summaries and Clinical Profile content are shared automatically once Passport is enabled for the patient; you **do** **not** need to attach them manually each time.
#### What is not automatically shared with patients
Patients **are** **not** automatically granted access to every record in the chart. For example:
* Individual lab reports, imaging reports, and other Reports **are** **not** visible by default.
* Specific visit note sections or chart items tagged as **Confidential** are never exported in CCDA files and are not surfaced via Patient Passport sharing.
To share those items, your practice must intentionally:
* Attach reports or notes to a **Patient Letter**, or
* Include them in a CCDA export you share directly with the patient.
#### Messaging and attachments from patients
If you allow two-way messaging:
* Patients can send new messages from Passport and attach files (e.g., outside records or photos).
* Replies and attachments arrive as **Patient Letters** in your Practice Home; you can file attachments directly into the chart as **Reports**.
You can also configure Passport as one-way (you push information out but do not allow patients to initiate messages) via the **Patient Passport Messages** settings.
## Where to verify "what was sent"
Here's where clinicians and staff can double-check outbound and inbound data:
* CCDA exports
* Single-patient exports: downloaded .zip file on your workstation, plus a record in the patient's Chronological Record indicating the type of export (Complete Record, Customized, Referral, etc.).
* Bulk exports: password-protected .zip file on your workstation.
* Carequality (Outside Care)
* Use the **Outside Care** button in the Clinical Profile to re-open the viewer and see exactly which documents are available and what you previously filed or imported.
* Direct messages & Elation Connect
* The signed **Provider Letter**/**Referral** in the patient's Chronological Record shows the final message body, attachments, and delivery method (Direct, fax, Elation, Connect).
* Sent faxes and Connect invitations show status such as **Fax Sent** or **Letter and its attachments will be faxed,** with error details for failures.
* Patient Passport
* The **Patient Letters** and visit summaries in the patient's chart mirror what the patient can see; if a record is not attached to a **Patient Letter** or included in a visit summary, it is not automatically visible in Passport.
Use these locations to answer patient or partner questions about "what you sent" vs what their system or portal is currently showing.
## Related Articles
* [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types)
* [Patient Chart Guide - Importing patient information from another EHR (CCD/CCDA Format)](/articles/import-patient-information-from-another-ehr-c-cda-format)
* [Elation-Carequality Integration Introduction](/articles/Carequality-Integration-Introduction)
* [Letter & Referral Guide - Sending and receiving Direct messages](/articles/how-to-use-direct-messaging)
* [Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Letter & Referral Guide - Accessing patient information sent by an Elation EHR user](/articles/access-patient-information-securely-shared-by-an-Elation-EHR-user)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
* [Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
# Sharing data outside Elation- CCDA, HIE, Direct messaging & Patient Passport
Source: https://help.elationhealth.com/articles/Sharing-data-outside-Elation-CCDA-HIE-Direct-Patient-Portal
This article explains how patient data flows out of and into Elation across CCDA exports/imports, Carequality (Outside Care), Direct messaging & Elation Connect, and Patient Passport.
## Overview
This article explains how patient data flows **out of** and **into** Elation across four main channels:
* C-CDA (**CCDA**) exports/imports
* **Carequality** (Outside Care)
* **Direct messaging** & **Elation Connect** (secure provider portal)
* **Elation Patient Passport** (patient portal)
It focuses on two questions clinicians and admins ask most:
* What exactly leaves my chart, and who can see it?
* When I "view" outside records vs **import** them, where do those records live in Elation?
## Quick comparison: external data channels
| **Channel** | **Primary audience** | **Direction** | **What they can see** | **View vs import in Elation** | \*\*Who initiates? |
| -------------------------------------- | -------------------------------------------------- | ---------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **CCDA export/import** | Other EHRs, registries, HIEs, patients | Outbound & inbound | Standard clinical summary (problems, meds, allergies, encounters, labs, care plan, etc.), optionally scoped to a specific use case (referral, complete record, care plan only). | Inbound CCD/CCDA files always create a **Patient Summary** report. Only demographics, allergies, problems, immunizations, and medications can be imported as structured data; all other sections remain view-only in the Patient Summary unless manually transcribed. | You initiate exports from the chart or Patient List report; outside organizations initiate inbound CCD/CCDA sends. |
| \*\*Carequality (Outside Care) | Carequality-enabled clinicians, HIEs, and EHRs | Bi-directional | Outbound: a CCDA summary for matched, consented patients. Inbound: CCDs plus other document types (e.g., PDFs, images) depending on the trading partner. | Inbound CCDs appear in the \*\* Outside Care\*\* viewer and can be filed and (optionally) imported into structured sections. Other document types are view-only in the viewer; to retain them you must download and upload them as Reports. | You initiate \*\* queries\*\* via the \*\* Outside Care\*\* button; external organizations initiate \*\* pulls\*\* of your CCDA data when they query Carequality and a match is found. |
| **Direct messaging & Elation Connect** | External clinicians, facilities, and organizations | Mainly outbound; inbound for Direct | Direct messages: the Letter/Referral body, attachments you choose, plus an automatically attached CCDA file for the patient when supported. Elation Connect: a secure, read-only snapshot of the exact documents you attached—never a live copy of your chart. | Inbound Direct CCD/CCDA attachments become Patient Summary reports. For new auto-created charts, compatible sections can auto-populate; for existing charts, you choose what to import, exactly like other CCD/CCDA imports. | You initiate outbound messages via **Provider Letters** and **Referrals**; external systems initiate inbound Direct messages to your Direct address. Connect invitations are triggered when you address a Letter/Referral to a non-Elation contact with fax or email. |
| **Patient Passport** | Patients and patient-authorized delegates | Mainly outbound from Elation to patients | By default: Clinical Profile (except records marked confidential), visit summaries for signed visit notes, Patient Letters, and any attachments you choose to send (e.g., labs, imaging, handouts). | Patient-visible data is read-only from the patient's perspective and does **not** change your internal structured chart. You control additional sharing (e.g., lab reports, orders) by attaching records to Patient Letters. | You invite patients and send messages/records from within the chart or via Bulk Letters; patients and delegates can reply if you allow messaging. |
## CCDA exports & imports
### What leaves Elation in CCDA exports
When you export a CCDA for a single patient or a cohort, Elation generates a structured clinical summary that can include (depending on the export type):
* Reason for referral
* Allergies, adverse reactions, alerts
* Medication history
* Problem list
* Encounters
* Immunizations
* Vital signs
* Social history
* History of procedures and implantable devices
* Relevant diagnostic tests and/or laboratory data (all structured values from signed lab results)
* Functional and mental status
* Assessments, plan of care, goals, and health concerns
You can control the scope by choosing:
* **Complete Record** (all available data, excluding confidential records)
* **Customized Record** (manually pick sections such as labs only, or meds + problems)
* **Referral Record** (referral-oriented subset)
* **Progress Notes** or **Care Plan** exports for more focused use cases
### What you can import from inbound CCD/CCDA files
When another EHR, registry, or HIE sends you a CCD/CCDA file (whether via Direct, Carequality, or manual upload):
* Elation converts the file into a **Patient Summary** report in the patient's chart.
* From that Patient Summary, you can import **only** the following sections as structured data into the Clinical Profile:
* Demographics
* Allergies
* Problems
* Immunizations
* Medications
Other sections—such as lab results, imaging reports, visit notes, and discharge summaries—remain part of the read-only Patient Summary. You can reference them any time but they are **not** merged into Elation's structured fields automatically.
### "View only" vs import for CCDA
* **View only. If you simply open and sign off a Patient Summary without importing any sections, the CCD/CCDA stays as an attachment in the chart. It does \*\* not** alter the Clinical Profile or other structured areas of the chart.
* **View + import. If you choose \*\* Import All** or \*\* Import & Reconcile\*\* for specific sections, Elation pulls demographics, allergies, problems, immunizations, and medications into the appropriate structured sections. All other sections remain view-only inside the Patient Summary.
This is true whether the CCD/CCDA arrived as a bulk migration file, a Direct message attachment, or through Carequality.
## Carequality (Outside Care)
### What Carequality is doing with your data
When your practice enables **Patient Data Sharing with Outside Care** and records patient consent, Elation participates in the national **Carequality** framework:
* Other Carequality-enabled organizations can **query** for your mutual patients.
* When there is a qualified match and consent, Carequality pulls a **CCDA file** of your patient's data from Elation and shares it with the querying organization.
* Elation does **not** share images or other non-CCDA document types through Carequality; we share CCDA-formatted data only.
The CCDA content we expose via Carequality matches the CCDA sections listed in the CCDA export guide (problems, medications, allergies, encounters, labs, care plan, goals, etc.).
### What you see when you query Outside Care
When you click **Outside Care** in the Clinical Profile and the patient has granted consent:
* Elation queries the Carequality network using the patient's demographics.
* Any matched outside records appear in the **Outside Care document viewer**.
* You may see multiple document types:
* **CCDs/CCDAs** – structured clinical summaries.
* \*\*PDFs, images (PNG, TIFF, etc.) – scanned notes, results, or other unstructured content.
Labs and notes may be available as documents depending on trading partner capabilities. Elation can only return what other Carequality-enabled organizations choose to share and what their patients have consented to share.
### Viewing vs importing Carequality documents into the chart
Carequality documents \*\* do not\*\* automatically merge into your chart:
* For **CCDs/CCDAs** in the Outside Care viewer:
* **Sign Off** – files the document into the patient's chart as a report, without importing discrete data.
* **Sign Off & Import** – files the document and allows you to select and import discrete data (demographics, allergies, problems, immunizations, medications) into the Clinical Profile, just like other CCD/CCDA imports.
* For **PDFs and images** in the Outside Care viewer:
* These are **view-only** in the viewer.
* To retain them in the chart, you must **download** the file and **drag-and-drop** it into the chart to file it as a Report.
Elation has no control over gaps or omissions in what other organizations share.
## Direct messaging & Elation Connect
### What's in an outbound Direct message
When you send a Provider Letter or Referral and the yellow banner indicates **Direct messaging**, Elation transmits a secure Direct message that typically includes:
* The **Letter/Referral body** text.
* Any attached chart records that are supported for Direct (e.g., visit notes, reports, labs, summaries).
* An automatically attached **CCDA file** for the patient's data, when supported by the recipient.
The receiving EHR decides:
* Whether to show the message body as a note, inbox item, or both.
* Whether to store attachments as scanned documents.
* Whether and how to parse the CCDA into their structured chart.
### What you see for inbound Direct messages
When you receive a Direct message in Elation:
* Incoming messages appear in:
* **Provider Letters inbox** on Practice Home; and/or
* **Requiring Action** in the patient's chart.
* Any attached CCD/CCDA file appears as a **Patient Summary** above the Direct message.
* Behavior differs by chart status:
* **No existing chart** – Elation creates a new chart and can automatically populate the Clinical Profile from the CCD/CCDA.
* **Existing chart** – Elation keeps the CCD/CCDA as a Patient Summary; you choose whether to import structured sections.
You can always:
* Open the Direct message to see **exactly** what text and attachments were received.
* Open the associated Patient Summary to see what was shared in the CCD/CCDA, and optionally import sections.
### What Elation Connect recipients can see
When you address a Provider Letter or Referral to a **non-Elation contact** with fax and/or email, Elation can invite that contact to **Elation Connect**, our secure provider portal:
* Connect is a **read-only** portal: it stores patient charts that contain only the records you sent from Elation, not your full internal chart.
* A Connect user can:
* View the **Letter/Referral** and its attachments.
* Download those records to transfer into their own system.
* Reply back to you; replies come into your Provider Letters inbox and the patient's chart.
\*\*Connect users never receive live access to your Elation chart. They only see the specific snapshot (Letter + attachments) that you chose to send for that patient.
## Elation Patient Passport (patient portal)
### Default patient-visible data
Once a patient registers for **Elation Patient Passport**, they see:
* Practice contact information.
* Last and next appointment dates.
* Key demographics and contact preferences.
* The Clinical Profile (problems, allergies, medications, immunizations, history, etc.), **excluding** items marked as confidential.
* A **visit summary** for every signed visit note, which includes vitals, procedures, tests/treatments (including referrals, medications, and diagnostic test orders), care plan/instructions, and follow-up details.
* Any **Patient Letters** and attachments you send them (e.g., lab reports, imaging reports, handouts).
Visit summaries and Clinical Profile content are shared automatically once Passport is enabled for the patient; you do **not** need to attach them manually each time.
### What is not automatically shared
Patients are **not** automatically granted access to every record in the chart. For example:
* Individual lab reports, imaging reports, and other Reports are **not** visible by default.
* Specific visit note sections or chart items tagged as **Confidential** are never exported in CCDA files and are not surfaced via Patient Passport sharing.
To share those items, your practice must intentionally:
* Attach reports or notes to a **Patient Letter**, or
* Include them in a CCDA export you share directly with the patient.
### Messaging and attachments from patients
If you allow two-way messaging:
* Patients can send new messages from Passport and attach files (e.g., outside records or photos).
* Replies and attachments arrive as Patient Letters in your Practice Home; you can file attachments directly into the chart as Reports.
You can also configure Passport as **one-way** (you push information out but do not allow patients to initiate messages) via the Patient Passport Messages settings.
## Where to verify "what was sent"
Here's where clinicians and staff can double-check outbound and inbound data:
* **CCDA exports** –
* Single-patient exports: downloaded .zip file on your workstation, plus a record in the patient's Chronological Record indicating the type of export (Complete Record, Customized, Referral, etc.).
* Bulk exports: Patient List report -> **Download CCDA**, with password-protected .zip file and audit trail in the report UI.
* \*\*Carequality (Outside Care) –
* Use the **Outside Care** button in the Clinical Profile to re-open the viewer and see exactly which documents are available and what you previously filed or imported.
* **Direct messages & Elation Connect** –
* The signed **Provider Letter/Referral** in the patient's Chronological Record shows the final message body, attachments, and delivery method (Direct, fax, Elation, Connect).
* Sent faxes and Connect invitations show status such as **Fax Sent** or **Letter and its attachments will be faxed,** with error details for failures.
* **Patient Passport** –
* The **Patient Letters** and visit summaries in the patient's chart mirror what the patient can see; if a record is not attached to a Patient Letter or included in a visit summary, it is not automatically visible in Passport.
Use these locations to answer patient or partner questions about "what you sent" vs what their system or portal is currently showing.
## Related Articles
* [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types)
* [Patient Chart Guide - Importing patient information from another EHR (CCD/CCDA Format)](/articles/import-patient-information-from-another-ehr-c-cda-format)
* [Elation-Carequality Integration Introduction](/articles/Carequality-Integration-Introduction)
* [Letter & Referral Guide - Sending and receiving Direct messages](/articles/how-to-use-direct-messaging)
* [Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Letter & Referral Guide - Accessing patient information sent by an Elation EHR user](/articles/access-patient-information-securely-shared-by-an-Elation-EHR-user)
* [Questions of the Month - Oct, Nov, Dec 2024](/articles/Questions-of-the-Month-Oct-Nov-Dec-2024)
* [Promoting Interoperability (MIPS) - Provider to Patient Exchange](/articles/Promoting-Interoperability-MIPS-Provider-to-Patient-Exchange)
* [Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
* [Questions of the Month - March 2025](/articles/Questions-of-the-Month-March-2025)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
# South Carolina State- SIMON- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/South-Carolina-State-SIMON-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the South Carolina Statewide Immunization Online Network [SIMON] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with South Carolina's Statewide Immunization Online Network (SIMON).
## What is the SIMON Immunization Registry Interface?
The SIMON Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to SIMON; South Carolina State's Statewide Immunization Online Network. Practices can also query SIMON for vaccination history or forecast.
## Why is the SIMON Immunization Registry Interface valuable?
With the SIMON Immunization Registry Interface, practices no longer need to separately log in to SIMON to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to SIMON. You can also pull vaccination history for specific patients from SIMON to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & SIMON
The Elation Team will assist you with initiating interface with SIMON. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
* Number of practice locations and the addresses for each location if you have multiple office locations
* If you have multiple office locations but not all of them are registered with SIMON, please register each location here: [https://simon-qa.dhec.sc.gov/simon\_qa/Onboarding/UserRegistration](https://simon-qa.dhec.sc.gov/simon_qa/Onboarding/UserRegistration)
## How to submit vaccination data to SIMON using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to SIMON. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using SIMON
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# South Dakota State- SDIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/South-Dakota-State-SDIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the South Dakota Immunization Information System [SDIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the South Dakota Immunization Information System (SDIIS).
## What is the SDIIS Immunization Registry Interface?
The SDIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to SDIIS, the South Dakota Immunization Information System. Practices can also query SDIIS for vaccination history or forecast.
## Why is the SDIIS Immunization Registry Interface valuable?
With the SDIIS Immunization Registry Interface, practices no longer need to separately log in to SDIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to SDIIS. You can also pull vaccination history for specific patients from SDIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & SDIIS
The Elation Team will assist you with initiating interface with SDIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
* Confirmation that your practice has registered with SDIIS
* Whether you are looking to submit vaccinations and query records from SDIIS, or just query records from SDIIS
If you would like to submit vaccination data to SDIIS (not query-only), testing is required before the interface can go live. Elation will coordinate the testing process with you after receiving your request. No testing is required for query-only interfaces.
## How to submit vaccination data to SDIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to SDIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using SDIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State's registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
Vaccination records submitted through Elation can only be edited or deleted directly within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Support Guide - Whitelisting Elation's web domain for email communications
Source: https://help.elationhealth.com/articles/Support-Guide-Whitelisting-Elation
This article describes workflows for ensuring you will always receive Elation's email communications.
## Overview
### Why is it necessary to whitelist Elation's domain?
Elation's main forum of communication is via email. This includes:
* EHR notifications
* Support communications
* Newsletters
* Webinar notifications
Whitelisting Elation's web domain ensures that emails from Elation are delivered to your inbox without being marked as spam.
## Workflow Instructions
Below are instructions on how to whitelist a domain for the popular email clients or services. Keep in mind that the exact steps may vary slightly depending on the version of the email client or service you're using, but the general process should be similar.
### Google (Gmail)
1. Open Gmail and log in to your account.
2. In the upper right corner, click on the gear icon (Settings) and select **See all settings.**
3. Go to the **Filters and Blocked Addresses** tab.
4. Scroll down and click on **Create a new filter.**
5. In the **From** field, enter the domain *elationhealth.com* as the domain you want to whitelist
6. Click on **Create filter.**
7. Check the box that says **Never send it to Spam.**
8. Click on **Create filter** again to save the changes.
### Outlook/Hotmail
1. Log in to your Outlook/Hotmail© account.
2. Click on the **Settings** gear icon in the top right corner and select **View all Outlook settings.**
3. In the left pane, select **Mail** and then **Junk email.**
4. Under the **Safe senders and domains** section, click on **Add.**
5. Enter the domain *elationhealth.com* as the domain you want to whitelist.
6. Click on **Add** again, then click **Save** to save your changes.
### Microsoft Outlook (Desktop)
1. Open Outlook©.
2. Click on **File** -> **Options.**
3. In the Outlook Options window, click on **Mail** in the left pane.
4. Under the **Junk Email** section, click on **Junk Email Options.**
5. In the Junk Email Options window, go to the **Safe Senders** tab.
6. Click on **Add** and enter the domain *elationhealth.com* as the domain you want to whitelist.
7. Click **OK** to save your changes.
### Yahoo Mail
1. Log in to your Yahoo Mail© account.
2. Click on the gear icon (Settings) in the upper right corner and select **More Settings.**
3. In the left pane, click on **Filters.**
4. Click on **Add** to create a new filter.
5. Give your filter a name.
6. In the **Set rules** section, select **From** and enter the domain *elationhealth.com* as the domain you want to whitelist.
7. Under **Then move the message to this folder** select **Inbox.**
8. Click on **Save** to save the filter.
### Apple Mail (macOS/iOS)
1. Open the Mail app on your Mac or iOS device.
2. Click on **Mail** in the menu bar and choose **Preferences** (on macOS) or go to **Settings** -> **Mail** (on iOS).
3. Go to the **Junk Mail** section.
4. Click on **Add** (macOS) or **Blocked Sender Options** (iOS).
5. In the pop-up window, enter the domain *elationhealth.com* as the domain you want to whitelist.
6. Click **OK** or **Done** to save your changes.
# Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format
Source: https://help.elationhealth.com/articles/Supported-Elation-CCDA-types
Learn more about using Elation to share patient Clinical Care Summaries in C-CDA (CCDA) format.
## Overview
### What are C-CDA (CCDA) files?
CCDA stands for Consolidated Clinical Data Architecture and it is used to create documents and standardize the content and structure of clinical care summaries. CCDA files allow you to securely transfer medical records between EHR systems. All Certified EHR systems, like Elation, are required to allow providers to import and export CCDA files into and out of the EHR.
CCDA files generated by Elation will contain the following information:
* Reason for Referral
* Allergies, adverse reactions, alerts
* History of medication use
* Problem List
* Encounters
* Immunizations
* Vital Signs
* Social History
* History of Procedures
* Implantable Devices
* Relevant diagnostic tests and/or laboratory data
* All structured lab test values in signed lab results.
* Functional Status
* Mental Status
* Assessments
* All data included in the main bullet points of the Assessments section in signed visit notes.
* Plan of Care
* All data included in the main bullet points of the Care Plan section in signed visit notes.
* Goals
* All data included in the sub-bullet points of the Care Plan section in signed visit notes.
* Health Concerns
### What are the benefits of C-CDA (CCDA) files?
C-CDA (CCDA) files allow providers and patients to securely transfer clinical information between different electronic health record systems when patients move between providers or institutions that use different electronic health record systems. You can share data C-CDA (CCDA) files with a patient directly to share with a provider on another EHR system or you can use C-CDA (CCDA) files to report data to registries or health information exchanges (HIEs) for quality reporting.
Some systems, like Elation, can even support importing data from CCDA files as structured data to assist with quicker and more accurate documentation. Review our [Patient Chart Guide- Importing patient information from another EHR (CCD/CCDA Format)](/articles/import-patient-information-from-another-ehr-c-cda-format) article for information about importing CCDA files received from other providers or institutions.
## Workflow Instructions
### Exporting C-CDA (CCDA) files for multiple patients
**ADMIN ONLY** In order to bulk export C-CDAs (CCDAs), you must have Admin level privileges. To become an Admin, you must ask an existing Admin level user in your practice (most likely a primary provider level account holder) to grant you privileges via the Manage Accounts Settings page. [Click here for more information about administrative privileges](/articles/administrative-privileges) .
You will use Elation's Patient List report functionality to generate C-CDA (CCDA) files in bulk for multiple patients. The bulk export will provide you with a password protected .ZIP file that you can download to your computer. When the file is unlocked and the contents are extracted, there will be folder of individually labeled CCDA files for each patient.
1. From the **Reports** menu in the blue navigation bar, click **Patient List**.
![Reports menu open in Elation's navigation bar with "Patient List" highlighted, the first option in the dropdown list.]()
1. Click **Generate List** to view a list of all patient charts for your practice. You can also use filters to narrow down the list of patients. Review the [Patient List Report Guide](/articles/find-patients-with-elations-patient-list) to learn more about filtering if needed.
2. Click **Download** -> **Download CCDA**.
![Patient List report showing the Download dropdown menu open with "Download CCDA" highlighted and outlined in red, alongside "Download CSV" and "Schedule a CCDA download" options.]()
1. Create and enter a password (twice) to protect the patients information contained in the .ZIP file that will be created from this export. You will need to securely share this password with the recipient of the C-CDA (CCDA) files if applicable.
2. Once you enter a password, the bulk C-CDA (CCDA) file will be generated and available to download.
!["Download your CCDA file" dialog showing "Your CCDA is ready." message with a "Download CCDA" button, indicating the bulk export is complete and ready to download.]()
If there are a lot of patient charts or a lot of clinical information in your patients' charts, it may take more than a few minutes for the bulk C-CDA file to be generated. Keep the Patient List Report window open until you see the download prompt.
##### Scheduling a CCDA download
To manage time efficiently and minimize interruption to your workflow, use the **Schedule a CCDA download** option to schedule a CCDA download during off-work hours. You can choose a specific date and time for the download or schedule the download for a specific number of days into the future.
!["Password protect your CCDA file" dialog with "Download on" selected, date set to 03/07/2022 at 04:30 PM, and a Schedule button.]()
Create and enter a password (twice) to protect the patients information contained in the .ZIP file that will be created from this export. Once you enter a password for the .ZIP file, make sure you copy the URL for the download so that you can download the file once it is ready.
!["Generating your CCDA file" dialog showing download scheduled for Mar 7th, 2022 at 4:30 pm, with "this URL" link highlighted and a Copy URL button.]()
### Exporting a C-CDA (CCDA) file for a specific patient
You can generate and export C-CDA (CCDA) files for specific patients directly from the patient's chart in Elation. You will have the following options for export:
* [Complete Record](#complete_record)
* [Customized Record](#customized_record)
* [Referral Record](#referral_record)
* [Progress Notes](#progress_note)
* [Care Plan](#care_plan)
If you are using the Elation Note, only data from corresponding standard blocks will be included in the export.
* Custom blocks must be nested inside standard blocks to ensure ensure that custom block data is included in the parent block's data class for USCDI/CCDA. For example, a custom block nested in allergies will have its results included in the allergies data class for the CCDA export.
#### Initiating an export from the patient's chart
1. From the patient’s chart, use the gray navigation bar to select **More** -> **Data Exchange**.
![The "More" menu expanded in a patient chart's gray navigation bar, with "Data Exchange" highlighted and indicated by a red arrow.]()
1. Select one of the **Export ...... (C-CDA)** options (see below) and wait for .ZIP file for the patient to download to your computer/laptop.
![Data Exchange Functions dialog open on a patient chart, showing "Export Entire Health Information (EHI)" button highlighted in blue at the top, with Export Complete Record, Customized Record, Referral Record, Progress Notes, Care Plan, Export QRDA1, Public Health Sharing, and Audit Logs options below.]()
1. You will find C-CDA file saved to the downloads location as specified by your web browser (usually it is a **Downloads** folder or the **Desktop**).
##### Export Entire Health Information (EHI)
The **Entire Health Information (EHI)** export is aligned to the
[regulatory criteria](/articles/EHI-Export-Criteria)
that requires all patient health information stored at time of export to be exported at the time of request by a patient. At this time, all data pertaining to the patient, excluding the sections outlined below, will be exported for single patient exports. Please view Elation's Designated Record Set
[here](/articles/EHI-Export-Criteria)
for more information on the data included in EHI Exports.
Data that is excluded from EHI exports:
* Files in Elation that can be tagged as ‘Keep this Confidential’ (e.g., orders and visit notes) or **Mark Confidential** (e.g., reports).
* Free text in the **Confidential** section of the Clinical Profile.
* Free text in the **Notes and Chart Management** section in the Demographic Dialog.
* Free text in the **Notes** section of our Elation Billing product.
**Exception:** The **Entire Health Information (EHI)** export has a different workflow than the other exports. After you click **Export Entire Health Information (EHI)** , a confirmation box will appear. Click **Export Patient EHI** in the confirmation box to request an export. Afterwards, you will receive two emails at the email listed in the confirmation box. The emails will have the subject line **ACTION REQUIRED: Elation Data Export**. One email will contain a download link for the export and the other email will contain the password to unlock the file after you download it. You will have **6 days** to download the file before the download link expires. You can optionally choose to email a copy of the export to the patient by checking off the **Also share with patient** box. We recommend verifying the patient’s email address before sending them the export.
##### Complete Record export
The
*Complete Record*
export will automatically include the following information as long as it is available in the patient's chart (and as long as the record is not marked as **Confidential**).
* Reason for Referral
* Allergies, adverse reactions, alerts
* History of medication use
* Problem List
* Encounters
* Immunizations
* Vital Signs
* Social History
* History of Procedures
* Implantable Devices
* Relevant diagnostic tests and/or laboratory data
* Functional Status
* Mental Status
* Assessments
* Plan of Care
* Goals
* Health Concerns
#### Customized Record export
The \*\*Customized Record \*\* export will allow you to manually select which sections of the chart you would share (as long as the record is not marked as **Confidential**). The specific sections available are:
* Practice's contact information
* Assigned provider's name
* Demographics
* Allergies/Intolerances
* Problems
* Cognitive/Functional Statuses
* Smoking Status
* Medications
* Immunizations
* Lab Results
* Chief Complaint
* Encounter Diagnoses
* Care Plan
* Instructions
* Procedures
* Vitals
* Insurance
#### Referral Record export
The Referral Record export shares all relevant information needed when referring a patient to another provider or institution (as long as the information is not marked as **Confidential**). The information included in the export are:
* Practice's contact information
* Assigned provider's name
* Recipient's full name
* Reason for Referral
* Allergies, adverse reactions, alerts
* History of medication use
* Problem List
* Encounters
* Immunizations
* Vital Signs
* Social History
* History of Procedures
* Implantable Devices
* Relevant diagnostic tests and/or laboratory data
* Functional Status
* Mental Status
* Assessments
* Plan of Care
* Goals
* Health Concerns
#### Progress Notes export
The **Progress Notes** export will export all signed visit notes (that are not marked as **Confidential**). The information included in the export are:
* Practice's contact information
* Assigned provider's name
* Demographics
* Assessments
* Plan of Care
* Review of Systems
* Chief Complaint
* Objective
* Subjective
* History of medication use
* Vital Signs
* Problem List
* Physical Findings
* Allergies, adverse reactions, alerts
If you are using the Elation Note, only data from corresponding standard blocks will be included in the export.
* Custom blocks must be nested inside standard blocks to ensure ensure that custom block data is included in the parent block's data class for USCDI/CCDA. For example, a custom block nested in allergies will have its results included in the allergies data class for the CCDA export.
#### Care Plan export
The Care Plan export will export all care plan data within signed visit notes (that are not marked as **Confidential**). The information included in the export is:
* Practice's contact information
* Assigned provider's name
* Goals (goals) - the **Care Plan** section of any visit note that also has the Visit Note Category called **Care Plan** selected.
* Health Concerns (problems) - any visit note
* Interventions (care plan) - any visit note that also has the Visit Note Category called **Care Plan** selected.
* Health Status Evaluations/Outcomes (assessments) - the **Assessments** section of any visit note that also has the Visit Note Category called **Care Plan** selected.
If you are using the Elation Note, only data from corresponding standard blocks will be included in the export.
* Custom blocks must be nested inside standard blocks to ensure ensure that custom block data is included in the parent block's data class for USCDI/CCDA. For example, a custom block nested in allergies will have its results included in the allergies data class for the CCDA export.
## Related Articles
* [Letters & Referrals Guide- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
* [Patient Chart Guide- Importing patient information from another EHR (CCD/CCDA Format)](/articles/import-patient-information-from-another-ehr-c-cda-format)
* [Electronic Health Information (EHI) Export Criteria](/articles/EHI-Export-Criteria)
# Telehealth: Billing & Workflow Recommendations
Source: https://help.elationhealth.com/articles/Telehealth-Coding-and-Workflows-Recommendations
Guidance on the different types of telehealth services, telehealth coding and how to leverage Patient Passport.
If your practice is exploring alternative methods to remotely check-in with your patients and evaluate their health, there are a number of telemedicine services that may be reimbursable by CMS and private payers. CMS specifically categorizes virtual services into 4 groups: telehealth visits, virtual check-ins, eVisits, and (new) telephone-only E/M.
In this article, we will cover the differences between each of these telemedicine services and how to bill for them.
## Telehealth Billing Decision Tree
The below decision tree was designed to help you understand which virtual services your practice may be delivering today. For more information about each type of virtual service and the billing codes associated with each, please see the information at the bottom of this article.
![Decision tree to classify virtual encounters. Three paths based on care delivery method (video, telephone, secure message) lead to outcomes: Telehealth Visit, Telephone E/M, Virtual Check-in, eVisit, or not a billable encounter.]()
## Telehealth waivers in place due to the COVID-19 public health emergency
The government has expanded Medicare’s telehealth benefits under the 1135 waiver authority, the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Coronavirus Aid, Relief, and Economic Security (CARES) Act and CMS’ Interim Final Rule.
What does this mean for you?
* **Telehealth requirements for originating/distant site status of the physician and beneficiary waived.** Historical restrictions that prevented clinicians from being paid except under certain circumstances (ex. a patient must be from a rural area and present at an approved facility as the **originating site** of service) have now been lifted.
* **Telehealth reimbursement increased to be on par with in-person services.** As long as the COVID-19 Public Health Emergency (PHE) is in effect, clinicians can bill for telehealth services provided for dates of service starting March 6, 2020. Telehealth services are paid under the Physician Fee Schedule for the same amount as in-person services as long as the proper coding is submitted. See billing guidance below for more information about how to bill for facility vs. non-facility rates.
*
These policies are based on CMS standards. Always double check with the policies designated by other Payers to ensure you are following their coding guidelines for telehealth services.
* **HIPAA regulations loosened.** The government is now allowing clinicians to use everyday technology (FaceTime, Skype, etc.) to interact with patients during the Public Health Emergency, in good faith that practices will continue to exercise caution under HIPAA.\*
* **Out-of-state providers do not need to be licensed in the state** where they are providing services if they are licensed in another state.\*
* **Telehealth and virtual check-in services can be provided to new patients.** To the extent that the 1135 waiver requires an established relationship, the HHS will not conduct audits to ensure that a prior relationship existed for claims submitted for telehealth visits during this public health emergency. Virtual check-ins may now be completed for new patients as opposed to only established beneficiaries. Note that the same does not apply to eVisits.
* **Remote staff supervision allowed.** Clinicians can supervise staff members virtually instead of needing to be on-site.
* **New telephone/audio-only E\&M codes are now reimbursable by CMS.** For the duration of the COVID-19 Public Health Emergency, CMS will be reimbursing care provided via phone/audio-only using the following newly accepted CPT® codes: 98966-98968 for qualified non-physicians and 99441-99443 for physicians. These codes allow for a greater amount of time spent to be coded for at a higher reimbursement rate than the existing G2012 telephone-only code.
\**Additional information applicable to the above waivers:*
* *The above updates apply to CMS Medicare FFS beneficiaries. Private payers may have specific coding requirements for telehealth, and states may have their own rules and regulations. Contact your state’s department of health or payer to confirm state- or payer- specific requirements.*
* *During the COVID-19 public health emergency, some states and payers are allowing telemedicine services to be provided via audio only/telephone. An example of this is California - where the Department of Managed Health Care released an all payer letter (and this follow up letter) stating that audio visits will be reimbursed the same as in-person E\&M, provided requirements are met for care delivery. Contact your state’s department of health or payer to confirm state-specific requirements.*
* *States may have their own requirements protection of healthcare data and licensure requirements.*
## Setting up your Elation account for telehealth
To learn more about how you can use Elation to deliver care for your patients through telemedicine with minimal disruption to care delivery and to the financial health of your practice, please see our step-by-step guide[here](https://docsend.com/view/g85h4xn). This guide covers how to complete a patient encounter through telemedicine and how to set-up your Elation account to support this.
Below are several quick set-up steps that you can take in your Elation account today so that you can begin seeing patients and billing for telehealth services:
| **Category** | **Set-up Step** | **Why?** |
| --------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Appointments | [Create a telehealth appointment type\*](/articles/calendar-and-booking-settings#appt_types) | Easily see which appointments on your calendar are telehealth |
| [Set-up your booking site](/articles/Patient-Booking-Site) | Allow your patients to self-schedule based on your availability for convenience and time-savings | |
| [Enable appointment reminders](/articles/appointment-reminders) | Save your practice time by automating appt reminders to your patients | |
| Completing the encounter | Use your Elation supplied HIPPA-compliant [Zoom](/articles/Elation-Telehealth-powered-by-Zoom) ® account. | The Elation-Zoom integration is covered under a Business Associate Agreement and fully HIPPAA compliant. |
| Documentation | [Create a telehealth, phone and/or eVisit visit note category](/articles/visit-note-categories). Tie this to your telehealth appointment type! | Label your visits by type in the chronological order for easy search capabilities |
| FFS Billing | [Create service locations as needed (POS 10 for home, POS 2 for non-home)](/articles/billing-settings---service-locations--procedure-codes) (See the [Telehealth visits requirement](#TelehealthVisits) below for more details) | For proper claim submission. |
| [Add telehealth CPT codes](/articles/billing-settings---service-locations--procedure-codes) | For easy search capability within the visit note and bill, and for proper claim submission | |
| [Collect patient responsibility digitally from patients](/articles/using-elation-to-securely-collect-patient-payments) (optional) | For collection of patient responsibility using Elation's secure-payment collection integration powered by Stripe®. | |
| [Enable patient invoicing](/articles/patient-invoicing) (optional) | To enable easy generation of invoices for your patients to submit to their insurance company for reimbursement (if you are collecting payment upfront) | |
| Non-Member / Flat-Fee Billing | Create a rate for telehealth visits | Establish your rate for these services |
| [Create a mechanism to track non-member patients](/articles/adding-patient-tags) (ie. patient tag) | Easily track which patients will be billed via flat-fee | |
| Passport | Set up Passport and communicate with your patients via Passport. [Invite your patients to Patient Passport](/articles/elation-patient-passport-an-introduction#howdoigetstarted) • [Enable “Patient Initiated Messages”](/articles/elation-patient-passport-an-introduction#7) and adjust your message routing settings • [Send individual messages to your patient via “Patient Letters”](/articles/elation-patient-passport-an-introduction#3) • [Send bulk messages to your patient panel via “Bulk Letters”](/articles/introduction-to-bulk-letters) | Use Passport as a secure method to communicate with your patients. Allow patients to initiate messages to your practice, which may be reimbursable virtual services. |
## Setting up your integrated billing system for telemedicine
Our team has created resources that will guide you through the necessary settings page updates to bill for telehealth. Each guide linked below provides detailed step-by-step instructions to ensure that your practice can successfully send telehealth charges from Elation to your integrated practice management system (PMS).
* [Tebra](/articles/Setting-up-your-Elation-account-for-telehealth#Tebra)
* [Akamai](/articles/Setting-up-your-Elation-account-for-telehealth#Akamai)
* [CollaborateMD](/articles/Setting-up-your-Elation-account-for-telehealth#CollaborateMD)
* [Practice Suite](/articles/Setting-up-your-Elation-account-for-telehealth#PracticeSuite)
* [ConnxtMD](/articles/Setting-up-your-Elation-account-for-telehealth#ConnxtMD)
* [AdvancedMD](/articles/Setting-up-your-Elation-account-for-telehealth#AdvancedMD)
* [HealthBiller](/articles/Setting-up-your-Elation-account-for-telehealth#HealthBiller)
## Types of Virtual Services
Breakdown of Virtual Service Types & Requirements
![Comparison table of four virtual service types — Telehealth, Virtual Check-ins, eVisits, and Telephone E/M — showing communication mechanism, requirements and waivers, and billing codes for each.]()
### Telehealth Visits
Telehealth visits are full-visits which require audio-visual, real-time, two-way interactive communication systems. Out of the three types of virtual services covered in this help center article (telehealth, virtual check-ins, eVisits), telehealth visits typically provide the highest reimbursement rate for Medicare/Medicaid. You can use Elation's HIPAA-compliant, [integrated video](/articles/Elation-Telehealth-powered-by-Zoom) feature powered by Zoom to complete your telehealth visits. See table above for additional requirements of Telehealth Visits.
Important Notes: CMS’ updated coding recommendation to earn the proper reimbursement rates, as of 1/1/2022, is to use the 99202-99205, 99211-99215 or CMS AWV G0438-G0439 codes + a 95 modifier + the POS code for the location where the patient received health related services
Previously, CMS’ recommendation was to use these CPT codes with modifier 95 + POS 02 (telehealth).
These policies are based on CMS standards. We recommend confirming telehealth coding requirements with each Payer before you submit your claims.
### Virtual Check-ins
Virtual Check-ins are reimbursable services for brief communications between providers and patients for specific purposes. These services are not restricted by originating site and other Medicare telehealth regulations. They can be provided when patients are in their homes, regardless of public health emergency declaration. These services can be rendered via telephone, email, or Elation’s Patient Passport.
While Virtual Check-ins must be patient initiated, providers can let patients know that they can reach out through this method to receive care, and patients may agree to change a previously scheduled face-to-face visit to a virtual encounter. Time spent should be documented in the note, and information that can be stored and shared should be stored in the patient’s electronic health record. See table above for additional requirements of Virtual Check-ins.
Billable codes and CMS Physician Fee Schedule Non-Facility estimated prices are listed below. Please note that these reimbursement rates may differ based on your locality for Medicare. Please check your health plan provider network representative for accepted codes and contracted rates, as coding requirements may differ by payer.
| Communication Method | Code | Estimated Reimbursement\* |
| -------------------------------------------- | ----- | ------------------------- |
| Phone call (audio only) | G2012 | \$14.80 |
| Image or video submitted by patient reviewed | G2010 | \$12.27 |
### eVisits
eVisits are reimbursable services that occur between an established patient and their provider through an online HIPAA-compliant portal, like Elation Passport. These services are not restricted by originating site and other Medicare telehealth regulations. They can be provided when patients are in their homes, regardless of public health emergency declaration.
eVisits must include clinical decision making and evaluation, assessment and management that would have otherwise been provided in the office. Simply responding to the portal or secure email messages does not qualify as a billable service.
While eVisits must be patient initiated, providers can let patients know that they can reach out through this method to receive care, and patients may agree to change a previously scheduled face-to-face visit to a virtual encounter. Time spent should be documented in the note, and information that can be stored and shared should be stored in the patient’s electronic health record. See table above for additional requirements of eVisits.
Billable codes and CMS Physician Fee Schedule Non-Facility estimated prices are listed below. Please note that these reimbursement rates may differ based on your locality for Medicare. Please check your health plan provider network representative for accepted codes and contracted rates, as coding requirements may differ by payer.
| Requirement | Code | Estimated Reimbursement\* |
| --------------------------------- | ----- | ------------------------- |
| 5-10 min | 99421 | \$15.52 |
| 11-20 min | 99422 | \$31.04 |
| 21+ min | 99423 | \$50.16 |
| Qualified nonphysician, 5-10 min | G2061 | \$12.27 |
| Qualified nonphysician, 11-20 min | G2062 | \$21.65 |
| Qualified nonphysician, 21+ min | G2063 | \$33.92 |
### Telephone-Only E/M
Telephone-only E/M codes are newly reimbursable services (for the extent of the COVID-19 public health emergency only) that occur between a patient and their provider through an audio-only/telephone call. The codes require assessment and management of a problem over the phone and require medical necessity to be billable. These codes allow for a greater amount of time spent to be coded for at a higher reimbursement rate than the existing G2012 telephone-only code for a Virtual Check-in. See table above for additional requirements of these telephone-only E/M codes.
Under CMS’ interim final rule, Medicare is also extending the definition of qualified non-physician practitioner for the CPT codes 98966-98968 to include LCSWs, clinical psychologists, physical therapists, occupational therapists, and speech language pathologists -- when the visit pertains to a service within the benefit category of those practitioners. These telephone E/M services may also be provided to family/guardians of Medicare beneficiaries, regarding the care of the beneficiary.
Billable codes are listed below. Please check your health plan provider network representative for accepted codes and contracted rates, as coding requirements may differ by payer.
| Requirement | Code |
| --------------------------------- | ----- |
| Physician, 5-10 min | 99441 |
| Physician, 11-20 min | 99442 |
| Physician, 21-30 min | 99443 |
| Qualified nonphysician, 5-10 min | 98966 |
| Qualified nonphysician, 11-20 min | 98967 |
| Qualified nonphysician, 21-30 min | 98968 |
\*\*This article is provided for instructional purposes only. Elation Health does not support or guarantee anything other than relay useful information from various organizations. Elation Health also does not provide support for third-party technologies. We recommend consulting your coding guidelines or \*
AMA
*for the most up to date information.*
*CPT copyright 2022 American Medical Association. All rights reserved.*
*Copyright ©2022 Zoom Video Communications, Inc. All rights reserved.© 2022 Stripe, Inc. All rights reserved.*
## Additional Resources from CSM
* [2022 Medicare Physician Fee Schedule Final Rule](https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2022-medicare-physician-fee-schedule-final-rule)
* [New/Modifications to the Place of Service (POS) Codes for Telehealth](https://www.cms.gov/files/document/mm12427-newmodifications-place-service-pos-codes-telehealth.pdf)
* [AMA special coding advice during COVID-19 public health emergency](https://www.ama-assn.org/system/files/covid-19-coding-advice.pdf)
* [COVID-19 Frequently Asked Questions on Medicare Fee-for-Service Billing](https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf)
## Related Articles
* [Adding Patient Tags](/articles/adding-patient-tags)
* [Automated Appointment Reminders](/articles/appointment-reminders)
* [Getting started with Patient Passport](/articles/elation-patient-passport-an-introduction)
* [How to set up Patient Invoicing](/articles/patient-invoicing)
* [How to set up your Elation Calendar](/articles/calendar-and-booking-settings)
* [How to set up your Patient Booking Site](/articles/Patient-Booking-Site)
* [Elation Integrated Video- Connecting with patients using video](/articles/Elation-Telehealth-powered-by-Zoom)
* [Visit Note Types](/articles/visit-note-categories)
# Tennessee State- TennIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Tennessee-State-TennIIS-Immunization-Registry-Interface-Guide
This article will describe how you can submit vaccination data to the Tennessee Immunization Information System [TennIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Tennessee Immunization Information System (TennIIS).
## What is the TennIIS Immunization Registry Interface?
The TennIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to TennIIS; the Tennessee Immunization Information System. Practices can also query TennIIS for vaccination history or forecast.
## Why is the TennIIS Immunization Registry Interface valuable?
With the TennIIS Immunization Registry Interface, practices no longer need to separately log in to TennIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to TennIIS. You can also pull vaccination history for specific patients from TennIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & TennIIS
The Elation Team will assist you with initiating interface with TennIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
* Did you have a TennIIS interface live on another EHR? Which EHR?
* Is your practice already set up in TennIIS? If yes, what is your Organization ID?
* User Tip: Your TennIIS Organization ID is typically found on the Organization Detail page in TennIIS and is a series of numbers. It is not your PIN number.
* Does your practice have an organizational NPI?
* Does your practice administer vaccinations at multiple locations?
* Does your practice participate in Vaccines for Children (VFC)?
* Does your practice have a provider participating in the Pandemic Provider Program?
## How to submit vaccination data to TennIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to TennIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using TennIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
# Texas State- ImmTrac2- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Texas-State-ImmTrac2-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Texas State Immunization Registry [ImmTrac2] directly within Elation.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Texas State Immunization Registry known as ImmTrac2.
## What is the ImmTrac2 Immunization Registry Interface?
The ImmTrac2 Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to ImmTrac2, the Texas State Immunization Registry. Practices can also query ImmTrac2 for vaccination history or forecast.
## Why is the ImmTrac2 Immunization Registry Interface valuable?
With the ImmTrac2 Immunization Registry Interface, practices no longer need to separately log in to ImmTrac2 to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to ImmTrac2. You can also pull vaccination history for specific patients from ImmTrac2 to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & ImmTrac2
The Elation Team will assist you with initiating interface with ImmTrac2. To notify us of your interest, please fill out this [Registration of Intent Form](/files/immunization-tx-immtrac2-registration.pdf) for ImmTrac2 and then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport). Select **Immunization Registry** as the **Request Type**, and send the following information to Elation. Afterwards a member of the Elation Team will collect the completed Intent form from you.
1. What is your Texas IIS ID?
* If you need to retrieve your Texas IIS ID, email [immtracmu@dshs.texas.gov](mailto:immtracmu@dshs.texas.gov) for assistance.
2. Are you currently submitting vaccinations to ImmTrac2?
3. Do you have an ImmTrac2 login? You must have one in order to utilize the interface. Please register for one [here](https://www.dshs.texas.gov/immunize/immtrac/) if needed.
## How to submit vaccination data to ImmTrac2 using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to ImmTrac2. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
Vaccination consent is not submitted with the Texas vaccination submissions. You must have patients sign the Texas ImmTrac-specific consent form for records and manually update the consent status in ImmTrac as needed.
## How to query for vaccination history/forecast using ASIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Immunization Registry Interface Introduction](/articles/Immunization-Registry-Interface-Introduction)
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Training: Clinical Workflows and Practice Operations
Source: https://help.elationhealth.com/articles/Training-Clinical-Workflows-and-Practice-Operations
In this article, we will share three training videos that will provide you with an overview of the before, during and after the visit workflows as well as best practices on using Elation for your Practice operations.
Below you will find three pre-recorded training videos that describe the before the visit, during the visit and after the visit workflows. One of the videos also describes the various administrative functionalities in Elation to assist with your Practice operations. These sessions are aimed at helping you understand the core functionalities of the software and guide you on how to connect various features together in your day-to-day workflows.
## Before the Visit & After the Visit
This training video will cover the various features you will need to prepare for a patient visit and follow up on after the visit responsibilities. This video is ideal for front office staff, anyone who manages appointments, faxes and patient communication. You can also skip to the following timeframes to view specific topics:
1. 1:07- Creating a New Patient Chart
2. 2:44- Finding Patient Charts
3. 4:13- Requiring Actions Queue
4. 6:55- Elation Schedule
5. 13:22- Appointment Reminders
6. 16:21- Fax Inbox Documents Management
* 20:17- Manually Add Lab Values to Lab Reports
7. 23:12- Drag & Drop Documents into the Patient Chart
* 25:20- Restore Deleted Reports or Visit Notes
8. 26:00- Patient Tags
9. 27:44- Document Tags
10. 29:57- Office Messages
11. 33:09- Patient Passport
* 36:01- Patient Passport Messages
12. 39:48- How to Contact Support
## During the Visit
This training video will walk you through the various features needed to document and complete a patient visit. This video is ideal for providers or anyone that manages clinical documentation and follow up for patients. You can also skip to the following timeframes to view specific topics:
1. 0:46- Finding the Patient Chart
2. 2:30- Navigating the Patient Chart
3. 5:18- Clinical Profile
4. 14:19- Visit Note Documentation
* 22:14- Managing Patient Medications
* 26:04- Medication History Download
* 30:25- Ordering Tests
* 35:51- Completing the Visit Note
5. 35:44- Provider Letters & Referrals
6. 40:36- Reviewing Lab Results
* 42:13- Manually Add Lab Values to Lab Reports
7. 42:33- Elation Integrated Video
8. 45:14- How to Contact Support
## Practice Operations
This training video will describe the various Administrative features in Elation and walk you through the customizations available within the Settings of the software. This video is ideal for anyone that manages office operations. You can also skip to the following timeframes to view specific topics:
1. 0:36- Administrative Reports
2. 0:36- Patient List Report
3. 2:49- Appointment Report
4. 3:37- Billing Report
5. 5:57- Calendar Settings (Patient Forms & Booking Site)
6. 5:57- Patient Forms
7. 9:05- Virtual Visits
8. 9:23- Appointment Types
9. 11:16- Calendar View
10. 11:37- Rooms
11. 11:47- Appointment Reminders
12. 12:48 Availability
13. 13:20- Booking Site
14. 14:58- Billing Related Settings
15. 14:58- Billing
16. 16:14- Practice Locations
17. 16:46- Insurance
18. 17:58- Other Practice Settings
19. 18:08- Patient Tags
20. 18:19- Document Tags
21. 18:28- Templates
22. 18:47- Print Headers
23. 19:08- Clinical Care Measure Settings
24. 19:36- Fax Usage & Settings
25. 19:49- Prescriptions
26. 19:57- Labs
27. 20:43- Lab Orders
28. 20:56- Provider Level User Settings
29. 20:56- Account Details
30. 21:21- Preferences
31. 21:52- Authorized Staff Delegates
32. 22:20- Patient Sharing Defaults
33. 22:42 Admin Level User Settings
34. 23:05- Manage Accounts
35. 24:03- User Groups
36. 24:36- Report & Visit Note Categories
37. 25:35- Patient Payments
38. 28:48- How to Contact Support
**Next Step**
\*\*Learn more about Elation in the \*\*
**Getting Started section of the Elation Help Center. If you have additional questions on your practice or organization's workflows, please reach out to Elation for further assistance.**
# Data Migration Guide- Transferring your data from your legacy EHR into Elation
Source: https://help.elationhealth.com/articles/Transferring-your-data-from-your-legacy-EHR-into-Elation
This article describes Elation’s standard offering for data migration and how to perform each option.
## Overview
### What is data migration?
Data migration is the process of transferring patient data from one EHR system to another EHR system.
### What are the benefits of transferring data from your legacy EHR into Elation?
Transferring your patient data from your legacy EHR into Elation has the following benefits:
* You can use historical data to build your Elation patient charts.
* You will not need to reference patient data in multiple locations because all your patient’s data will be available in your patient’s chart in Elation.
### How do you transfer data from your legacy EHR into Elation?
There are two options for transferring your data from your legacy EHR into Elation. Practices are encouraged to pursue both options if possible to maximize the amount of data that can be moved into Elation.
1. Elation’s complimentary data migration - Elation performs one import of each of the following data types as long as as the data meets our specifications:
* Demographics
* Appointments
* CCDAs
2. ‘Just-in-time’ manual migration - you manually move your data into Elation as patients are about to be seen in the office
## Migration Details & Instructions
### Elation’s complimentary data migration
Elation can perform one complimentary import of each of the following data types if the data meets our specifications.
* Demographics
* Appointments
* CCDAs
These bulk imports can save you time and ensure you have the historical data you need by go-live to start seeing patients. If you would like Elation to perform a bulk import of any of the below data types, please follow the instructions below to request your data from your legacy EHR and send it to Elation.
Reference the table below for more details about each data type.
| Data Type | Supported Formats | What kind of data does this import add to Elation? | What is required of the customer? | When is the data imported? |
| ------------ | ----------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------- | ------------------------------------------------------------------------ |
| Demographics | .csv, .xls, .xlsx, .txt | Patient demographics and Insurance | Send data in the supported format to Elation | 5 days prior to your **go-live** (i.e your first day charting on Elation |
| Appointments | .csv, .xls, .xlsx, .txt | Appointment Date & Time, Duration, Provider Scheduled, Description, Appointment Status | | |
| CCDAs | .xml | Discrete elements: Basic Demographics, Allergies, Problems, Immunizations, Medications All other data from the CCDA is stored as a read-only file in the patient’s chart. | | |
#### Step 1: Inquire how to export data from your legacy EHR
1. Ask your legacy EHR the following questions to understand what options they offer for requesting your data in bulk.
* How do I obtain demographics for all of my patients into a spreadsheet file? Can I generate this file from the EHR myself?
* How do I obtain CCDA files for all of my patients? Will I be able to export CCDA files in bulk or will I need to export for one patient at a time?
* How do I obtain future appointments into a spreadsheet file? Can I generate this file from the EHR myself?
* How do I export a copy of all of my patient charts? What type of records are included in this export and what format(s) do they come in? Can I export patient charts in bulk or will I need to export for one patient at a time?
* How long does it take to perform each of the 4 exports mentioned above?
2. Once you have and understand the answer to the questions above, share the details with your Elation Engagement Advisor.
#### Step 2: Export and share data from your legacy EHR with Elation
5 days prior to your Elation **go live**:
1. Export the **demographics**, **CCDAs** and **appointments** data from your legacy EHR.
2. Send the files to Elation through a secure URL that is provided by your Elation Engagement Advisor.
Elation’s team will review the data and, barring any issues, will import into your account by your **go live**.
*
If we find quality issues with your legacy EHR data, your migration timeline and **go live** date may be affected.
#### Step 3: Request a full data export from your legacy EHR
Besides exporting your demographics, CCDA, and appointment exports, you will need to request a
**full data export**
from your legacy EHR for record-keeping purposes. Wait until you ‘go-live’ and start seeing patients using Elation to make this request.
*
Data that you receive through this full export will not be imported into Elation by Elation’s team. If you wish to bring any additional data into Elation, you’ll need to use the [‘just-in-time’ manual migration process](#manual_migration) .
### Enhanced Bulk Document Import (paid add-on)
In addition to the complimentary data migration, Elation offers an **Enhanced Bulk Document Import** for practices that want to make their historical documents more accessible and actionable within Elation.
With this paid offering, Elation uses OCR and AI to parse the text of imported PDFs and scanned images and generate a summary of each document. This unlocks two capabilities that the standard bulk document import does not provide:
* **Full-text search in the Chronological Record.** The parsed text of each imported document is indexed and keyword-searchable. When you search the Chronological Record, matching imported documents appear in the results — not just documents whose titles match your search terms.
* **Clinical Insights integration.** AI-generated summaries of the 20 most recent imported documents are made available to Elation AI, so Clinical Insights can surface relevant historical information to support clinical decision making.
This offering is available to:
* New customers onboarding with Elation
* Existing customers bringing on additional locations or providers
To learn more or request this add-on, contact your Onboarding Manager or Customer Success Manager.
### ‘Just-in-time’ manual migration
With the **Just-in-time** migration method, you or a member of your practice manually adds data into Elation as patients are about to be seen. This method gives you complete control over the timing and outcome of your data import and allows you to exclude data for inactive patients.
#### Step 1: Inquire how to export data from your legacy EHR
Ask your legacy EHR the following questions to understand what options they offer for exporting your data in bulk. This helps expedite your data transfer workflows.
* How do I export a copy of all of my patient charts? What type of records are included in this export and what format(s) do they come in?
* How long does it take to perform a chart export?
* Can I export patient charts in bulk or will I need to export this data for one patient at a time?
#### Step 2: Import records on a rolling basis
Prior to a patient’s appointment,
[follow these linked instructions to manually upload data to your patient’s chart](/articles/filing-documents-to-a-patient-chart)
in Elation.
We typically see practices upload the following records but you can transfer as much data as you deem fit:
* Last visit note
* Most recent lab results
## Frequently Asked Questions
### Can patients view their migrated visits in Patient Passport?
Migrated visits are often imported as attached documents — such as PDFs or scanned chart files — rather than structured Elation visit notes. Because of this, they do not automatically appear in [Patient Passport](/articles/elation-patient-passport-an-introduction) the way visit notes documented directly in Elation do.
If a patient needs to review older visits, you can share those records directly by printing or downloading them, or by uploading them to the patient portal using your existing document-sharing workflow.
## Related Articles
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
* [Patient Chart Guide- Importing patient information from another EHR (CCD/CCDA Format)](/articles/import-patient-information-from-another-ehr-c-cda-format)
# Troubleshooting EPCS (Controlled Substances) Prescription Errors in Elation EHR
Source: https://help.elationhealth.com/articles/Troubleshooting-EPCS-Controlled-Substances-Prescription-Errors-in-Elation-EHR
## 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.
### 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.
### 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.
### 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.
### 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.
### 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.
### 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.
### 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.
### 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.
### 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.
### 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.
* Receive a rejection stating the sender does not meet controlled substance directory requirements. This indicates a directory‑listing issue with your EPCS registration that Elation Support needs to review; contact Support directly rather than repeating the troubleshooting steps above.
Reach Support in‑product or at [https://help.elationemr.com/s/contactsupport](https://help.elationemr.com/s/contactsupport).
## Related Articles
* [EPCS Sign Up Guide](/articles/how-to-complete-the-epcs-sign-up-process)
* [EPCS Token / Password Update Guide](/articles/how-to-update-your-epcs-token)
* [Prescriptions Guide - ePrescribing controlled substance medications](/articles/how-to-e-prescribe-controlled-substances)
* [User Accounts Guide- Setting up Elation EHR accounts and Provider account authentication](/articles/EHR-account-setup-and-Provider-account-authentication)
# Troubleshooting Failed Lab Orders in Elation EHR
Source: https://help.elationhealth.com/articles/Troubleshooting-Failed-Lab-Orders-in-Elation-EHR
## 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.
### 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.
### 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.
### 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).
### 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.
### 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.
### 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).
### 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.
### 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.
### 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](https://help.elationemr.com/s/contactsupport).
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Practice Home Guide- Checking for requiring action items](/articles/follow-up-outstanding-orders-referrals)
* [Lab Orders & Results - Using the regular Lab Order Form](/articles/Regular-Lab-Order-Form)
* [Lab Orders & Results - Managing lab vendors](/articles/Managing-lab-vendors)
* [Letter & Referral Guide - Faxing lab, radiology or other orders to vendors](/articles/efaxing-lab-and-radiology-orders)
# Troubleshooting MFA Login Issues and Account Lockouts in Elation EHR
Source: https://help.elationhealth.com/articles/Troubleshooting-Login-and-Account-Lockouts-Non-MFA-in-Elation-EHR
## Troubleshooting MFA Login Issues and Account Lockouts in Elation EHR
This guide helps practices resolve login problems caused by multi‑factor authentication (MFA), including lost devices, blocked codes, or factor errors. It also covers how Admins can reset factors so users can get back in quickly and securely.
### What this article covers
* MFA prompts (authenticator code, push approval, security key/biometric, or email code) that prevent login and how to recover access.
* How Admins can reset a user’s MFA factor(s), and what to do if the locked‑out user is the sole Admin at the practice.
* Best practices to prevent future MFA lockouts (e.g., set up multiple factors and choose the right factor per device).
### Quick diagnosis: Identify your factor and error
If you have multiple factors, use the dropdown (⏷) on the MFA screen to pick a different factor and attempt login again.
**Common symptoms by factor:**
* **Authenticator app:** 6‑digit code rejected or app on a device you no longer have.
* **Okta Verify:** push not received; use “enter code” instead and verify from the app.
* **Security key/biometrics:** browser/OS prompt fails; may need to unlock your password manager or use the device with Touch ID/Face ID configured.
* **Email code:** code not arriving; check spam or IT filtering (least secure option).
*Note: SMS/phone call codes are not supported by Elation due to security risks.*
### Fastest recovery paths by scenario
* **Lost or changed phone (Authenticator app or Okta Verify)**
* Ask an Admin at your practice to reset your MFA factors in Manage Accounts so you can set them up again at next login.
* If you’re the sole Admin, contact Elation Support; we’ll verify your identity and reset your factors for you.
* **Security key or biometric not working**
* Try on the device where the key/biometric is registered; if using a password‑manager‑stored key, sign into your password manager first so the browser can find the key.
* Use the factor dropdown to switch to another factor (e.g., Authenticator app) and log in; then update or re‑register the key in Settings later.
* **Okta Verify push not received**
* Choose **enter code** in Okta Verify and type the 6‑digit code from the app; or switch to another factor via the dropdown and log in.
* **Email authentication not working**
* Check spam/junk and email filtering; resend the code; if unreliable, log in with another factor and remove/re‑add Email Authentication (remember it’s the least secure option).
### Admin steps: Reset a user’s MFA so they can log back in
* Go to **Settings** → **Manage Accounts** → find the user → click **Reset Multi‑factor** next to their name. This clears their factors so they’ll be prompted to set up a new factor at next login.
* If the locked‑out person is the only Admin at your practice, have them contact Elation Support; we’ll verify their identity and reset the factors on their behalf.
### After a reset: Set up MFA again
* The user will be prompted to set up at least one factor at next login; we strongly recommend adding more than one (e.g., Authenticator app plus a security key/biometric) for backup.
* You can manage or add factors later in **Settings** → Security/MFA preferences (update or remove individual factors as needed).
### Using the right factor for the right device
* **Authenticator app (e.g., Google Authenticator):** reliable across devices; enter the 6‑digit code during login.
* **Okta Verify:** you can approve a push or enter a code; great if your organization uses Okta.
* **Security key or biometric (Touch ID, Face ID, Windows Hello, password‑manager key):** best for a single, personal device; set a second factor for mobile/alternate devices.
* **Email authentication:** available but least secure; may be blocked by filters; use only when other factors aren’t feasible and add a stronger backup factor.
### Helpful tips
* Select **Do not challenge me on this device for the next 24 hours** on the MFA screen if you want a 24‑hour grace period on that browser/device.
* Do not share accounts; each user must log in with their own unique credentials and set up their own MFA factor(s).
### Still locked out?
* If there’s an Admin available, ask them to reset your factors in Manage Accounts so you can set them up again at next login.
* If you are the sole Admin or can’t reach an Admin, contact Elation Support:
* Include your full name, practice name, best callback number, and your login email.
* We’ll verify your identity and reset factors for you.
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication Guide - Quick Start Guide](/articles/Multi-Factor-Authentication-Quick-Start-Guide)
* [Multi-Factor Authentication Guide - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Updating authentication factors](/articles/Updating-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Frequently Asked Questions](/articles/Multi-Factor-Authentication-FAQ)
* [User Accounts Guide- Troubleshooting EHR login issues](/articles/User-Accounts-Guide-Troubleshooting-account-login-issues)
# Troubleshooting Login and Account Lockouts (Non‑MFA) in Elation EHR
Source: https://help.elationhealth.com/articles/Troubleshooting-MFA-Login-Issues-and-Account-Lockouts-in-Elation-EHR
## Troubleshooting Login and Account Lockouts (Non-MFA) in Elation EHR
Use this guide to resolve common sign‑in problems and account lockouts that are not related to multi‑factor authentication (MFA). If your issue involves verification codes, authenticators, or second‑factor prompts, see our MFA guides instead.
### What this article covers
This article covers login errors, forgotten passwords, locked accounts, browser compatibility, and email access issues that are not related to MFA challenges.
### First checks
* Use the correct login page: [https://app.elationemr.com/login/](https://app.elationemr.com/login/) and a supported desktop browser (Google Chrome or Mozilla Firefox).
* Check the Elation Status Page for any active service disruptions; if all systems are Operational and you still can’t sign in, continue below.
* Verify you’re using the correct login email. If you don’t remember it or no longer have access to that inbox, contact Support with your full name, practice name, and best callback number.
### Reset your password (fastest fix)
* Go to [https://app.elationemr.com/password/reset/](https://app.elationemr.com/password/reset/), enter your Elation login email, and submit. You’ll receive an email from [support@elationemr.com](mailto:support@elationemr.com) titled **Elation Password Reset.** Follow the link to set a new password, then return to the login page to sign in.
* If you don’t receive the reset email, check Spam/Junk and try again; make sure you entered the email tied to your Elation account. If you still can’t access that inbox, contact Support for assistance.
Elation passwords must be at least 12 characters and are case‑sensitive.
### If you’re locked out
* For your security, an account locks for one hour after 10 unsuccessful login attempts in a row.
* Ask an Admin Level User at your practice to unlock your account:
* Admin signs into Elation → Settings → Manage Accounts → clicks **Unlock…** next to your name. Afterwards, check your email for a password reset and update your password.
* If an Admin isn’t available, contact Elation Support to unlock your account and complete a secure password reset.
### If you can’t access or confirm your login email
* Try to locate your Elation login email by searching for past messages from [support@elationemr.com](mailto:support@elationemr.com) such as **Your Elation Account is Ready!** or credentialing reminders you received during setup.
* If you no longer have access to the email address on file, contact Support for help regaining access to your account and updating your login email.
### New users who haven’t activated their account
* If you haven’t completed registration, look for the invitation email “Welcome to Elation! Quickly complete your account setup” and click Get Started to finish setup.
* An Admin Level User can resend your invite via Settings → Manage Accounts → Inactive Users → Resend invite.
### Browser and device tips
* Elation EHR is supported on desktop Chrome and Firefox. If you’re using a different browser or a mobile web browser, switch to a supported desktop browser and retry.
### Not an MFA issue? How to tell
If you’re not seeing prompts for a verification code or authenticator approval and only the email/password screen fails, follow the steps above. If the problem is the verification step itself, use our MFA setup, update, or reset guides.
### When to contact Elation Support
Contact Elation Support and include:
* Your full name
* Practice name
* Best callback number
* Your login email (if known)
* A brief description of the error (and any on‑screen messages)
Reach Support from within Elation or at [https://help.elationemr.com/s/contactsupport](https://help.elationemr.com/s/contactsupport).
## Related Articles
* [User Accounts Guide- Troubleshooting EHR login issues](/articles/User-Accounts-Guide-Troubleshooting-account-login-issues)
* [User Accounts Guide- Changing your password](/articles/changing-your-password)
* [User Accounts Guide- Best practices for keeping your Elation account secure](/articles/User-Accounts-Guide-System-Requirements-and-Recommendations)
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication - Quick Start Guide](/articles/Multi-Factor-Authentication-Quick-Start-Guide)
# Troubleshooting Outbound Fax Failures in Elation EHR
Source: https://help.elationhealth.com/articles/Troubleshooting-Outbound-Fax-Failures-in-Elation-EHR
How to recognize a fax failure, interpret error details, resolve common issues, and when to contact Elation Support.
## Troubleshooting Outbound Fax Failures in Elation EHR
### How to recognize a failed fax
* Check the status on the sent correspondence. You’ll see one of: **Fax Pending,** **Fax Sent,** or **Fax Failed.**
* Look for failure notifications in two places:
* Your Practice Home **Urgent** inbox. Faxes that have exhausted all automatic retries appear here and in the Fax Outbox **Needs attention** bucket.
* The patient chart under **Requiring Action.**
* Open the failure notification and click **Tell Me More** to view the error reason and tailored troubleshooting steps from our fax provider.
* To retry the same number after resolving the issue, use Actions → **Refax.**
### Quick fixes checklist
* Confirm the recipient’s fax number and that you intended to fax (not message another Elation user, who will receive it in their EHR instead of via fax). Outbound faxes are sent from Elation-owned fax numbers (area code 650) and not from your practice’s inbound electronic fax number.
* Call the destination number and listen for a healthy fax tone (clear, high-pitched) before resending. If the line is busy or in use, resending after a short interval often succeeds.
* Keep transmissions under 40 pages when possible; split large attachments or have the recipient retrieve attachments via Elation Connect to reduce failure risk on long transmissions.
* If you want attachments delivered by fax (not just via Elation Connect), check the **Also fax copies of attachments** box when available.
* If your fax continues to fail with the correct number and a good tone, ask the recipient to adjust their fax to allow longer transmissions and confirm no line/paper/ink issues on their side, then try again.
### Understanding timing and automatic retries
* Elation will automatically attempt to resend a failed transmission up to 5 times within \~30 seconds before marking it Failed.
* Status can take up to 20 minutes to update in the patient chart due to processing time between systems.
* Failed faxes do not count toward your practice’s fax usage overage calculations.
### How to resend
* To resend to the same number, open the failure notification and click **Refax.**
* To send to a different number, create a new Letter or Referral with the updated fax number or Contact (you can’t edit the original fax’s number).
### If status says "Fax Sent" but recipient can’t find it
* **Fax Sent** confirms the transmission completed successfully.
* Ask the recipient to check their fax inbox for a cover page and/or pages that reference viewing attachments online if the fax exceeded page limits or if Elation Connect delivery was used.
### Common fax failure causes and targeted resolutions
* Busy or in-use recipient line
* What you’ll see: **line busy** or similar in error details, and a healthy fax tone once the line frees up.
* Fix: Retry using **Refax** after a short interval; call to confirm line availability and fax tone first.
* Receiving line not picking up
* What you’ll see: **no answer,** **receiving line not picking up,** or similar in error details, and no fax tone at all when you call the number directly.
* Fix: This means the destination isn't currently set up to receive faxes. Ask the recipient's office to check their fax equipment or provide a working fax number, then create a new Letter or Referral with the corrected number to resend.
* Long transmissions or packet loss (VoIP)
* What you’ll see: failures on larger attachments or variable success by time of day.
* Fix: Keep under 40 pages, split into multiple faxes, or have the recipient use Elation Connect for attachments; ask recipient to allow longer transmissions on their fax device.
* Contact type or attachment constraints
* What you’ll see: difficulty sending when **Organization** contact and the draft has more than 40 pages.
* Fix: For >40 pages, send to an **Individual** contact or split pages; if needed, adjust the contact type to **Individual.**
* Attachments not arriving by fax
* What you’ll see: recipient receives only cover/body pages, not attachments.
* Fix: Ensure **Also fax copies of attachments** is selected when available; otherwise, attachments are accessed via Elation Connect.
* Wrong destination or non-fax recipient
* What you’ll see: delivery not reaching the intended fax device.
* Fix: Verify the 10-digit fax number and recipient workflow. If the recipient is an Elation EHR user, they receive the correspondence inside Elation rather than via fax.
* Generic "requires further investigation" message
* What you’ll see: **This error requires further investigation. Please contact Elation Support and share example** instead of a specific reason in the failure details.
* Fix: This message appears when the error code returned by Elation's fax provider doesn't yet have a specific description mapped in Elation. Check the Fax Outbox or Practice Home **Urgent** inbox for a later successful attempt to the same number before resending. If the fax is still failing, use **Refax**, then contact Elation Support with the failure notification's error details if it persists.
### Where to view and manage sent faxes
* View sent faxes in the patient’s chart timeline for Letters and Referrals, and on the Reports → Consult tab for Referrals.
* Failure notifications appear in your Practice Home **Urgent** inbox and the patient chart **Requiring Action** section with error details and next best actions.
* If your practice uses Workspaces and a sent fax isn’t appearing in the Fax Outbox, confirm you’re in the Workspace it was sent from. Admin-level users can switch to **Return to practice view** to see faxes from every Workspace at once.
### Best practices to reduce future failures
* Keep outbound faxes under 40 pages when possible; use Elation Connect for large records or split into smaller transmissions.
* Save frequently used destinations as Contacts with accurate fax numbers; update preferred fax details when they change.
* Monitor practice fax usage in Settings → Fax Usage & Settings; failed pages don’t count toward usage, but optimizing workflows reduces cost and friction.
### When to contact Elation Support
Contact us if:
* You’ve retried and verified the recipient line has a healthy fax tone, but the fax still fails with the same error reason; include the failure notification’s error details in your message.
* The receiving line still won't pick up or produce a fax tone after the recipient has checked their equipment and confirmed the number; include the destination number, whether you heard a fax tone, and the failure notification's error details in your message.
* You suspect a platform issue or need help interpreting error details.
In-product: from the failure notification or relevant page, click **I need help** → **Contact Elation Support.** Web: visit our Contact Support page at [https://help.elationemr.com/s/contactsupport](https://help.elationemr.com/s/contactsupport).
## Related Articles
* [Fax Outbox — Tracking and recovering outbound faxes](/articles/fax-outbox)
* [Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax)
* [Letters & Referrals Guide - Frequently Asked Questions](/articles/Letters-Referrals-Guide-Frequently-Asked-Questions)
* [Letter & Referral Guide - Monitoring fax usage](/articles/fax-usage)
* [Fax Inbox Guide - Managing fax settings & fax usage](/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage)
* [Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox)
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
# Troubleshooting Patient Payments and Membership Issues in Elation EHR
Source: https://help.elationhealth.com/articles/Troubleshooting-Patient-Payments-and-Membership-Issues-in-Elation-EHR
## 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.
### 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.
### 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.
* Failed payment count badge is showing on the Practice Home **Payment** button.
To quickly review all failed payments, click the **Payments** dropdown on the Practice Home navigation bar and select **View Failed Payments**. The Patient Payment Report will open pre-filtered to show only failed transactions, including the specific Stripe decline reason for each.
**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.
* A patient on a monthly plan hasn't been charged for several months.
### Payment issues: step‑by‑step fixes
* **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](mailto: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.
* **Card declined or HSA/FSA failure** — In the Patient Payment Report, check the status — the specific Stripe decline reason (such as “Insufficient funds” or “Card expired”) appears in parentheses next to the status, making it easier to diagnose the issue. 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).
* **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.
* **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.
* **Can’t locate a payment or payout** — Check Reports → Patient Payments Report; filter by patient or date. Payments a patient submits directly through your Payment Site aren't linked to a patient chart, so they won't turn up in a search by patient name — filter by transaction date instead. For payout timing, log into Stripe via Settings → Patient Payments → Go to Stripe account to view weekly payouts.
### Membership issues: step‑by‑step fixes
* **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.
* **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.
* **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.
* **Change plan amount/frequency or pause/unenroll** — Edit plan details in Settings → Membership Management (plan amount/frequency). Changes to the billing amount take effect on the next renewal for existing patients (unless an override exists). Changes to the billing frequency only apply to patients who enroll after the change — see the symptom below. 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.
* **A patient on a monthly plan hasn't been charged for several months** — Check the patient's next renewal date on their subscription. If it's far in the future (for example, months away on a plan billed monthly), the plan's billing frequency was likely changed after this patient enrolled. Changing a plan's billing frequency does not reschedule patients already enrolled — they keep the renewal date they were originally scheduled for. To move a patient's renewal, go to the patient's **Demographics** → **Insurance, Payment & Membership**, click **Edit** on the subscription, click **Override** next to **Next renewal date**, and enter the new date — see [Editing a patient's membership plan](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans#editing-a-patients-membership-plan). Review every patient on the affected plan whenever you change a plan's billing frequency.
* **Refund a membership payment** — Refund from the Patient Payments Report by locating the transaction and selecting Refund. Partial/pro‑rated refunds are not available.
### 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.
### 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.
### 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.
### 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.
### 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.
* **ACH Processing** status is normal during the ACH settlement window (1–10 business days) including after the due date.
* 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](https://help.elationemr.com/s/contactsupport).
## Related Articles
* [Patient Payments Guide - Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Membership Management Introduction](/articles/Introduction-to-Membership-Management-with-Elation)
* [Membership Management- How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
* [Membership Management- How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans)
* [Billing Guide- Recording payments from patients](/articles/Recording-Payments-from-Patients)
* [Billing Guide- Patient Invoicing- Generating invoices to patients for services rendered](/articles/patient-invoicing)
# Patient Payments Guide – Troubleshooting Stripe activation and connection issues
Source: https://help.elationhealth.com/articles/Troubleshooting-Stripe-activation-and-connection-issues
This article helps you identify and resolve common issues with your Stripe connection for Elation Patient Payments.
## Overview
### When to suspect a Stripe connection issue
You may have a Stripe activation or connection issue if the Patient Payments feature is visible in Elation, but you experience any of the following:
* All payment charges fail.
* Stripe shows no issues, yet no transactions appear in Elation.
* Stripe shows issues (such as verification warnings or payout holds), but your staff are unaware because they have not checked the Stripe **Dashboard**.
## Workflow Instructions
Before contacting Elation Support, complete the following checks to identify and resolve common issues.
### Check your Stripe account from Elation
| 1 | Go to Settings → Patient Payments . |
| - | ---------------------------------------------------------- |
| 2 | Click Go to Stripe account to open your Stripe Dashboard . |
![]()
### Review your Stripe account status
![]()
Once in the Stripe Dashboard, check for the following:
* Pending verification tasks: Stripe may require additional identity or business verification before you can process payments. Look for any alerts or banners prompting you to complete verification steps.
* Payout holds: Confirm there are no holds on your payouts. Stripe may pause payouts if verification is incomplete or if there are issues with your account.
* Bank account information: Verify that your bank account details (account and routing numbers) are correct and match the entity type you selected during setup.
### Verify your Industry setting in your Stripe account (for HSA/FSA issues)
If you are having trouble receiving FSA or HSA payments, confirm your Industry setting in Stripe account is set to **Doctors and Physicians**:
| 1 | In your Patient Payments settings page in Elation, click Go to Stripe account . |
| - | -------------------------------------------------------------------------------- |
| 2 | In the Stripe Dashboard , locate and click Settings . |
| 3 | Scroll down to Professional details or Business details . |
| 4 | Click Edit to view the details. |
| 5 | When the Additional Information dialog window opens, click Edit to make changes. |
| 6 | Update your Industry to **Doctors and Physicians**. |
![]()
## When to contact Elation Support
If you have completed the self-service checks above and are still experiencing issues, contact Elation Support for further assistance.
### How to contact Support
Use the I need help → Contact Elation Support button at the top of your Elation account.
### Information to provide
To help resolve your issue quickly, include the following details in your support request:
* Practice name
* Patient example: Patient name (or ID) and the date/time of the attempted charge.
* Stripe charge ID(s): If available, include any Stripe charge ID(s) from failed transactions.
* Screenshots: If you are able, any non-PHI screenshots of error messages or examples you can provide.
## Related Articles
* [Patient Payments Guide – Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Patient Payments – Frequently Asked Questions](/articles/Patient-Payments-Frequently-Asked-Questions)
* [How to register for Stripe account with Elation](https://docsend.com/view/u5pujrn5mrghwnkj)
* [Patient Payments Guide – Obtaining a 1099 Tax Form for your Stripe account](/articles/Patient-Payments-Guide-Obtaining-a-1099-Tax-Form-for-your-Stripe-account)
# Troubleshooting ePrescribing Errors for Regular Medications in Elation EHR
Source: https://help.elationhealth.com/articles/Troubleshooting-ePrescribing-Errors-for-Regular-Medications-in-Elation-EHR
## Troubleshooting ePrescribing Errors for Regular Medications in Elation EHR
This guide helps your practice resolve issues when a non‑controlled prescription errors during sending or doesn’t arrive at the pharmacy. For controlled substances (EPCS), see our EPCS-specific guides and requirements, which differ from regular medications.
### What this article covers
* Sending new, non‑controlled prescriptions from Elation EHR to a retail or mail‑order pharmacy via ePrescribe.
* Diagnosing “didn’t go through” reports from pharmacies and common send-time errors or blocks in the EHR.
* Safe fallback workflows for urgent fills if electronic networks or integrations are degraded.
### How to recognize a failed or blocked ePrescription
* Monitor your Urgent inbox in the Elation desktop app for failed prescription notifications. The mobile app (Elation Go) does not show failed prescription notifications, so continue monitoring on desktop for any send failures.
* If you sent the prescription from Elation Go (mobile), confirm on desktop that it completed successfully or take recovery steps below if you see a failure notification in Urgent.
### Quick fixes checklist
* Confirm you selected a pharmacy and clicked Prescribe on the Prescription Summary. Prescriptions only transmit electronically after you review the summary and click Prescribe.
* Select the correct pharmacy from the Surescripts directory:
* Search by name plus city, street, ZIP, phone, or store number to disambiguate similar store names.
* Elation cannot add non‑network pharmacies; ask the pharmacy to enroll with Surescripts if they don’t appear, or use print/call workflows as needed.
* Ensure your practice location information is complete. For ePrescribing, each prescribing location must have a 10‑digit phone and fax number; Elation will prompt you if anything is missing before transmission.
* Verify the patient’s address is present. Patient addresses are required for both non‑controlled and controlled ePrescriptions. If the patient is unhoused or unknown, use “HOMELESS” or **UNKNOWN** with a local city/state/ZIP as allowed.
* Confirm the prescriber can ePrescribe:
* Provider Account Authentication must be completed before sending ePrescriptions in Elation.
* Staff can send regular (non‑controlled) prescriptions only if authorized as a Prescription Delegate; controlled substances cannot be ePrescribed by staff delegates.
* Completing Provider Account Authentication does not guarantee ePrescribing is active on the account. If you see an **eRx Not Yet Active** message when attempting to prescribe even though authentication and prescribing permissions are already in place, ePrescribing itself still needs to be activated for your account. Contact Elation Support to have it enabled. In the meantime, you can save the prescription as a draft or print it.
* If Elation or network services are degraded: for urgent scripts, call the pharmacy with a verbal order; for non‑urgent, Save as draft and send once service returns to normal.
### Pharmacy says they never received the script
* Re-open the order in Elation and verify you selected the intended pharmacy and clicked Prescribe (not just Save/Print). Then re‑send if needed.
* Search for and select the exact store location in the Surescripts directory (include city/ZIP/phone), then re‑send. If the pharmacy isn’t listed in Surescripts, it can’t receive eRx through the network; use print or call‑in workflows.
* If the prescription is time‑sensitive and the pharmacy still can’t locate it, call the pharmacy to confirm receipt and fill; re‑send or provide a verbal order as allowed by state law and your policy.
### Medication- and form-related causes
* **Discontinued/off‑market drugs:** If the product’s NDC is obsolete, you may be prompted to choose an active alternative or create a custom medication; you may need to print or call if ePrescribing is not supported.
* **Custom/compound medications:** These are not associated with an NDC in Elation and may not support eRx at all pharmacies; print/call workflows may be required. Note: EPCS explicitly disallows eSending custom/compound controlled substances, which require a different workflow.
### Mobile app considerations (Elation Go)
* Elation Go supports sending new non‑controlled prescriptions but does not show failed prescription notifications; confirm send success or take recovery steps in the desktop app if the pharmacy reports non‑receipt.
### Safe fallback and recovery workflows
* For urgent fills during downtime or when the pharmacy can’t find the script: call in a verbal order to the pharmacy per policy and state rules.
* For non‑urgent prescriptions: save as Draft in Elation and send once services are back to normal; print if needed and permitted.
* If the pharmacy doesn’t appear in the Surescripts directory: print the prescription or call in the order, and ask the pharmacy to enroll with Surescripts for future eRx.
### Prevent issues before they start
* Keep prescriber profiles complete and authenticated (NPI, license, and required Provider Account Authentication) to enable ePrescribing privileges.
* Maintain accurate patient demographics, including a complete address, to avoid eRx send failures.
* Save patients’ preferred pharmacies in Elation and always select the exact destination store when prescribing to reduce misrouting.
### When to contact Elation Support
Contact Elation if:
* You’ve confirmed the pharmacy selection, prescriber authentication, patient address, and practice location details are all correct, but your ePrescription still fails to send.
* You suspect a platform or network issue unrelated to the pharmacy or your data.
Include the patient name, pharmacy name and location, date/time of the attempted send, and any error messages you saw in Elation. You can contact Support from within Elation or at [https://help.elationemr.com/s/contactsupport](https://help.elationemr.com/s/contactsupport).
## Related Articles
* [Prescriptions Guide- ePrescribing controlled substance medications](/articles/how-to-e-prescribe-controlled-substances)
* [Prescription Form Guide - ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Elation Go- The Mobile App for Practices](/articles/elation-go-the-mobile-app-for-practices)
* [Promoting Interoperability (MIPS) - e-Prescribing](/articles/Prescription-Form-Guide-patient-prescription-benefits)
* [User Accounts Guide- Setting up Elation EHR accounts and Provider account authentication](/articles/staff-permissions--staff-delegates)
* [User Accounts Guide- Provider Level Account vs. Staff Level Account Privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges)
# Multi-Factor Authentication Guide - Updating authentication factors
Source: https://help.elationhealth.com/articles/Updating-authentication-factors-for-MFA
This article guides you through the process of updating your authentication factors for multi-factor authentication.
## Content
* [Overview](#Overview)
* [Workflow Instructions](#Workflows)
* [Frequently Asked Questions (FAQ)](#FAQ)
All Elation users are **required** to use multi-factor authentication for security and compliance purposes.
## Overview
You can change your authentication factors anytime in your Elation Settings. If you remove one, you won’t be able to use it to log in. Make sure you always have at least one authentication factor set up.
## Workflow Instructions
To update your authentication factor(s):
| **1** | Login to Elation. |
| ----- | --------------------------------------------------------------------------- |
| **2** | Go to **Settings** -> **Account Details** . |
| **3** | Click **Edit factors** . |
| **4** | Click **Remove** to remove any authentication factor you don’t want to use. |
| **5** | Click **Setup** to set up at least one authentication factor. |
## Frequently Asked Questions (FAQ)
[Click here for answers to common MFA questions—including troubleshooting login issues, choosing authentication factors, and more](/articles/Multi-Factor-Authentication-FAQ).
## Related Articles
* [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA)
* [Multi-Factor Authentication Guide - Setting up authentication factors](/articles/Setting-up-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Resetting authentication factors](/articles/Resetting-authentication-factors-for-MFA)
* [Multi-Factor Authentication Guide - Frequently Asked Questions](/articles/Multi-Factor-Authentication-FAQ)
# Fax Inbox Guide - Uploading documents to the Fax Inbox
Source: https://help.elationhealth.com/articles/Uploading-documents-to-the-Fax-Inbox
This article describes how you would upload documents from your computer/laptop to the the Fax Inbox.
This article describes how you would upload documents from your computer/laptop to the the Fax Inbox.
📖
**RECOMMENDED READING**
[Click here for an introduction to the Fax Inbox feature in the EHR](/articles/Fax-Inbox-Introduction)
.
## Overview
### How do I upload documents to the Fax Inbox?
You can upload documents from your computer to the Fax Inbox using one of the two methods below:
* Using the **Upload Files** button in the Fax Inbox toolbar
* Using the drag-and-drop feature
### When would I upload documents to the Fax Inbox versus directly in a patient’s chart?
Documents from the Fax Inbox can be filed into the patient’s chart for records, including uploaded documents. For certain scenarios, it is better to upload documents directly into a patient’s chart. We recommend uploading documents to the following locations depending on the following scenarios:
| Upload to Fax Inbox | Upload to Patient’s Chart |
| -------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| A single document containing records for multiple patients. | A single document for a single patient. [Click here for instructions on how to upload documents directly into a patient’s chart](/articles/filing-documents-to-a-patient-chart) . |
| Multiple documents that need to be combined into a single record for a single patient. | |
### Which file formats does Elation Support?
Elation Supports the following document file formats:
* .PDF, .JPEG, .PNG, or .GIF files
* You will see the images of these documents directly within the Fax Inbox and patient charts.
* All other file types (ie. .DOC, .CSV, .XLS, etc.)
* You can store these files in the Fax Inbox and patient charts. However, to view the content of these files, you must download the file to your computer and open the file with compatible software on your computer.
## Workflow Instructions
### Using the **Upload Files** button to upload documents to the Fax Inbox
One method for uploading documents to the Fax Inbox is by using the
**Upload Files**
button located at the top of any section of the Fax Inbox. This scenario is most ideal for uploading multiple document files at once.
We recommend uploading documents to the **Unfiled Images** [section](/articles/Fax-Inbox-Introduction#sections) of the Fax Inbox to distinguish uploaded documents from faxed documents (which would be stored in the **Incoming Documents** section).
To upload document files using the
**Upload Files**
button:
1. Open the **Fax Inbox**.
2. Go to the **Unfiled Images** section.
3. Click **Upload Files**.
4. Locate the document files you want to upload from your computer.
5. Select the document file(s) and then click **Open**.
You can select multiple files by holding down the **Control** or **Command** key on your keyboard while you click on the files that you want to upload.
1. You will see notifications at the top of the **Unfiled Images** section indicating that the files you selected are processing.
Do not move or delete any of the files from your computer before they have finished uploading.
1. Once the document file has finished processing, you will see a yellow banner at the bottom of your Fax Inbox indicating new documents are available.
2. Click the **Refresh** button in the yellow banner to refresh your Fax Inbox to see the newly uploaded document files.
* Each document file will appear in its own listing.
* The title of each document listing will be the title of the file as it is on your computer.
### Using the drag-and-drop feature to upload documents to the Fax Inbox
One method for uploading documents to the Fax Inbox is by using the **drag-and-drop** feature. This scenario is most ideal for uploading documents one by one.
1. Open the **Fax Inbox**.
2. Go to the **Unfiled Images** section.
3. Separately locate the document file you want to upload on your computer.
4. Use your mouse/trackpad to click on a file from your computer, hold down the cursor and then drag the file over the Fax Inbox.
5. A blue **Drop Here to Upload** graphic will appear.
6. Let go of your cursor to drop the document into the dotted blue square.
7. You will see notifications at the top of the **Unfiled Images** section indicating that the file you selected is processing
Do not move or delete any of the files from your computer before they have finished uploading.
1. Once the document file has finished processing, you will see a yellow banner at the bottom of your Fax Inbox indicating a new document is available.
2. Click the **Refresh** button in the yellow banner to refresh your Fax Inbox to see the newly uploaded document file. Each document file will
* appear in its own listing.
* be have the title of the file as it is on your computer.
## Frequently Asked Questions
### Do I need to keep the Fax Inbox open when uploading a document?
You do not need to keep the Fax Inbox open when uploading a document. If you navigate away from the Fax Inbox while a document is still processing, the progress bar will still be there when you return. However, do not delete or move the file(s) from where they currently are on your computer before the processing is complete.
### Can I email a scanned document to a fax number or address that routes into the Fax Inbox?
Currently, Elation does not support emailing documents directly into the Fax Inbox. To get a scanned document into Elation without a physical fax machine, scan the document to your computer and upload it using the **Upload Files** button or the drag-and-drop feature described above, or use the Elation Go mobile app to scan and upload the document directly into a patient's chart.
## Related Articles
* [Fax Inbox Introduction](/articles/Fax-Inbox-Introduction)
* [Fax Inbox Guide - Receiving faxes in your Elation Fax Inbox](/articles/Receiving-faxes-in-your-Elation-Fax-Inbox)
* [Fax Inbox Guide - Actioning on documents within the Fax Inbox](/articles/Actioning-on-documents-within-the-Fax-Inbox)
* [Fax Inbox Guide - Filing documents from the Fax Inbox into a patient's chart](/articles/Filing-documents-from-the-Fax-Inbox-into-a-patient-s-chart)
* [Fax Inbox Guide - Managing fax settings & fax usage](/articles/Fax-Inbox-Guide-Managing-fax-settings-and-fax-usage)
# User Accounts Guide - Best practices for disabling accounts
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-Best-practices-for-deactivating-accounts
This is a best practice guide on the actions a practice should take before deactivating or disabling a staff or provider's Elation account.
**Closing Your Practice or Transitioning EHRs?** If you are closing your entire practice or transitioning to a different EHR system, see our [Offboarding Guide – Data Export & Patient Communication Checklist](/articles/offboarding-data-export-patient-communication) for a comprehensive guide to exporting patient data and notifying patients.
## Overview
### What happens when an Elation user account is disabled?
When an Elation user account is disabled, the user will no longer have access to the account and its data. This guide walks practices through recommended action items that should be taken before provider/physician or staff level users leave your practice and before their Elation account is disabled.
### Why is this guide important?
Following these best practices ensures a smooth transition when team members leave your practice. This will ensure:
* No action items are misfiled or overlooked
* Patients are properly reassigned and notified
* Pending prescriptions and messages are handled appropriately
* Administrative reports are preserved before account deactivation
## Workflow Instructions
**Checklist: Disabling a provider account**
1. [Notify Elation of the departure](#notifying-elation) Share the date and whether a replacement is joining.
2. [Clear Practice Home Queue items](#practice-home-queues) Signed reports, Rx requests, office messages.
3. [Notify labs, imaging, and hospital facilities](#lab/imaging/hospital-reports) Ask them to reroute results to another provider.
4. [Set a cutoff date for refill requests](#refill-requests) Tell Support when to turn off e-prescribing for this provider.
5. [Download the CSV reports from the Disable dialog](#downloading-reports-before-disabling) Post-dated messages and future appointments.
6. [Reassign patients and future appointments](#appointments-with-the-departing-provider) So Passport messages and visits route correctly.
7. [Confirm another EPCS Access Control Manager is in place](#access-controls-for-epcs) Required if this provider holds that role.
8. [Save reports you'll need later](#administrative-reports) Patient List, Billing, and Appointment reports tied to this provider are hard to reconstruct after the account is disabled.
**Checklist: Disabling a staff account**
1. [Clear Practice Home Queue items](#practice-home-queues-2) Signed reports, office messages.
2. [Download the post-dated messages CSV from the Disable dialog](#post-dated-office-messages) Do this before disabling the account.
3. [Confirm another EPCS Access Control Manager is in place](#access-controls-for-epcs-2) Required if this staff member holds that role.
**Checklist: Moving a retiring provider to an Admin-only Staff account**
1. [Complete every item in the Provider account checklist](#action-items-for-provider/physician-accounts)
2. [Notify Elation of the retirement date and the transition plan](#steps-to-transition-a-retiring-provider-to-an-admin-only-staff-account)
3. [Create the new Staff Level account](#steps-to-transition-a-retiring-provider-to-an-admin-only-staff-account)
4. [Grant Admin privileges to the new account](#steps-to-transition-a-retiring-provider-to-an-admin-only-staff-account)
5. [Disable the Provider Level account only after the above are done](#steps-to-transition-a-retiring-provider-to-an-admin-only-staff-account)
### Notifying Elation
Before disabling any Provider Level User, reach out to our Support Team via the **I need help** button to let us know that these changes will occur. Include the following information:
* Which provider level user is leaving your practice
* The date that this provider level user will no longer need their account active
* Is a new provider/physician taking their place?
* If so, how many hours will the new provider work per week and will they need an account with prescribing privileges?
* New provider/physician's start date
With notification of this change and the information above provided, our teams can ensure that your Elation information, like billing, is properly updated.
### Provider retiring but staying as Administrator
If a provider is retiring from clinical practice but wants to remain involved in practice administration, you can disable their Provider Level account and create a free Staff Level account with Admin privileges. This approach removes the provider seat from your subscription while preserving their ability to manage the practice.
#### Why consider this approach?
* **Reduce subscription costs** – Disabled Provider Level Users are not counted toward your provider license summary, so you will no longer be charged for that provider seat.
* **Maintain administrative access** – Staff Level accounts can be granted Admin privileges, allowing the retiring provider to continue managing user accounts, configuring settings, and overseeing practice operations.
* **No additional cost** – Staff Level User accounts can be added for free.
#### Steps to transition a retiring provider to an Admin-only Staff account
Before disabling the provider account, follow all steps in the [Action items for Provider/Physician Accounts](#action-items-for-provider/physician-accounts) section below (Practice Home queues, patient reassignment, appointments, EPCS, reports, etc.).
Reach out to the Support Team via the **I need help** button or [submit a request](https://app.elationemr.com/support/) to let Elation know the provider is retiring and the date their account should be deactivated. Include whether a replacement provider is joining.
Go to **Settings** → **Manage Accounts** and click **Invite Staff** . Use the retiring provider's preferred email address (this can be the same email if the provider account is disabled first, or a different email).
After the staff account is active, click **Make Admin** next to the new Staff Level account in **Manage Accounts** .
Once the Staff Level account is set up and the provider has completed all clinical handoff tasks, disable the Provider Level account by clicking **Disable** next to the provider's name in **Manage Accounts** .
#### Impact on subscription and invoices
* Disabled Provider Level Users are not counted in the provider license summary on the **Manage Accounts** page.
* Notify Elation before the provider's last active date so billing can be updated appropriately. Include the date the provider will no longer need their account active.
* For questions about how this change affects your specific invoice or contract, reach out to Elation using **I need help** → **Contact Elation Support**.
#### What the retiring provider can do with a Staff Level Admin account
With Admin privileges on a Staff Level account, the retiring provider can do the following administrative tasks:
* Manage user accounts (invite, disable, re-enable, unlock)
* Configure practice settings (billing, templates, labs, calendar, etc.)
* Enable features such as MFA, Patient Booking, Patient Forms, and Patient Payments
* Manage User Groups and Report/Visit Note Categories
#### What the retiring provider cannot do with a Staff Level account
Staff Level accounts do not have Provider Level privileges, so the retiring provider will not be able to:
* Sign visit notes, prescriptions, orders, or referrals
* Have a calendar in Elation
* Be listed as the rendering or billing provider on claims
* Have patients assigned to them
* Access EPCS (electronic prescribing of controlled substances)
If the retiring provider is an Access Control Manager for EPCS, assign those permissions to another eligible user before disabling the provider account. Each practice needs at least two Access Control Managers, one of which is a provider. Also, ensure that all lab vendors are notified. Some vendors may be able to reroute lab results to a different provider within the practice.
### Action items for Provider/Physician Accounts
The following changes will occur immediately once provider/physician level accounts are disabled:
* The provider will not be able to log in to Elation
* Your practice will no longer be able to view their schedule on the calendar
* The provider's Practice Home queue will be hidden
* Any office messages that are left in their queue will need to be acknowledged by another provider/physician in the practice
* Any other open items in their queue will need to be signed or completed by another provider/physician in the practice
* Patients who are assigned to the disabled provider/physician will need to be re-assigned to another provider/physician in the practice
* The provider/physician will be removed from all administrative reports
Please read through each section below to make sure the proper actions are taken to ensure a smooth transition.
#### Practice Home Queues
Please have the departing provider address and/or complete all items in their [Practice Home Queues](/articles/the-requiring-actions-queue-follow-up-on-action-items) (e.g., Reports, Rx Request, Office Messages, etc.) before they leave your practice. If there are any open items remaining after their departure, make sure another provider in the practice addresses the open items before disabling the departing provider/physician's account.
**Exception:** Elation does not currently offer a bulk or admin-level tool to reassign or clear all outstanding Requiring Action items from a provider's queue at once after their account has already been disabled. Each item — such as a pending prescription refill request or lab order awaiting sign-off — needs manual, per-patient review by an active provider. For a pending refill request, the item stays tied to the original prescriber; an active provider needs to send a new prescription to the pharmacy going forward, which does not retroactively clear the original request.
#### Lab/Imaging/Hospital Reports
Please notify the different facilities from which you receive electronic results and let them know of the provider's departure from your practice. Specifically, we recommend sharing the provider's last day and asking them to forward any of the reports they ordered to a different provider at your practice (provide the new provider's NPI number) after that date if possible.
If the facilities are unable to forward the electronic results to a different provider at your practice, the results will not automatically arrive in Elation. Your practice will need to retrieve these reports directly from the facilities via their own websites or have the reports sent to your practice via fax or paper mail.
#### Refill Requests
Please reach out to our Support team through [this form](https://app.elationemr.com/support/), or through the **I need help** → **Contact Elation Support** option within Elation, to notify us of the date to turn off the Refill Request feature for the provider who is leaving.
After this date, pharmacies will see that the provider's electronic prescribing functionalities are disabled and will send refill requests to your office via fax instead. The new attending provider at the practice should respond to these faxed refill requests via Elation by sending a prescription electronically back to the pharmacy so that the next time the same patient needs a refill, the refill request will come directly to the new attending provider through an electronic request in Elation.
#### Downloading reports before disabling
When you disable a provider account, the **Disable** confirmation dialog lists the data that will be lost and gives you a way to download it as a CSV before the account is disabled — no support ticket required.
For provider accounts, the dialog covers two data sets:
* **Post-dated Office Messages** — any [post-dated messages](/articles/post-date-a-message-to-yourself-or-a-colleague) the departing provider sent to themselves or other members of the practice. These are automatically signed off and stored in the patient's chart once the account is disabled.
* **All future scheduled appointments** — every upcoming appointment on the departing provider's calendar.
Each bullet in the dialog has an inline **Download report (CSV)** link that downloads just that report. The primary action button is labeled **Disable & Download CSVs** — clicking it downloads both reports and disables the account in one step.
For non-provider (staff) accounts, the disable dialog only covers Post-dated Office Messages, and the primary button is labeled **Disable & Download CSV** (singular). See the staff section further down for details.
##### How to download the reports
Go to **Settings > Manage Accounts** and locate the provider's account.
Click **Disable** next to the provider's name. A confirmation dialog will appear listing the affected data.
Click an individual **Download report (CSV)** link next to a bullet to download just that report without disabling the account yet, or click **Disable & Download CSVs** to download both reports and disable the account in one step.
The inline **Download report (CSV)** links let you review the data before committing to the disable action. Once you're ready, use **Disable & Download CSVs** or click the standard **Disable** button.
##### What's in the Post-dated Office Messages report
The CSV includes one row per pending post-dated message and contains the following columns:
| Column | Description |
| -------------------------------- | ------------------------------------------------------ |
| Patient ID | Elation patient ID |
| Patient Name | Patient's full name |
| Patient Chart URL | Clickable link to the patient chart (opens in Elation) |
| Patient Assigned Provider | The patient's assigned provider |
| Patient Primary Service Location | The patient's primary service location |
| Type | Message type (e.g., Office Message) |
| Message Body | The text of the message |
| Created Date | When the message was originally created |
| Delivery Date | The scheduled future delivery date |
| Sender Name | The name of the user who created the message |
| Recipient Name | The intended recipient(s) of the message |
Only messages with a future delivery date that have not yet been addressed are included in the report.
##### What's in the Future Scheduled Appointments report
The CSV includes one row per upcoming appointment on the departing provider's calendar and contains the following columns:
| Column | Description |
| -------------------------------- | ---------------------------------------------------------- |
| Patient ID | Elation patient ID |
| Patient Name | Patient's full name |
| Patient Chart URL | Clickable link to the patient chart (opens in Elation) |
| Patient Assigned Provider (PCP) | The patient's assigned primary care provider |
| Patient Primary Service Location | The patient's primary service location |
| Appointment Date | Date of the appointment (in the practice's local timezone) |
| Appointment Time | Time of the appointment (in the practice's local timezone) |
| Timezone | The practice's local timezone |
| Status | Appointment status (e.g., Scheduled, Confirmed) |
| Appointment Type | The type of appointment |
| Duration | Length of the appointment |
| Provider | The provider the appointment is scheduled with |
| Location | The service location for the appointment |
| Recurring | Whether the appointment is recurring (Yes/No) |
| Visit Type | Virtual or In person |
| Description | Appointment description or notes |
Open either CSV in Excel or Google Sheets. The **Patient Chart URL** column contains a clickable hyperlink formula that takes you directly to the patient's chart.
#### Patient Passport Messages
Before disabling the departing provider's account, we recommend you pull a [Patient List Report](/articles/find-patients-with-elations-patient-list) of all the patients assigned to the leaving provider using the **Reports** → **Patient List** report tool and reassign those patients to a different provider at the practice. You reassign a patient by updating the **Provider assigned in practice** field on the patient's Demographics **Provider Information** tab — see [Patient Demographics Guide- Provider Information](/articles/Patient-Demographics-Guide#provider-information) for details. If there are many patients, our Technical Team can assist with reassigning multiple patients at once.
This way, after the departing provider's account is disabled, all new patient Passport messages will be routed to the new provider instead of the departing provider.
**Exception:** If any of the departing provider's patients have a [VIP-marked chart](/articles/vip-chart-feature), un-mark the VIP designation and reassign the patient before disabling the account. Only the **Provider assigned in practice** can remove a chart's VIP designation, so this step can't be completed afterward without contacting Elation Support.
#### Appointments with the departing Provider
Any appointments scheduled on the departing provider's calendar for any date after they have left will need to be manually transferred to a different provider's calendar because the departing provider's calendar will be hidden from the practice once their account is disabled.
Before disabling the account, download the **All future scheduled appointments** CSV directly from the **Disable** confirmation dialog to get a full list of upcoming appointments that need to be reassigned. See [Downloading reports before disabling](#downloading-reports-before-disabling) for details.
You can move appointments by editing each appointment and changing the provider it is assigned to, as shown in the image below.
![Edit Patient Appointment panel open with the Provider dropdown expanded, showing Karly Smith, NP selected and a list of alternative providers to reassign the appointment to.]()
You can also download an appointment report by selecting **Reports** → **Appointment Report** from the top blue bar of your account to find and reference appointments scheduled with the departing provider in the future.
If you need to view an appointment report that is longer than 2 weeks, please manually type in the **From:** and **To:** dates and click the **Download List of Appointments as CSV** button to download the report and view in a spreadsheet software on your computer.
If you need to view an appointment report that is longer than 6 months, you will need to break up the time frame into multiple reports, download the reports to your computer as a CSV file and then combine the data in a spreadsheet software application. For example, if you would like to see all appointments from 2020, you will need to run 3 reports; each with the following time frames:
#### Access Controls for EPCS
If the departing provider is an [Access Control Manager](/articles/how-to-set-up-epcs-access-controls) for EPCS set up and configuration, please ensure there is another Access Control Manager at your practice before the provider leaves. Reference the [EPCS Access Controls Guide](/articles/how-to-set-up-epcs-access-controls) to update access control settings if needed.
#### Administrative Reports
If you need to retain a copy of any administrative reports for the departing provider, you must download the reports prior to disabling the departing provider's account. Please reference the following articles for each administrative report you might need:
* [Patient List Report Guide](/articles/find-patients-with-elations-patient-list)
* [Billing Report Guide](/articles/lightning-reports)
* [Appointment Report Guide](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments)
If the account is already disabled and you did not download these reports beforehand, see [I already disabled a provider's account. How do I see which patients they saw or get their past appointment history?](#i-already-disabled-a-providers-account-how-do-i-see-which-patients-they-saw-or-get-their-past-appointment-history) below.
#### Recommended: Notify Patients Using Bulk Letters
When a provider is leaving your practice, follow these steps to notify affected patients via a Bulk Letter:
Go to **Reports** → **Patient List** and filter by the departing provider to identify their patient panel.
Select all patients from the list and click **Send Bulk Letter** to notify them about: The provider's departure date • Who will be taking over their care • How to request copies of their medical records if needed
Update patient assignments to ensure Passport messages route to the correct provider going forward.
See the [Bulk Letter Guide](/articles/introduction-to-bulk-letters) for detailed instructions on creating and sending bulk letters.
After a departing provider's account is disabled, if a patient sends the departing provider a message from an existing Patient Letter, those messages will not appear in the newly assigned provider's inbox. We recommend that the **Everyone** Practice Home queue is checked periodically to check for these kinds of Passport messages.
### Action items for Staff Accounts
While it is not necessary to alert our Teams when staff level accounts are disabled, we still recommend the following workflows occur before disabling a staff level account.
#### Practice Home Queues
Please have the departing staff address all items in their [Practice Home Queues](/articles/the-requiring-actions-queue-follow-up-on-action-items) (e.g., Office Messages, Patient Letters, etc.) before they leave your practice. If there are any open items remaining after their departure, make sure another member in the practice addresses the open items before disabling the departing staff's account.
#### Post-dated Office Messages
If the departing staff sent [post-dated messages](/articles/post-date-a-message-to-yourself-or-a-colleague) to themselves or other members of the practice, those messages will be automatically signed off and stored in the patient's chart once the staff account is disabled.
**Before disabling the account**, you can download a CSV report of all pending post-dated messages directly from the disable confirmation dialog — no support ticket required.
##### How to download the report
Go to **Settings > Manage Accounts** and locate the staff account.
Click **Disable** next to the staff member's name. A confirmation dialog will appear.
In the confirmation dialog, click **Download report (CSV)** to download the report without disabling the account yet, or click **Disable & Download CSV** to download the report and disable the account in one step.
The **Download report (CSV)** link lets you review the report before committing to the disable action. Once you're ready, use **Disable & Download CSV** or click the standard **Disable** button.
##### What's in the report
The CSV includes one row per pending post-dated message and contains the following columns:
| Column | Description |
| -------------------------------- | ------------------------------------------------------ |
| Patient ID | Elation patient ID |
| Patient Name | Patient's full name |
| Patient Chart URL | Clickable link to the patient chart (opens in Elation) |
| Patient Assigned Provider | The patient's assigned provider |
| Patient Primary Service Location | The patient's primary service location |
| Type | Message type (e.g., Office Message) |
| Message Body | The text of the message |
| Created Date | When the message was originally created |
| Delivery Date | The scheduled future delivery date |
| Sender Name | The name of the user who created the message |
| Recipient Name | The intended recipient(s) of the message |
Only messages with a future delivery date that have not yet been addressed are included in the report.
Open the CSV in Excel or Google Sheets. The **Patient Chart URL** column contains a clickable hyperlink formula that takes you directly to the patient's chart.
#### Access Controls for EPCS
If the departing staff is an [Access Control Manager](/articles/how-to-set-up-epcs-access-controls) for EPCS set up and configuration, please ensure there is another Access Control Manager at your practice before the staff leaves. Reference the [EPCS Access Controls Guide](/articles/how-to-set-up-epcs-access-controls) to update access control settings if needed.
### How to disable an Elation Account
To disable Elation accounts, you must have administrator (Admin) level privileges. If you do not see **Manage Accounts** in your Settings page, then you are not an Admin. To become an Admin, you must ask an existing Admin level user in your practice (most likely a primary provider level account holder) to grant you privileges via the **Manage Accounts** settings page.
Once you have addressed the action items listed above, you are ready to disable the departing user's Elation account. To deactivate or disable a provider or staff level Elation account within your practice, Admin Users in your practice can follow these steps:
Select your email address from the blue bar at the top right of your Elation page and select **Settings** from the drop down.
Scroll to the bottom and click into the **Manage Accounts** settings section under **Admin Users Only** .
Select the down arrow to the left of **Active Users** to expand the list of active Provider or Staff users at your practice.
Click the **Disable** button next to the name of the user that you want to disable.
Read through the confirmation prompt and then click **Disable Account** to disable the user's account.
## Frequently Asked Questions
### I already disabled a provider's account and an appointment was left on their calendar. How do I fix it?
If an appointment is still scheduled with a provider after their account is disabled, go to **Settings** → **Manage Accounts**, find the provider under **Inactive Users**, and click **Enable**. This restores their calendar so you can open the appointment and reassign it to another provider (or delete it, if it's no longer needed). See [Managing Elation accounts for providers and staff](/articles/managing-user-accounts) for more on re-enabling accounts. Once the appointment is reassigned or removed, you can disable the provider's account again.
### I already disabled a provider's account. How do I see which patients they saw or get their past appointment history?
You don't need to re-enable the account for this. Run the [Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments) with **All Physicians** selected for the relevant date range — a disabled provider's appointments still appear in the results, including which patients they saw.
Re-enabling is only necessary if you want to filter the report specifically by that provider's name, or open their calendar directly:
Go to **Settings** → **Manage Accounts**, find the provider under **Inactive Users**, and click **Enable**.
Use the [Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments) filtered to that provider, or open their calendar directly.
Once you have the data you need, go back to **Manage Accounts** and click **Disable** next to the provider's name.
To avoid this extra step in the future, download the provider's [Patient List](/articles/find-patients-with-elations-patient-list), [Billing](/articles/lightning-reports), and [Appointment](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments) reports before disabling their account — see [Administrative Reports](#administrative-reports).
**Related Articles**
* [Offboarding Guide – Data Export & Patient Communication Checklist](/articles/offboarding-data-export-patient-communication)
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
* [Practice Home Guide- Checking for requiring action items](/articles/check-for-your-offices-daily-to-do-list)
* [Post Date a Message Guide- Reminders & Task Follow Up](/articles/post-date-a-message-to-yourself-or-a-colleague)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Billing Guide- Billing Report](/articles/lightning-reports)
* [Calendar Guide- Searching for appointments using the Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments)
* [Bulk Letter Guide- Mass communication with Patients](/articles/introduction-to-bulk-letters)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [EPCS Access Controls Guide](/articles/how-to-set-up-epcs-access-controls)
# User Accounts Guide- Chart access permission control options (Premium)
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-Chart-access-permission-options
This guide will describe the various chart access permission control options available in Elation EHR.
## Overview
### What are chart access permission controls?
Chart access permission controls allow you to prevent certain staff members from gaining unauthorized access to certain patient charts in your EHR. The various control options enable you to grant chart access to:
* exclusively the provider assigned to the chart
* certain providers or staff for specific cohorts of charts
* exclusively clinical staff for all charts
### What are the benefits of chart access permission controls?
Patient data contains sensitive information that must be protected to ensure confidentiality and comply with privacy regulations. Limiting chart access helps prevent unauthorized access, protects patient privacy, and maintains data integrity by ensuring that only authorized personnel can view or modify information.
## Workflow Instructions
Chart access permission controls are part of Elation's [Premium EHR](/articles/Premium-EHR-Features-Guide) offering. If you are already a Premium EHR user and you are interested in using any of the features listed in this article, click the **I need help** button to notify Elation and a member of the Elation Team will activate the feature for you.
If you are interested in upgrading to Premium EHR to use any of the features listed in this article, click the **I need help** -> **Contact Elation Support** button and a member of the Elation team will assist you.
There are three (3) chart access permission control options in Elation EHR:
* **VIP Charts** - Manually apply chart access restrictions to specific charts to protect patient privacy and meet compliance needs. [Click here to learn more about the VIP Charts feature](/articles/vip-chart-feature).
* **Patient Cohorts** - Automatically provision chart access permissions according to present criteria to protect patient privacy and meet compliance needs.
* [Click here to learn more about the Patient Cohorts feature](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria).
* **Block All Chart Access** - Prevent specific users from accessing any patient charts.
* [Jump to the Block All Chart Access section below to learn more about the feature](#block_all_chart_access).
### Using the VIP Charts feature
The VIP Charts feature allows you to manually apply chart access restrictions to specific charts to protect patient privacy and meet compliance needs. [Click here to learn more about the VIP Charts feature](/articles/vip-chart-feature).
### Using the Patient Cohorts feature
The Patient Cohorts feature allows you to automatically provision chart access permissions according to present criteria to protect patient privacy and meet compliance needs. [Click here to learn more about the Patient Cohorts feature](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria).
### Using the Block All Chart Access feature
The Block All Chart feature allows Admin Level Users to designate which users have permission to access all patient charts within the practice.
*
To use this feature, you must have [Admin level privileges](/articles/administrative-privileges) . To become an Admin, you must ask an existing Admin Level User in your practice (most likely a primary provider level account holder) to grant you privileges via the [Manage Accounts Settings Page](/articles/managing-user-accounts) .
![Edit Profile dialog for user Five Staff showing the checked "Access to view patient charts" checkbox highlighted, with an arrow pointing to the Edit button in the Active Users list below.]()
#### Revoking a user's access to all patient charts
To revoke a user's access to all patient charts:
| **1** | Go to **Settings** -> **Manage User Accounts** . |
| ----- | ----------------------------------------------------------------------------------------------------------------------- |
| **2** | Click the **Edit** button next to their name. |
| **3** | Uncheck the **Access to view charts** checkbox in the Account Details section to revoke their access to patient charts. |
| **4** | Click **Update** or **Save** to save the changes. |
Users without chart access permissions will
* see an **Unauthorized access** page when they attempt to open any patient charts.
* continue to have access to all other pages in the EHR such as the Practice Home, Reports and Settings.
#### Granting a user access to all patient charts
To grant a user access to all patient charts:
| **1** | Go to **Settings** -> **Manage User Accounts** . |
| ----- | ------------------------------------------------------------------------------------------------------------------- |
| **2** | Click the **Edit** button next to their name. |
| **3** | Check the **Access to view charts** checkbox in the Account Details section to grant them access to patient charts. |
| **4** | Click **Update** or **Save** to save the changes. |
Users with chart access permissions will be able to view patient charts as usual.
## Related Articles
* [Patient Chart Guide- Limiting access to patient charts based on patient criteria (Premium)](/articles/Patient-Chart-Guide-Restricting-access-to-patient-charts-based-on-patient-criteria)
* [Patient Chart Guide- Marking charts as VIP for restricting access (Premium)](/articles/vip-chart-feature)
* [User Accounts Guide- Administrative privileges](/articles/administrative-privileges)
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
# User Accounts Guide- Configuring delete permissions (Premium)
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-Configuring-delete-permissions
This article describes Premium EHR features that restrict who can delete documents within patient charts, including two tiers of delete permission control.
## What delete permissions are available in Elation EHR?
By default,
* any user can delete any document within a patient's chart.
* any user can modify demographics or clinical profile information within a patient's chart.
* only Admin Level Users can modify certain Settings if that Settings page is configured for **Admin Only**. If that Settings page is not configured for **Admin Only** then any user can modify those Settings.
Elation offers two Premium EHR tiers for restricting document deletion. Both tiers leave demographics, clinical profile, and Settings unaffected.
| | **Standard delete permissions** | **Strict delete permissions** |
| ---------------------- | -------------------------------------------- | -------------------------------------------- |
| Admin Level Users | Can delete any document | Can delete any document |
| Provider Level Users | Can delete any document | Can only delete their own unsigned documents |
| Non-admin staff | Can only delete their own unsigned documents | Can only delete their own unsigned documents |
| Patient chart deletion | Not restricted | Blocked for all non-admin users |
## How to configure delete permissions
Delete permission controls are Elation Premium EHR offerings that take effect as soon as the feature is enabled. If you are already a Premium EHR user and are interested in using either tier, click the **I need help** button to notify Elation and a member of the Elation team will activate the feature for you.
If you are interested in upgrading to Premium EHR to use this feature, click **I need help** → **Contact Elation Support** and a member of the Elation team will assist you.
### Standard delete permissions
Once standard delete permissions are enabled:
* Only Provider Level Users and Admin Level Users can delete documents within a patient's chart.
* All other users can only delete documents they created themselves that are not yet signed. If a non-Provider or non-Admin user attempts to delete a document they did not create, or one that is already signed, they will see an alert error message that prevents the deletion.
![Alert dialog blocking document deletion, reading: "An error has occurred. Please refresh the page. If this persists, contact Support using the 'I need help' menu above."]()
### Strict delete permissions
Strict delete permissions apply a higher level of control. Once enabled:
* Only Admin Level Users can delete any document within a patient's chart.
* Provider Level Users and all other non-admin users can only delete documents they created themselves that are not yet signed. Attempting to delete any other document will trigger an alert error message.
* Non-admin users are also blocked from deleting patient charts. Only Admin Level Users can delete a patient chart when this feature is enabled.
## Frequently Asked Questions
### What is considered a 'document' in the patient's chart?
A document is any type of information that is filed or saved to a patient's Chronological Record. Common examples include Orders, Visit Notes, and Patient Letters.
### Does either delete permission tier prevent users from editing demographics or clinical profile information?
No. Neither tier affects the ability to edit demographics or clinical profile information.
### What is the difference between standard and strict delete permissions?
With standard delete permissions, Provider Level Users retain the ability to delete any document. With strict delete permissions, Providers are subject to the same restriction as non-admin staff — they can only delete their own unsigned documents. Strict delete permissions also prevent non-admin users from deleting patient charts, which standard delete permissions do not restrict.
### I should be allowed to delete documents, what should I do?
Consult with an Admin Level User in your practice to verify your role and whether you should have expanded delete access. Admins can request a change to your permissions by contacting Elation Support.
### Can both tiers be enabled at the same time?
No. Only one tier can be active for a practice at a time. Contact Elation Support if you need to switch between tiers.
## Related Articles
* [User Accounts Guide- Administrative privileges](/articles/administrative-privileges)
# User Accounts Guide- Provider User Settings
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-Provider-User
This article describes the various account customization options available for Provider level account users in the EHR.
## Overview
### What is a Provider Level account?
Provider Level accounts are usually used by physicians, non-physician practitioners or other medical providers. [Click here to learn more about Provider Level accounts](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges).
Given the different privileges available for Provider Level accounts there are various account details that Provider Level account users should be mindful of and preferences that Provider Level account users can utilize. The **User Settings** are unique and specific to each Provider Level account user and include the following:
* Account Details
* Preferences
* Authorized Staff Delegates
* Patient Sharing Defaults
![Account Details page with User Settings sidebar highlighted, showing Account Details selected and Preferences, Authorized Staff Delegates, and Patient Sharing Defaults listed below it.]()
## Provider User Settings
### Provider Level account details
As a Provider level account user, you can access your Provider level account details by going to
**Settings**
→
**Account Details**
. Customizations include:
1. Account Details
* Full Name
* Elation login email
* Credentials
* TIN (Tax ID Number)
* NPI (National Provider Identification Number)
2. Credentials
* Medical License State
* Medical License Number
* DEA Number
* Supervising Provider's name (if applicable)
*
The Supervising Provider must have their own active Elation Provider level account in order for their name to appear in this dropdown menu.
* Rx Authorization (Prescription Authorization Number for Supervising Provider, if applicable)
* XDEA/NADEAN number (for Narcotic Addiction DEA numbers)
3. Authentication Documents & Electronic Signature
* See the [Provider Account Authentication Guide](/articles/how-to-complete-account-authentication) for more information on how to manage your Authentication Documents and Electronic Signature.
4. Lab Identifiers
* Quest ID & LabCorp ID fields for your lab vendor account numbers (if applicable)
*
For all other lab vendors, Elation will include your vendor account numbers for you when applicable.
5. Billing
* Supervising Provider
* Billing Provider
*
The Supervising Provider and Billing Provider preferences will automatically populate the Provider's name in the corresponding billing fields when enabled via your [Billing Settings](/articles/billing-settings---service-locations--procedure-codes#enabled_billing_fields) .
### Provider Level account preferences
As a Provider Level User, you will have the following customizations available for you under
**Settings**
→
**Preferences**
:
* Setting a default [Visit Note Format](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) for each encounter [(appointment) type](/articles/calendar-and-booking-settings#Appointment_Types)
* Setting a default [Practice Location](/articles/adding-a-second-practice-location) for e-Prescribing
* Turning on notifications for messages tied to Letters and Referrals and setting default notification timeframes
* Setting Drug-to-Drug alert levels and turning on or off Drug-to-Allergy alerts to [monitor for drug interactions](/articles/drug-decision-support)
* Specifying which [Clinical Reminders](/articles/clinical-reminders-for-clinical-quality-measures) you want to appear at the top of your Visit Note drafts
* Specifying whether or not you want ICD-9 codes to display alongside ICD-10 codes
* Specifying whether or not you want [CPT Codes](/articles/billing-settings---service-locations--procedure-codes) to display when you enter [Assessments](/articles/visit-note-assessments) in your Visit Notes.
### Authorized Staff Delegates
In Elation, each Provider Level User can authorize individual Staff Level Users to sign orders, prescriptions, referrals and edit billing information on their behalf; we call these authorized staff delegates.
[Click here to learn more about configuring authorized staff delegates](/articles/staff-permissions--staff-delegates)
.
### Patient Sharing Defaults
If you are using the [Elation Patient Passport](/articles/elation-patient-passport-an-introduction) feature to communicate with your patients securely through your EHR, you can set a default for what information is automatically shared with a patient upon inviting them to register for an account and connect with your practice. [Click here to learn more about the various sharing options](/articles/elation-patient-passport-an-introduction#sharing_settings).
These defaults are applied to all new patients assigned to you, and they impact patients who have not yet received a Passport invitation. Elation does not currently offer a separate per-patient Passport access level setting within this Settings section—however, you can override the default sharing settings for individual patients directly from their chart under **Passport Sharing Options**.
For a detailed explanation of what information patients can see by default in Passport—including messaging, demographics, Clinical Profile details, visit summaries, and appointment information—see the ["What patients can see by default in Passport"](/articles/elation-patient-passport-an-introduction#default_available_info) section of the [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction).
### Google Calendar Sync
The Google Calendar Sync feature allows you to easily keep track of patient appointments and personal events in the same place. When turned on, you will be able to see the calendar events from your Google Calendar in Elation, and you will be able to see Elation patient appointments in your Google Calendar. Utilizing this feature will allow you to see patient appointments on your mobile device, reduce double bookings, and manage your time more effectively.
[Click here to learn more about connecting your Google Calendar to Elation](/articles/introduction-to-google-calendar-sync)
.
## Frequently Asked Questions (FAQ)
### Do I need to store my NADEAN in my Elation account?
When Providers save their XDEA/NADEAN number in their account details, Elation will automatically send the XDEA/NADEAN number to pharmacies, when applicable, when you are [e-Prescribing Controlled Substance Narcotic Addiction medications](/articles/how-to-e-prescribe-controlled-substances).
### Can other users in my practice see my account preferences?
Other users in your practice cannot see your account preferences. The settings under **User Settings** are unique and specific to each Provider Level User account.
**Next Step** Review your account details and set your preferences to ensure a smooth experience when using Elation EHR.
## Related Articles
* [User Accounts Guide- Provider vs. staff level account privileges](/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges)
* [Provider Account Authentication Guide](/articles/how-to-complete-account-authentication)
* [Drug Decision Support Guide- Monitoring drug interactions](/articles/drug-decision-support)
* [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates)
* [Elation Patient Passport Guide](/articles/elation-patient-passport-an-introduction)
* [Calendar Guide- Synchronizing your Google Calendar with Elation](/articles/introduction-to-google-calendar-sync)
# User Accounts Guide - Provider Level account vs. Staff Level account
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-Provider-vs-staff-level-account-privileges
This article outlines the different privileges available for the two types of Elation accounts- Provider and Staff.
## Overview
### What are the two types of Elation accounts?
Elation EHR offers two types of accounts for users – **Provider Level** and **Staff Level**.
* **Provider Level accounts**
* Usually used by physicians, non‑physician practitioners, or other medical providers who:
* Have patients and visit notes assigned to them
* Sign clinical documentation (visit notes, orders, referrals, prescriptions)
* Are listed as the rendering and/or billing clinician on claims
* **Paid user licenses** (**provider seats**) and come with a fee as stated on your contract with Elation. Each provider seat is intended for a single named clinician.
* **Staff Level accounts**
* Usually used for administrative or clinical staff who support clinicians with scheduling, documentation, and billing. Staff Level accounts are **free of charge** and are ideal for roles such as:
* Front office and billing staff
* Medical assistants and clinical support staff
* Scribes and other documentation support roles
* Do not replace a Provider Level account and do not sign visit notes or bill as rendering providers.
### Account Privilege Comparison
| Privileges vs. Account Type | Regular Provider | Non-Prescribing Provider | Limited Use Provider | On Call Provider | Staff |
| ---------------------------------------------- | ---------------- | ---------------------------------------------------------- | -------------------- | -------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Specific Calendar Schedule** | ✓ | ✓ | ✓ | ✓ | When Staff Level Users select a **Default Provider** in their Account Details settings, that provider calendar will be the default calendar shown. |
| **Telehealth Zoom Visits** | ✓ | ✓ | ✓ | **Not** able to activate the telehealth Zoom feature, but **can start virtual visits** from a Regular and Non-Prescribing Provider calendar. | **Can start virtual visits** from a Regular and Non-Prescribing Provider calendar. |
| **Document in a Visit Note** | ✓ | ✓ | ✓ | ✓ | ✓ |
| **Sign a Visit Note** | ✓ | ✓ | ✓ | ✓ | Can document in a visit note, but **cannot** complete the note by Signing Off. |
| **Enter/Edit Billing Information (Pre-Sign)** | ✓ | ✓ | ✓ | ✓ | ✓ |
| **Sign Bills** | ✓ | ✓ | ✓ | ✓ | **Cannot** sign bills on behalf of Providers. |
| **Enter/Edit Billing Information (Post-Sign)** | ✓ | ✓ | ✓ | ✓ | Must be a **Billing Delegate** of a Provider. |
| **Draft Prescriptions** | ✓ | ✓ | ✓ | ✓ | ✓ |
| **ePrescribing Regular Substances** | ✓ | Must be a **Prescription Delegate** of a Regular Provider. | ✓ | ✓ | **Not** able to ePrescribe any substances. Can draft scripts and send on behalf of the Provider if the staff is a **Prescription Delegate** . |
| **ePrescribing Controlled Substances (EPCS)** | ✓ | **Not** able to ePrescribe any controlled substances. | ✓ | **Not** able to ePrescribe any controlled substances. | **Not** able to ePrescribe any controlled substances. |
| **Draft Electronic Lab Orders** | ✓ | ✓ | ✓ | ✓ | ✓ |
| **Sign and Send Electronic Lab Orders** | ✓ | ✓ | ✓ | ✓ | Must be an **Order Delegate** of a Provider. |
| **Draft Ancillary Orders (non-lab)** | ✓ | ✓ | ✓ | ✓ | ✓ |
| **Sign and Send Ancillary Orders (non-lab)** | ✓ | ✓ | ✓ | ✓ | Must be an **Order Delegate** of a Provider. |
| **Draft Referrals** | ✓ | ✓ | ✓ | ✓ | ✓ |
| **Sign and Send Referrals** | ✓ | ✓ | ✓ | ✓ | Must be a **Referral Delegate** of a Provider. |
### Sample Accounts View
Here are examples of what the Provider versus Staff account privileges look like:
![Side-by-side comparison showing Provider User view with Print & Close, Sign & Close, ePrescribe buttons highlighted on Imaging Requisition and Prescription forms, versus Staff User view showing only Save as Draft & Close and Discard options available.]()
## Workflow Instructions
### Standard Provider Level Account privileges
Provider Level accounts are usually used by physicians, non-physician practitioners or other medical providers. For these reasons, Provider Level accounts offer functionalities that Staff Level accounts do not. Here are some common examples:
* Providers can have patient charts assigned to them.
* Providers have a Calendar in Elation.
* Providers can sign all important clinical documentation such as:
* visit notes
* test orders
* prescriptions
* referrals
* electronic test reports
* Providers can amend their own visit notes after the visit note is signed.
* Providers can edit the billing information of their own visit notes after a visit note is signed.
* Providers can sign office messages that Provider Level Users are part of.
* Administrative reports are catered towards Provider Level User data.
* Providers can append their signature to Reports when using the annotate feature.
### Staff Level Account privileges
Staff Level accounts are usually for administrative or clinical staff, including:
* Front office staff
* Billing staff
* Medical assistants and nurses
* Scribes and other documentation support roles
Staff Level users support clinicians with documentation and operations, but do **not** have the full set of Provider Level privileges above. For example, they do not sign visit notes as the billing/rendering clinician, and their credentials are not used as the treating provider on claims.
There is one important exception: Staff Level users can take certain clinical and billing actions **on behalf of a provider** when that provider explicitly designates them as an [authorized staff delegate](/articles/staff-permissions--staff-delegates). In that case, a Staff Level user may:
* sign test orders on a provider's behalf
* sign prescriptions and/or send prescription medications to pharmacies (controlled substance medications cannot be e-Prescribed by staff delegates) on a provider's behalf
* sign referrals on a provider's behalf
* edit billing information of the provider's signed visit notes
This delegation pattern is how many practices configure **scribes** in Elation: as Staff Level users with the appropriate delegate relationships to the Provider Level clinicians they support.
#### Example: Configuring a biller who is not a provider
If your practice has a dedicated biller who is not a clinician, configure them as a Staff Level user with the appropriate billing permissions.
**Setup pattern:**
| **1** | Create a **Staff Level account** for the biller. |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Have each provider add the biller as a **Billing Delegate** under their **Provider Managed Delegates** settings ( **Settings** → **Provider Managed Delegates** → **Edit Signed Bills** ). This allows the biller to not only enter and edit billing information in visit note drafts, but also edit billing information in signed visit notes on behalf of those providers. |
| **3** | Grant **Admin** privileges at your own discretion should you believe the biller also needs to manage user accounts and practice-level settings. |
**What the biller can do as a Staff Delegate:**
* Enter or edit billing information before a visit note is signed
* Edit billing information in signed visit notes for providers who have designated them as a **Billing Delegate**
* View and manage bills in **Billing Home**
**What the biller cannot do as a Staff Delegate:**
* Sign visit notes or bills on behalf of providers
* Sign prescriptions, orders, or referrals (unless separately configured as a delegate for those actions)
Billing Home metrics—such as Charges, Payments, and AR—are visible to any user with access to Billing Home. You cannot hide these metrics on a per-user basis.
#### Using Staff Level accounts for scribes
In Elation, a **scribe** is not a separate account type. Instead, scribes are typically configured as **Staff Level users** who help one or more providers with visit documentation and billing workflows.
A Staff Level "scribe" can:
* Document in visit notes on behalf of a provider (for example, capturing the clinical story during or after the encounter)
* Enter or edit billing information before a visit note is signed
* Edit billing information for a provider's signed visit notes when designated as that provider's **Billing Delegate**
They do **not**:
* Replace a Provider Level account for the clinician
* Sign visit notes as the rendering provider
* Prescribe medications under their own credentials
For practices using **Note Assist**, Elation's AI‑powered ambient scribing tool, staff and scribes can also help review and edit the AI‑generated content before the provider signs the note.
### Licenses and seats (e.g. "scribe seats")
Elation's user accounts map directly to the licenses (or **seats**) in your contract:
* **Provider Level accounts** are **limited seats** (based on your contract). Each seat is intended for one named clinician whose credentials are used to sign notes, orders, referrals, and prescriptions, and to appear as the rendering/billing provider on claims.
* **Staff Level accounts** are **unlimited, free seats** for administrative and clinical support staff, including front office, billing staff, medical assistants, and human scribes.
#### "Scribe" the person vs. "scribe license" the product
It's important to distinguish between:
* A **scribe as a person** – a staff member who helps document visits and support billing workflows. In Elation, this person should always have their own **Staff Level account** and, when appropriate, be configured as an **Authorized Staff Delegate / Billing Delegate** for the providers they support.
* A **"scribe license" or Note Assist subscription** – a **product subscription** tied to a specific **Provider Level account**. This is distinct from the Staff Level user accounts that human scribes use.
Human scribes **do not share** a provider's login and do not "own" a Note Assist license themselves. Instead:
* The **Provider Level user** holds the Note Assist subscription.
* Any staff or scribes who help with documentation still log in as **themselves** on Staff Level accounts, following the normal delegation model.
* The provider remains the one who reviews and signs the visit note.
#### Note Assist "scribe license" and reassignment
[Note Assist](/articles/Note-Assist-Guide) is Elation's AI‑powered ambient scribing and note‑writing solution. Practices may purchase upgraded Note Assist subscriptions for specific providers.
Key points:
* A Note Assist subscription is **attached to a specific Provider Level account**, not to a Staff Level "scribe" account.
* When your practice wants to **reassign** a Note Assist subscription from one provider to another, Support or your Customer Success Manager must update the subscription assignment on your behalf.
##### How to reassign a Note Assist subscription between providers
If you need to move a Note Assist subscription from one provider to another, please **reach out to Elation Support or your Customer Success Manager** with all of the following information below. Support/CSM will make the changes as requested and then notify you once this is done.
* Name of the provider to turn Note Assist OFF
* Name of the provider to turn Note Assist ON
* The date you want the switch to take effect
This process ensures the Note Assist subscription follows the correct Provider Level user, while Staff Level scribes continue to work from their own accounts using the standard delegation model.
### Setting up user accounts
[Click here for instructions on how to invite members of your practice to create an Elation account based on the account type you assign](/articles/managing-user-accounts).
## Frequently Asked Questions
##### I have a Supervising Physician. Do they need their own Elation account?
Yes, if you have a Supervising Physician and you need to send their credentials along with any electronic prescriptions you create, then your Supervising Physician must have their own [authenticated](/articles/how-to-complete-account-authentication) Provider Level User account with Elation. This is required even if your Supervising Physician does not need direct access to your patient data.
Once your Supervising Physician has activated and authenticated their Elation account, take the following actions to automatically send their credentials along with yours when e-Prescribing:
| **1** | Go to your Elation **Settings** . |
| ----- | ----------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Edit Profile** under **Account Details** . |
| **3** | Select your Supervising Physician's name in the **Supervising Provider** field under the **Credentials** section. |
For more context on provider vs. staff seats and how licenses work in Elation, see the sections **"What are the two types of Elation accounts?"** and **"Licenses, seats, and 'scribe seats'"** above.
##### Which account type should I use for a scribe?
Use a **Staff Level account** for scribes.
Staff Level accounts are designed for administrative and clinical support roles, including scribes. They can:
* Document in visit notes
* Enter billing information before sign‑off
* Edit billing information for a provider's signed visit notes when configured as a Billing Delegate
The supervising clinician should keep a **Provider Level account** and remain the one who signs visit notes, prescriptions, orders, and referrals as the rendering/billing provider.
##### How do I configure a Staff Level user as a scribe for a specific provider?
To configure a Staff Level user as a scribe for a specific provider:
| **1** | **Create a Staff Level account** for the individual (do not share or reuse the provider's login). |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Have an **Admin‑level user** review and manage the Staff Level user from **Settings → Manage Accounts** , as described in the Administrative privileges guide. |
| **3** | Have the **Provider Level user** add that Staff Level user as an **Authorized Staff Delegate** (and Billing Delegate, if desired) under their **User Settings** , so the scribe can sign specific items and edit billing information on the provider's behalf. |
##### Can my scribe use my provider login or my MFA device?
No. Shared or generic user accounts are **not permitted** in Elation.
Each individual must:
* Log in with their **own unique Elation user account**, and
* Use their **own multi‑factor authentication (MFA) factor(s)** when MFA is enabled.
Sharing a Provider Level login or sharing an MFA device with a scribe or staff member violates Elation's security policies and makes it harder to track who performed which clinical actions in the chart.
To give your scribe access:
| **1** | Create a **Staff Level account** for them. |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Configure them as an **Authorized Staff Delegate** (and Billing Delegate, if desired) under your **Provider User Settings** , so they can take appropriate actions on your behalf while still logging in as themselves. |
## Related Articles
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
* [User Accounts Guide- Administrative privileges](/articles/administrative-privileges)
# User Accounts Guide- System Requirements and Recommendations
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-System-Requirements-and-Recommendations
This article provides in depth information on system requirements and recommendations for your Elation EHR account.
## Recommendation Overview
Elation recommends using specific devices and browsers and keeping your device operating system and web browsers up to date to ensure the Elation EHR application operates efficiently and as intended for your practice.
### Device Configuration
Elation EHR works best on a computer device that has at least a 13 inch screen.
### Recommended Browsers
Elation recommends using Google Chrome or Mozilla Firefox as your computer's web browser when using Elation EHR. Using these browsers ensures that you will have the best user experience with Elation EHR as our engineers test and design on those browsers. Using
[other browsers](#other_browsers)
can cause irregular behavior within Elation EHR.
### Staying Updated
Keeping your device operating system and web browsers fully updated will help ensure that Elation EHR works as intended and also keeps your Elation account secure. We recommend checking for these updates routinely and often, and updating when the update is available.
Setting up automatic updates and update notifications on your device can help make sure you don't miss opportunities for updating your browsers and device. Updating device operating system: [Update macOS on Mac](https://support.apple.com/en-us/HT201541)
[Update Windows](https://support.microsoft.com/en-us/windows/update-windows-3c5ae7fc-9fb6-9af1-1984-b5e0412c556a) Updating browsers: [Update Google Chrome](https://support.google.com/chrome/answer/95414?hl=en\&co=GENIE.Platform%3DDesktop)
[Update Mozilla Firefox](https://support.mozilla.org/en-US/kb/update-firefox-latest-release)
## Importance of following the recommendations
It is very important to follow the recommendations detailed above to ensure your experience using Elation EHR is the best it can be. Staying up to date keeps your account as secure as possible. For more information on keeping your account secure, please reference the
[User Accounts Guide- Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure)
.
## Frequently Asked Questions
### Elation EHR is showing irregular or not expected behavior, what should I try?
If you are experiencing irregular or not expected behavior, we recommend trying to clear your cache/cookies on your web browser, in addition to our standard recommendations. Irregular behavior can be a result of old, saved data affecting your browser.
* [Google Chrome: How to clear cache](https://support.google.com/accounts/answer/32050?co=GENIE.Platform%3DDesktop\&hl=en)
* [Mozilla Firefox: How to clear cache](https://support.mozilla.org/en-US/kb/how-clear-firefox-cache)
### Can I use Safari or Microsoft Edge as a web browser when using Elation EHR?
Our engineers test and design Elation EHR to work best on the computer version of Google Chrome and Mozilla Firefox. We expect Elation to work on Safari and Microsoft Edge, but cannot guarantee that it will work flawlessly.
### Can I use Internet Explorer as a web browser when using Elation EHR?
Elation EHR does work with Internet Explorer, but we recommend Google Chrome or Mozilla Firefox for the best experience. If you run into irregular behavior in Internet Explorer, such as pop-up boxes or windows displaying at the wrong size, switching to Chrome or Firefox typically resolves it.
### Can I use Elation EHR on a tablet or mobile device?
The full EHR is currently not designed for use on a tablet. There are certain functionalities available on our iOS© App Elation Go. We recommend reviewing the following Help Center Article to learn more about Elation Go: [Elation Go- The Mobile App for Practices](/articles/elation-go-the-mobile-app-for-practices)
### How do I update Elation EHR?
Our engineers keep your Elation EHR version up to date for you, so you do not need to look out for manual updates on your end.
*Copyright © 2023 Apple Inc. All rights reserved.*
## Related Articles
* [User Accounts Guide- Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure)
* [User Accounts Guide- Updating your login email address](/articles/updating-your-loginemail)
* [User Accounts Guide- Changing your password](/articles/changing-your-password)
# User Accounts Guide - Troubleshooting EHR login issues
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-Troubleshooting-account-login-issues
This article will describe how you can troubleshoot account login issues while trying to access Elation EHR.
## Overview
### What is login troubleshooting?
Login troubleshooting helps you resolve common issues when accessing your Elation EHR account, including forgotten passwords, locked accounts, and email access problems.
### Why is this important?
Quick resolution of login issues ensures you can access patient records and continue providing care without unnecessary delays. Understanding who to contact—your practice admin first, then Elation Support—helps resolve issues faster.
### Who controls user access?
**PRACTICE ADMIN RESPONSIBILITY** Practice admins manage invites, deactivation, reactivation, and login unlocks; Elation Support only steps in when no active admin can perform these actions.
Your practice's Admin Level Users are the primary owners of account access decisions. For login issues, your practice admin should be your first point of contact. Admins can:
* Confirm whether your account is active or disabled (disabled accounts cannot log in)
* Unlock your account after failed login attempts
* Reset MFA if you lose access to your authentication device
* Re-enable a previously disabled account
If you're unsure who your practice admin is, ask a colleague or check with your practice manager. Most practices designate the practice owner or office manager as an Admin Level User.
#### When to contact Elation Support
Contact [Elation Support](https://help.elationemr.com/s/contactsupport) only when:
* Your practice does not have an active Admin Level User.
* All admins are locked out and cannot help each other.
* Your admin cannot access Settings → Manage Accounts due to a technical issue.
For more about how MFA works and how to choose authentication factors, see [Multi-Factor Authentication Introduction](/articles/Multifactor-Authentication-MFA), and for general security guidance see [Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure).
## Workflow Instructions
### Accessing the Elation EHR login page
The Elation EHR Login website is [https://app.elationemr.com/login/](https://app.elationemr.com/login/). Please make sure you are accessing the website from a Google Chrome or Mozilla Firefox browser on your desktop as Elation is only compatible with these two desktop web browsers.
### Recovering your login email
Your Elation EHR Login email is the email you use to sign in to your account and is usually the email that the Elation Team uses to communicate with you.
If you do not remember your login email or you no longer have access to your login email, [click here to contact the Support Team](https://help.elationemr.com/s/contactsupport) for assistance. Provide Elation with the following information to expedite the conversation:
* Your full name
* Your Practice's name
* Your best call back number
### Resetting your password
Your Elation EHR login password is the password you entered when you first registered for your Elation EHR account. The password is a minimum of 12 characters and is case sensitive. If you need to reset your password:
**1**
Go to [https://app.elationemr.com/password/reset/](https://app.elationemr.com/login/)
**2**
You must have access to the email address you use for your Elation account in order to reset your password. If you do not have access to this email address, [click here to contact the Support Team](https://help.elationemr.com/s/contactsupport) for further assistance.
Enter your Elation login email address & click **Submit Request**.
**3**
You will receive an email in your email inbox from [support@elationemr.com](mailto:support@elationemr.com) with the subject line **Elation Password Reset.** Click on the link in the email to reset your password.
**4**
Enter your new password twice & then click **Update Password** .
**5**
Click **Back to Login Page** ( [https://app.elationemr.com/login/](https://app.elationemr.com/login/) ) to login with your email and new password.
### Unlocking a locked account
Each Elation EHR Account has a fail-safe in case anyone maliciously tries to access your Elation account; an Elation account will be locked for 1 hour if there were 10 or more unsuccessful login attempts in a row. If you are the owner of the account and have accidentally locked yourself out:
| **1** | Ask an Admin Level User in the practice to help you unlock your account by having the Admin Level User: Go to **Settings**. • Click **Manage Accounts** in the **Admin Users Only** section. • Click the **Unlock...** button with your name at the top of the page. |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Afterwards, check your email inbox for a password reset email and reset your password to log in. |
| **3** | If an Admin Level User is unavailable to help you unlock your account, [click here to contact our Support Team](https://help.elationemr.com/s/contactsupport) for assistance with unlocking your account. |
### Contacting Support
If you are having trouble remembering or accessing your Elation EHR email address or you are having trouble resetting your password, [click here to contact the Support Team](https://help.elationemr.com/s/contactsupport) for further assistance. Provide Elation with the following information to expedite the conversation:
* Your full name
* Your Practice's name
* Your best call back number
## Frequently Asked Questions
### I was told my account is "disabled"—is that the same as being locked out?
No. These are two different situations:
* Locked out (temporary): Your account is locked for 1 hour after 10 or more failed login attempts. An admin can unlock it immediately, or you can wait 1 hour and try again.
* Disabled (Admin action): A practice admin intentionally turned off your account. You cannot log in until an admin re-enables it. This typically happens when someone leaves the practice or no longer needs access.
If you're unsure which situation applies to you, contact your practice admin. Elation Support cannot override a practice's decision to disable an account—only your practice admin can re-enable it.
### The "Get Started" link in my welcome email says "this link is not valid." How do I complete setup?
Invitation links expire after a set period. If you click **Get Started** in your welcome email and see a message that the link is not valid, follow these steps:
| **1** | **Check for a newer email.** Make sure there isn't a newer email from Elation with a valid link. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | **Contact your practice admin** and ask them to check your invite status and resend your invitation: Your admin can go to **Settings** → **Manage Accounts**. • They should expand the **Inactive Users** section for Providers or Staff. • Next to your name, they will see a status badge. If it shows **Invite expired**, they can click **Resend invite** to send you a fresh invitation. |
| **3** | **Check if your account is already active.** In some cases, you may have already completed registration. Try logging in at [https://app.elationemr.com/login/](https://app.elationemr.com/login/) with the email address associated with your invitation. If you forgot your password, click **Forgot Password?** to reset it. |
| **4** | **Verify your email address is correct.** If the invitation was sent to the wrong email, your admin can click **Edit** next to your name in **Manage Accounts** , correct the email address, and click **Save** . A new invitation will automatically be sent to the updated email. |
If your practice does not have an active Admin Level User available to help, contact [Elation Support](https://help.elationemr.com/s/contactsupport) for assistance.
### I clicked "Forgot Password?" and got a message that my email address has not been confirmed. What do I do?
This means you haven't completed your account's initial setup yet — **Forgot Password?** only works for accounts that have already been activated. Look for the welcome email from Elation and click **Get Started** to complete setup. If you can't find that email or the link says it's not valid, follow the steps above for [a "this link is not valid" message](#the-get-started-link-in-my-welcome-email-says-this-link-is-not-valid-how-do-i-complete-setup).
## Related Articles
* [User Accounts Guide- Best practices for keeping your Elation account secure](/articles/Best-practices-for-keeping-your-Elation-account-secure)
* [User Accounts Guide- Administrative privileges](/articles/administrative-privileges)
# User Accounts Guide- Viewing activity logs for users in your practice
Source: https://help.elationhealth.com/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice
This article describes the User Activity Log feature in Elation that is used to monitor the actions take by users in your practice.
## What is the User Activity Log?
The User Activity Log allows [Admin Level Users](/articles/administrative-privileges) to see and monitor actions performed by all users in the EHR from January 1, 2023 to present. Non-Admin Level Users will be able to see and monitor their own activity. The activity in the User Activity Log includes, but is not limited to:
* Accessing, deleting or merging patient charts
* Creating certain content in the patient’s demographics including:
* Address
* Phone
* Email
* Contact preference
* Insurance (including deleting)
* Creating certain content in the Clinical Profile including:
* Patient’s profile picture
* Patient allergies
* Patient drug intolerances
* Problems
* Medical History
* Family history
* Patient’s provider list
* Immunization history
* Creating, deleting or printing visit notes (including vitals and certain bullets)
* Creating and updating bills (including CPT Codes and Diagnosis Codes)
* Creating, signing and deleting orders
* Deleting discontinued medications
* Deleting medication history reports
* Approving and denying prescription refill requests
* Creating and deleting letters
* Creating, signing, acknowledging, and deleting Office Message threads
* Creating and deleting non-visit notes
* Reassigning and deleting reports
* Creating and deleting appointments
## What are the benefits of using the User Activity Log?
The User Activity Log provides a convenient way to review activity performed by various users within the EHR. Through the use of powerful filters, you can quickly review all actions performed for a given patient and/or by a specific user. This new functionality will simplify and expedite the process of understanding when actions were performed and by whom and allow you to access the relevant patient chart to take next steps if needed. You will also be able to undo certain actions such as deleting certain records or merging charts.
Use cases for the User Activity Log include:
* *Which chart did I update?*
* In the busyness of a typical day, sometimes someone in the practice makes a change to a chart only to forget which chart they modified. This can make it difficult to continue making necessary changes, or to revert changes that have been made by mistake. With the User Activity Log, you can easily see all the charts recently viewed.
* *Who has viewed or taken action on a particular chart?*
* Sometimes certain charts are sensitive and your practice may want to ensure only authorized practice users are accessing the chart. With the User Activity Log, you can search for a specific patient and view all the users who have viewed or taken action on that patient's chart.
* *What actions has this user performed?*
* In some scenarios, a practice may have concerns that a particular user might be attempting to view or do more than they should. With the User Activity Log, you can search for a particular practice user and review all the actions performed by that user across charts to ensure it is aligned with what they are authorized to do.
* *How do I restore a deleted patient chart?*
* You can use the User Activity Log to restore a patient chart; whether it was deleted or merged away.
## Using the User Activity Log
### Accessing the User Activity Log
To access the User Activity Log, go to **Reports** -> **User Activity Log**.
![Reports menu expanded showing all options, with "User Activity Log" highlighted by a red outline at the bottom of the list.]()
### Viewing data in the User Activity Log
By default, we will list user activity from **January 1, 2023** to present. The activity log will list up to 20 activities per page. Use the page navigation buttons to move between different pages of the activity log.
* [Admin Level Users](/articles/administrative-privileges) can see and monitor actions performed by all users in the Practice.
* Non-Admin Level Users can only see and monitor their own activity.
You can use the following filters to narrow down the activity log data. Click the **Search** button after applying filters to see the results that match your filter(s).
![Activity Logs page with the filter bar highlighted, showing User, Patient, Record Type, Action, Start Date, and End Date fields, all empty, with a Search button.]()
#### **User Activity Log Filters**
To prevent a disabled user from accessing their account while it is temporarily enabled for this purpose, you can adjust their email. (Ex. If their email is [john.smith@email.com](mailto:john.smith@email.com) you can update it to [john.smith+disabled@email.com](mailto:john.smith+disabled@email.com).
| **Filter** | Use Case |
| ----------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| User | Select the User in your practice you wish to monitor. - This filter will not be available for non-Admin Level Users. Non-Admin Level Users can only see their own activity.
- You can only filter for one user at a time.
- You will not be able to filter for disabled users but you will be able to see their activity listed in the User Activity Log. To filter for the activity of a disabled user, you must temporarily enable their account, view their activity log and then disable their account again.
/callout |
| Patient | Enter the **Patient ID** into this filter if you want to look at the activity log for a specific patient. - You can only filter for one patient at a time.
To locate a patient’s **Patient ID**: - Open the patient’s chart
- Click on the patient’s name to open their Demographics
- Click the **Copy** button next to **Elation Patient ID** at the top of their demographics.
|
| Record Type | Select the type of record you wish to look at. You can select multiple records at a time. - For example, select **Visit Note** if you want to see all activity related to visit notes.
|
| Action | Select the type of action you wish to look at. - You can select multiple actions at a time.
- For example, select **Delete** if you want to look at all delete activity.
|
| Start Date | Select the date you wish to start filtering the activity by. The date cannot be before January 1, 2023. |
| End Date | Select the date you wish to stop filtering the activity by. |
#### **User Activity Log Data Columns**
| Column | Description |
| ------------------------------------------------------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Date | Lists the Date and Time of the activity in your practice’s timezone. |
| User | Lists the full name of the User that performed the activity. - You will also see activity for disabled users. However, you will not be able to filter for disabled users unless you temporarily activate their account.
- If your practice uses any API integrations with Elation, you will see ‘API User’ listed for activity performed via the integration.
|
| Patient | Lists the full name of the Patient tied to the activity. - You can click on the patient’s name to open their chart if needed.
- You will not be able to click on the patient’s name to open their chart if their chart was deleted or merged away. You must first restore or unmerge the chart first to access the chart again.
|
| Patient DOB | Lists the date of birth of the Patient - Useful when multiple patients have the same exact name.
|
| Action | Lists the action performed on the Patient. - The **Update** action may be recorded if a user accesses a record but does not modify it. This can occur because a draft of the record is automatically saved when it is accessed, even if no changes are made.
|
| Record Type | Lists the type of record the action was performed on. |
| Record ID | Lists the Record ID of the record in Elation’s database. - This is often used by Elation’s Support Team for troubleshooting.
|
| Restore
(only available for certain Record Types) | Allows you to click a **Restore** button to restore certain deleted records. Restored records can be accessed immediately. - After a record is restored, the “Restore” button will be replaced with the designation **Restored** for reference.
The following records can be restored from the User Activity Log: - Patient Charts
- Both restoring deleted charts and unmerging merged charts
- Visit Notes
- Non-visit Notes
- Reports
- Medications (including discontinued medications)
- Medication History Download Reports
|
\
## **Frequently Asked Questions (FAQ)**
### **How is the User Activity Log different from the Audit Log?**
The activity data in the [Audit Log](https://help.elationemr.com/s/article/Patient-Chart-Guide-Audit-Logs) is specific to each patient’s chart whereas the User Activity Log lists activity within all patient charts (unless you choose to filter the data by a specific Patient ID). You will not be able to undo any actions within the Audit Log but you can undo certain actions, such as deleting certain records or merging charts, within the User Activity Log. \
### **How often does the User Activity Log update with new (recent) data?**
Recent actions may take up to 30 minutes to appear. \
\
### **When will I be able to see activity prior to January 1, 2023?**
The User Activity Log will only list actions performed on or after January 1, 2023. If you need information about actions performed prior to this date, please click the **I need help** -> **Contact Elation Support** button at the top of your Elation account and the Elation Support Team will be able to assist you with this request.\
\
### **Is there a way to download a report of the data in the User Activity Log?**
A download option is currently unavailable at this time but it is something under consideration for future development. If you need help obtaining a download of activity, please click the **I need help** -> **Contact Elation Support** button at the top of your Elation account and the Elation Support Team will be able to assist you with this request.
If you only need a user's login history, Admin Level Users can self-serve a CSV of the last 90 days of logins directly from the **Edit Profile** dialog in **Manage Accounts** — no support ticket required. See [Downloading a user's login history](/articles/managing-user-accounts#downloading-a-user%E2%80%99s-login-history) for instructions.
### **Does the User Activity Log track who downloaded a Patient List Report (CSV export)?**
No. Downloading a Patient List Report as a CSV is not one of the tracked action types in the User Activity Log or the patient chart Audit Log, so there isn't a self-service way to see who has downloaded a Patient List Report.
### **Can I filter Referral activity by the receiving provider or facility?**
Not directly. You can filter the User Activity Log by the referring provider (**User**), set **Record Type** to **Referral**, and choose a date range to see which patients that provider has created referral records for. There isn't a filter for the provider or facility a referral was sent to. If you need this level of detail, click **I need help > Contact Elation Support** to request a custom data export.
### **Why does a record show the action of ‘Update’ if I viewed it but did not make changes to it?**
When performing certain actions, such as viewing a medical order, a draft of the content being viewed will be saved, regardless of whether a change was made. As a result of this draft being saved, the record is considered to be modified and will thus be categorized as an 'Update' action.
### **How do I find a fax that I filed into the wrong chart?**
The Action filter does not have a dedicated "File" option for tracking fax filings from the Fax Inbox. To narrow down where a mis-filed fax might have gone:
1. Filter the User Activity Log by your user and the date the fax was filed to see every chart you touched that day.
2. If you remember the record type the fax was filed under, add that as an additional filter to shorten the list.
3. Open the remaining candidate charts and check the Chronological Record for a fax or scanned document matching the one you're looking for.
### **How do I find outgoing faxes?**
The User Activity Log doesn't track fax delivery status. Use the [Fax Outbox](/articles/fax-outbox) instead — it lists every fax your practice has sent (Letters, Referrals, and orders faxed to vendors) along with its destination, sender, and delivery status, including faxes that are retrying or need attention.
### **How do I find out who deleted a fax from the Fax Inbox?**
Deleting a fax or document page from the Fax Inbox is not visible in the User Activity Log or patient-chart Audit Logs.
* If you need to identify who deleted a page, click **Help** → **Contact Elation Support**. Support can investigate the available backend audit records.
* If the deletion occurred more than 7 days ago and you also need the document restored, include the approximate deletion date and time, number of pages, and any information about who may have deleted them.
See [Restoring documents deleted from the Fax Inbox](https://app.glean.com/articles/Restoring-documents-deleted-from-the-Fax-Inbox).
\
\
## **Related Articles**
* [User Accounts Guide- Administrative privileges](https://help.elationemr.com/s/article/administrative-privileges)
* [Patient Chart Guide- Audit Logs](https://help.elationemr.com/s/article/Patient-Chart-Guide-Audit-Logs)
* [User Accounts Guide- Managing Elation accounts for providers and staff](https://help.elationemr.com/s/article/managing-user-accounts)
* [Fax Outbox](/articles/fax-outbox)
# Membership Management - How to manage membership plans
Source: https://help.elationhealth.com/articles/Using-Elation-Membership-Management-to-Create-Membership-Plans-and-Manage-Enrollments
Learn how to use Elation's Membership Management feature to create and manage membership plans.
📖 **RECOMMENDED READING**
Read the [Membership Management Introduction](/articles/Introduction-to-Membership-Management-with-Elation) article to learn about the membership management features offered and how to get started.
**Contents**
* [Overview](#overview)
* [Workflow Instructions](#workflows)
* [Creating a membership plan](#add)
* [Editing a membership plan](#edit)
* [Deleting a membership plan](#delete)
## Overview
### How do membership plans work?
With Elation's membership management functionality, you can create an unlimited number of custom patient membership plans. Each plan you make will have a specific billing amount and frequency. This flexibility allows you to create unique offerings to support all your patients.
In this guide, you'll discover how to create, name, and set the **rules** for these membership plans, as well as how to manage them. Afterwards, you can enroll patients in their appropriate plan(s).
## Workflow Instructions
### Creating a membership plan
Click **Settings** → **Membership Management**.
Click **+ Create a Plan**.
Fill in the following details:
* **Plan Name** — Assign a unique name that is only visible to your practice and not patients.
* **Display Name** — Assign a patient-facing name that will be used in patient communications. Avoid entering any PHI in the display name.
* **Description** (optional) — Enter an internal description about the membership plan.
* **Billing Amount** — Specify the amount that will be invoiced or charged to the patient based on the **Billing Frequency**.
* **Billing Frequency** — Specify how often the patient will be charged the **Billing Amount**. Select from annually, semi-annually, quarterly, or monthly.
* **Payment reason** — Specify a payment reason that appears on the receipt and payment. The default payment reason is **Membership fee - medical services**.
Click **Create plan**.
**Double-check the billing frequency before you create the plan.** If you set the wrong frequency (for example, **annually** when you meant **monthly**) and only correct it after patients enroll, those existing patients will keep the renewal date they were originally scheduled for — see [Editing a membership plan](#editing-a-membership-plan) for what happens and how to fix it.
### Editing a membership plan
Click **Settings** → **Membership Management**.
Click **Edit** next to the plan you want to edit.
Make changes and click either **Update plan** to save the changes, or click **Close** to cancel.
If changes are made to the billing amount or billing frequency, patients will be updated about the change.
If changes are made to the billing amount, all patients enrolled in that plan that do NOT have an override amount set to their subscription will automatically be charged the updated amount on their renewal date.
**Changing the billing frequency does not reschedule patients already enrolled in the plan.** Patients already enrolled keep the next renewal date they were originally scheduled for. Only patients enrolled *after* the change bill on the new frequency.
This matters most when a plan was created with the wrong frequency. For example, if a plan was set up as **annually** and later corrected to **monthly**, patients enrolled under the annual setting keep their annual renewal date — Elation will not charge them again until that date arrives, up to a year later, and no error or warning is shown.
After changing the billing frequency, open the Membership Report and review the next renewal date for each patient enrolled in the plan. To move a patient's renewal, edit their subscription from the patient's **Demographics** → **Insurance, Payment & Membership** section, click **Override** next to **Next renewal date**, and enter the new date — see [Editing a patient's membership plan](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans#editing-a-patients-membership-plan).
### Deleting a membership plan
Click **Settings** → **Membership Management**.
Click **Delete** next to the plan you want to delete.
Click **Delete** to confirm. All patients enrolled in that plan will become unenrolled immediately. No notification is sent to patients at the time of unenrollment.
📖 **Next Article to Read**
[Membership Management- How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans) .
## Related Articles
* [Introduction to Membership Management with Elation](/articles/Introduction-to-Membership-Management-with-Elation)
* [Membership Management- How to Enroll Patients in Plans](/articles/Membership-Management-How-to-Enroll-Patients-in-Plans)
* [Membership Management - Patient Self-Enrollment](/articles/Membership-Management-Patient-Self-Enrollment)
* [Membership Management- How Patients Receive Communications](/articles/Membership-Management-How-Patients-Receive-Communications)
* [Membership Management- How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
* [Membership Management - Frequently Asked Questions](/articles/Membership-Management-Frequently-Asked-Questions)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
# Telehealth Guide- Using Spruce alongside Elation for patient encounters
Source: https://help.elationhealth.com/articles/Using-Elation-Spruce-telehealth
A detailed guide on how to deliver virtual care using Elation and Spruce together.
## What is Spruce?
Spruce is a secure, HIPAA compliant communication platform that enables patients and their providers to readily connect. With Spruce, patients and providers can seamlessly discuss symptoms over messages, then have a phone call or virtual video appointment with their provider - all in one space. Both patients and providers can have peace of mind knowing that they can receive and give care in a secure, simple and adaptable way.
## What is the Elation-Spruce integration?
The Elation-Spruce integration allows you to
* automatically create charts for patients in Spruce when you create their chart in Elation
* easily keep patient contact information up to date in both systems
* automatically transfer your messages (especially telehealth related) from Spruce into Elation so that all of the patient's clinical data is easily stored in one place for billing purposes.
See the [Elation-Spruce- Message Sync Integration Guide](/articles/Elation-Spruce-Integration-Guide) for more detailed information about the integration features.
## Quick tips for using Spruce with Elation
### Do I need to sign up for the **integrated** Spruce option to be able to provide and bill for telehealth?
No, you do not! The benefit of using the integrated experience with Spruce is that you will not need to individually create patients in Spruce and you can more easily sync copies of conversations from Spruce to Elation. However, you can still use Spruce for telehealth visits alongside Elation without using the integration. Please see the
[Transferring your conversations into Elation without an integration](#transfer)
section for more information.
### What virtual services can I bill for by using Spruce?
There are 3 main types of virtual services recognized by Medicare and commercial payers. The following table covers which services you can deliver with Spruce.
| **Virtual Service** | **Description** | **Spruce Workflow** |
| ------------------- | ------------------------------------------------------------------------------------------------------------------------------------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Telehealth | Full patient visits performed in real time with video and audio | Hold a visit with your patient with a video call |
| Virtual Check-ins | Patient initiated brief communication via phone or review of patient-submitted images that mitigates the need for an in-person visit | Phone: have a phone call with your patient through Spruce (or with your regular phone) Review of patient-submitted images: Review images sent to you by the patient. Respond via phone, email, or message. |
| eVisit | Patient-initiated communication via an online patient portal | Cannot be completed in Spruce as a certified patient portal must be used. Please use Elation’s Patient Passport instead. |
Please refer to this [help center article](/articles/Telehealth-Coding-and-Workflows-Recommendations) for more information about virtual services.
### What workflow would you recommend for Telehealth visits?
1. In Elation, schedule the patient for a virtual visit. Remind them to install and set-up their Spruce account prior to the visit date.
2. When you are ready to start the virtual visit, message your patient with Spruce to check if they are ready. Next, initiate your video call in Spruce.
3. Create your visit note in Elation. Update the visit note category to **Telehealth**.
*
Learn how to create a **Telehealth** category using the [Visit Note Categories Guide](/articles/visit-note-categories)
4. Apply the **Telehealth** visit note template to document the details of the video call.
*
Elation pre-loaded a simple **Telehealth** Visit Note Template to your own during your Account Set Up. Learn how to create your own Telehealth \*\* visit note template using the [Visit Note Templates Guide](/articles/elation-visit-note-templates)
5. Bill for the E/M code that you would have used for an equivalent in-office visit. Depending on the patient’s insurance, make sure you add any necessary modifiers and Place of Service. (See Elation's Telehealth Billing Guidelines [here](/articles/Telehealth-Coding-and-Workflows-Recommendations) to understand the latest Telehealth billing requirements.)
**How do I bill for a Virtual Check-in?**
Since billing codes can only be added to Visit Notes in Elation, click on **Visit Note** in the patient’s chart followed by **Simple Note**. Change the visit note category to **Telehealth** and document a description of the virtual check-in. Add the billing codes to this visit note and then sign the visit note.
Learn how to create a **Telehealth** category using the [Visit Note Categories Guide](/articles/visit-note-categories)
## Inviting your patients to communicate via Spruce
Spruce allows providers to communicate with their patients via SMS and/or Secure Messaging directly within Spruce. SMS communications will be sent to patients mobile phone as text messages, while Secure Messaging will take place in the Spruce application and requires the patient to install the Spruce application on their mobile device.
### Contacts in Spruce
Patients must have a Contact in Spruce in order to be invited to communicate. To add a new contact:
1. Click on the Contacts icon
2. Click **New Contact**
3. Enter the patient's name, date of birth, contact information and another other demographics details
4. Click **Save**
See the
[Elation-Spruce Integration- How syncing works](#syncing)
section to learn more about how Elation can help you create Spruce Contacts and what information is synchronized.
### Inviting your patients from the Inbox
1. Click the Inbox icon in the menu bar
2. When the Inbox opens, click the Compose icon.
3. Click **Invite Patient** from the dropdown
4. Select the type of invitation method you need to use
5. Use the search box to search for an existing patient
6. Click the **Invite a new patient** button to invite a new patient
* Enter the patient’s name, phone number, and/or email address
5. Click **Send Invite**
6. A new conversation window will open for you and the patient
![Spruce Inbox showing numbered steps 1–5: Inbox icon selected, Compose icon clicked, "Invite Patient" highlighted in dropdown, "Invite Patient to Spruce" dialog open with Emotional Support provider selected, search field, and Send Invite button highlighted.]()
### Inviting your patients from a new message
1. Click the Inbox icon in the menu bar
2. When the Inbox opens, click the Compose icon.
3. Click **Secure Message** or **SMS** depending on the conversation method you want to use.
* SMS communications will be sent to patients mobile phone as text messages, while Secure Messaging will take place in the Spruce application and requires the patient to install the Spruce application on their mobile device.
4. Search for the patient in the **to:** field.
* Patient who have already been invited to a conversation will display in Blue. Patients who need an invite will display in Gray.
5. Select the patient you want to invite
6. Spruce will automatically send the patient an invite.
**Inviting your patients from your contacts**
1. Click on the Contacts icon
2. Click **Invite Patient**
3. Select the type of invitation method you need to use
4. Use the search box to search for an existing patient
5. Click the **Invite a new patient** button to invite a new patient
* Enter the patient’s name, phone number, and/or email address
4. Click **Send Invite**
5. A new conversation window will open for you and the patient
![Spruce Contacts screen showing steps to invite a patient: Contacts icon (step 1) and Invite Patient button (step 2) highlighted, with the "Invite Patient to Spruce" dialog open showing "Search patients to invite" field (step 3) and Send Invite button (step 4).]()
## Composing messages in Spruce
### Starting messages
1. Click the Inbox icon in the menu bar
2. When the Inbox opens, click the Compose icon.
3. Click **Secure Message** or **SMS** depending on the conversation method you want to use.
* SMS communications will be sent to patients mobile phone as text messages, while Secure Messaging will take place in the Spruce application and requires the patient to install the Spruce application on their mobile device.
4. Search for the patient in the **to:** field.
* Patient who have already been invited to a conversation will display in Blue. Patients who need an invite will display in Gray and an invitation will automatically be sent to them if they need one.
5. Start typing your message in the \*Type a message...\*box
6. Click **Send >** to send your message
### Adding attachments
* For both SMS and Secure Message, you are able to attach files like photos, videos, and PDFs.
* For Secure Messages, you are able to attach additional items, such as a Spruce Visit or a Payment Request (if you are using Spruce's integrated payments)
### Using Saved Messages
* Use your Saved Messages for quick actions or responses
* You can be creative with these, but common uses are for booking an appointment, reminding patients about an appointment, quick check-ins, and sharing contact information.
### Scheduling a message
* If you’d like to send out a message at a specific date or time, simply compose your message and schedule the preferred date/time and press the **Schedule** button. You will see the message queued in the patient conversation dialog box.
**Please Note**: While Spruce's app to app conversations are HIPAA compliant, SMS communications that go outside of the Spruce platform will require patient consent. You can read more about Spruce’s White Paper on HIPAA compliance [here](https://spruce.docsend.com/view/nur46mb). There is a template for obtaining patient consent for SMS/email messaging on page 12.
## Having a video call with your patient
### Before the Video Call
To initiate a video call with the patient, the patient must be invited to Secure Message and have the Spruce mobile app downloaded on their phone.
For best practices, we recommend recording the appointment or scheduled video call in Elation and then sending a message to the patient a few minutes prior to the start of the video call to ensure the patient is prepared and the video call is not missed.
### Starting the Video Call
Once ready, the provider can begin a video call by clicking on the patient's name from the Secure Message and then click the \*\*Video \*\* icon.
![Spruce Compose Message screen with patient Sally Sue selected in the To field, and an arrow pointing to the Video call icon (circled in red) in her contact card.]()
### After the Video Call
Once the call has ended, Spruce will automatically log the date and duration of the video call.
Providers can then use the **Internal** notes section to document the visit from the video call directly in Spruce and use either the [manual transfer method](#transfer) or [Elation-Spruce integration](#syncing) to transfer the information to Elation to begin billing.
Only providers are able to initiate a video call.
Spruce video calls are not recorded.
## Transferring conversations into Elation without an integration
Using Spruce without the Elation-Spruce integration, providers and staff can transfer Telehealth visit documentation from Spruce to Elation using the following methods: Formatted Copy & Paste and Conversation Links.
### Formatted Copy & Paste
To make the transfer for patient communications easy, Spruce has a conveniently formatted copy and paste feature. To copy specific messages from Spruce to Elation:
1. Open the patient’s conversation in Spruce.
2. Highlight the relevant messages and copy, or click the three dots icon next to a specific message, then click **Select Message** >> **Copy Messages**
3. In Elation, open a visit note or the desired location, and paste the message content. The formatted text will include the timestamp of the message, the sender of the message, and the channel in which it was sent.
### Conversation links
Spruce also has conversation links, which are unique links that allow providers and staff to seamlessly access the conversation that took place.
To copy the conversation link from Spruce to Elation:
1. Open the patient conversation in Spruce.
2. Press the Conversation Link icon at the top of the Spruce conversation
![Spruce conversation with patient Sal Mak open, showing the Conversation Link icon (chain link) circled in red in the top toolbar.]()
1. Paste the Conversation Link into Elation using your preferred note format.
*
**Please Note** : You must be logged into Spruce to access this link in the future.
## Elation-Spruce Integration- How syncing works
Integrating Spruce to Elation offers additional benefits, such as Spruce Contact creation from Elation, contact information sync between systems, and correspondence syncing. If you are interested in these additional benefits, please [click here to notify Elation](https://help.elationemr.com/s/contactsupport).
| **Elation** | | **Spruce** | **Notes** |
| ------------------------------ | - | ----------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Chart Creation | → | Contact Creation | Charts must be created in Elation to sync over to Spruce. Once the chart is created in Elation, the Contact will be created in Spruce instantaneously. |
| Demographic Edits | ↔ | Demographic Edits | Demographic edits can be made either in Elation or Spruce. Each time a change is made to a patient’s demographics in one platform, these changes will be reflected in the other platform. Only the following demographic information will sync: Patient first and last name • Phone numbers (up tp 2 different phone number types) • Email address • Date of birth • Gender |
| Visit Note or Report created\* | ← | Conversations | Conversations can be synced from Spruce to Elation through either manual syncing (Selective Sync) or Automatic Sync \*Select Sync will create a Simple Note and Automatic Sync will create a *Miscellaneous*Report |
### Creating Contacts in Spruce from Elation
Patients must have a Contact in Spruce in order to be invited to communicate via SMS, Secure Message or Video. When you create a new chart in Elation, a new Contact for the patient will be created in Spruce immediately and this will also create the patient link. You will receive a message in your Spruce Inbox with a note describing this automation for record keeping purposes.
Creating a new Contact in Spruce does not automatically create a new chart Elation chart. Patient/Contact creation only occurs from Elation to Spruce.
### Linking patients
1. Select the patient's contact in Spruce to open the contact card.
2. Scroll down to Integrations and click **Link Contact to EHR**.
3. Select **Elation** from the drop down menu.
4. Search for the patient by the name or the Chart ID number\*\* used for that patient in Elation.
* This search must have the full first or last name in order to pull up the patient. It is not case sensitive.
5. Once the correct chart appears, select it and verify that the information from Elation matches the information you have in Spruce.
6. Click\*\* Link\*\* to connect the Elation chart with the Spruce contact.
To remove a link follow the above instructions and when under Integrations hover over the integration you want to unlink and you will see it will say "Remove Link" when you are hovered over.
To see Spruce's demonstration of this workflow, please click [here](https://www.loom.com/share/9a83b4ae4501408ca52c889f789abcc3) .
### Message Syncing
There are two ways messages from Spruce can sync into Elation: Selective or Automatic.
#### Selective Sync (Recommended)
Selective sync allows you to choose one or more messages you would like to sync into Elation. This option allows you to control which messages you would like to copy to Elation. When using this option, you can select which patient chart in Elation the messages are filed under. The patient you are currently viewing in Spruce will be the default.
The message(s) chosen for syncing will populate into Elation as a Simple visit note and you will be able to [add Telehealth billing information directly](/articles/Telehealth-Coding-and-Workflows-Recommendations) to the Simple visit note directly.
To use Selective Sync:
1. Open the conversation in Spruce
2. Hover over any messages until three small vertical dots\*\* appear to the right of the message and click on them.
3. Select the **Select Message** option from the menu.
4. Squares will appear to the left of each message that you can click to select the individual messages you would like to copy to Elation, they are selected when blue.
5. Click **Sync to Elation** at the top of the conversation, below the patient name
6. A box will pop up and if this patient is already linked to their patient chart in Elation it will be populated under patient
* If the patient name is blank, search for the patient by full first and/or last name.
* You can also edit to a different patient than what was prefilled
7. Enter a **Note Subject** if desired.
8. Click **Done** in Spruce to exit the select message view
9. Open or refresh the patient’s chart in Elation and sign off on the visit note in the Requiring Actions queue.
*
**Please Note** : If your practice utilizes Patient Passport, signing off on visit notes will automatically send the visit summary to the patient.
To see Spruce's demonstration of this workflow, please click [here](https://www.loom.com/share/ae02d980185e41a684cbafb225c94195) .
![Spruce conversation for Sal Mak showing "Sync to Elation" button highlighted at top, a selected internal note message, and the "Sync Messages to Elation" dialog with patient pre-filled and Save button highlighted.]()
![Elation patient chart showing "Requiring Action" queue with 1 item: an unsigned Spruce Conversation visit note dated Feb 17, 2022, awaiting provider sign-off.]()
#### Automatic Sync
Automatic sync will sync all new SMS and Secure Messages in Spruce automatically to Elation every 24 hours. With automatic sync, the messages from Spruce will populate into Elation as **Miscellaneous (MISC)** Reports. This option can be used to attach supporting documentations when [billing for Virtual Check-Ins.](/articles/Telehealth-Coding-and-Workflows-Recommendations)
To access in Elation, click on the **Reports** tab, then the MISC category to access all Spruce conversation reports for a patient.
**Please Note** : Whether using Selective Sync or Automatic Sync, the visit note or miscellaneous report will appear in the **Requiring Action** queue of the patient’s chart, and will require provider sign off to file in the patient’s chronological record.
## Helpful Videos and Links About Using Elation and Spruce
* Spruce Integration Help Center article: [https://help.sprucehealth.com/article/470-elation-integration](https://help.sprucehealth.com/article/470-elation-integration)
* Elation-Spruce Link Charts Video: [https://www.loom.com/share/9a83b4ae4501408ca52c889f789abcc3](https://www.loom.com/share/9a83b4ae4501408ca52c889f789abcc3)
* Elation-Spruce Selective Sync Video: [https://www.loom.com/share/ae02d980185e41a684cbafb225c94195](https://www.loom.com/share/ae02d980185e41a684cbafb225c94195)
* Spruce Help Site: [https://help.sprucehealth.com/](https://help.sprucehealth.com/)
* Elation Support: [Click here to contact Support](https://help.elationemr.com/s/contactsupport)
* Spruce Support: [support@sprucehealth.com](mailto:support@sprucehealth.com)
* In-App Spruce Support: Search for *Spruce Support*
\*© Spruce Health \*
## Related Articles
* [Elation-Spruce- Message Sync Integration Guide](/articles/Elation-Spruce-Integration-Guide)
# Using Elation to Succeed in HMSA Payment Transformation
Source: https://help.elationhealth.com/articles/Using-Elation-to-Succeed-in-HMSA-Payment-Transformation
For Hawaii Customers Only. Learn how to use Elation's Visit Note Templates and Structured Data Entry fields to meet HMSA Payment Transformation quality measure requirements.
## Using Elation to Succeed in HMSA Payment Transformation
We are invested in helping Elation providers succeed in quality programs through use of Elation, including HMSA's Payment Transformation (PT) program. Through use of Elation’s built-in Visit Note Templates and Structured Data Entry fields, you will successfully meet quality measure requirements in your normal charting workflow. This help center article is intended to demonstrate what actions in Elation can be taken to close HMSA Payment Transformation measures.
The HMSA Payment Transformation program is a reimbursement model established by the Hawai’i Medical Service Association (HMSA), a nonprofit health insurance company in Hawai’i. Physician organizations (POs) and their primary care providers (PCPs) in Hawai’i are reimbursed in a per-member-per-month (PMPM) payment model, rather than in the typical fee-for-service (FFS) payment model, and based on quality performance. For more information, please refer to the HMSA Payment Transformation website: [https://hmsa.com/portal/provider/zav\_pel.aa.PAY.100.htm](https://hmsa.com/portal/provider/zav_pel.aa.PAY.100.htm).
## Visit Note Templates
The following measures require specific procedure codes and/or diagnoses to be billed in order to satisfy the measure. Elation has developed visit note templates on your behalf to help your practice meet measure requirements using a more streamlined workflow.
To apply your visit note templates to a visit note, follow the steps below:
1. Access your Visit Note Templates by clicking on the **Visit Note Templates** button in the top left hand corner of the visit note.
2. Select the visit note template(s) you want to apply to your visit note by clicking the checkbox next to the visit note template name.
3. Click **Export All Selected to Note** to import the templates to your visit note.
4. The contents of each visit note template are now present in the visit note.
Note: Multiple visit note templates can be applied to the same visit note. Use the visit note template list as a checklist and select all the visit note templates that are applicable to the patient’s visit.
## Elation Billing Section
If you are trying to satisfy a measure using only claims data, the appropriate diagnosis and/or procedure codes must be included on claims submitted to HMSA. If Elation is integrated with a PMS system that handles billing and sends out claims data to HMSA for your practice, diagnosis and/or procedure codes should be included in the Billing Information section of the Visit Note.
Please refer to the [Billing](http://help.elationemr.com/customer/en/portal/articles/1488238-billing) help article for more information on how add codes to the billing section in Elation.
If a provider would like their staff to be able to edit the billing section on their behalf, the provider must add the staff member as a billing delegate in their settings page. For more information on how to add a staff member as a billing delegate, please view the [Staff Permissions / Staff Delegates](http://help.elationemr.com/customer/en/portal/articles/1666149-staff-permissions-staff-delegates) help article.
## Elation-Coreo Integration
The Elation-Coreo integration is a partnership between Navvis and Elation developed to support providers in demonstrating high quality in HMSA’s Payment Transformation program by minimizing double documentation in Elation and Coreo.
Benefits of the integration:
* Beat the claim lag! With the Elation-Coreo integration, procedure and diagnosis codes entered into the billing section of signed visit notes will appear in Coreo within 4 business days. You won’t have to wait for claims to be processed to get credit for measures, giving you a more accurate picture of your current performance and allowing you to prioritize patient outreach.
* Reduce supplemental data entry by allowing Coreo to leverage data entered in the patient’s chart that may live outside the visit note billing section. Some measures can be satisfied by clinical data\* including:
* Immunizations in the Clinical Profile
* Lab results entered in the Point-of-Care lab result form or received from integrated labs, such as DLS or CLH
* Blood pressure values entered in structured visit note fields
Please refer to the guides attached below for more information on what actions you can take in Elation to get credit for Coreo measures. Note that the attached guides were created for practices who are currently live on the Elation-Coreo integration. If your practice has not signed the consent form allowing Elation to share data with Navvis-Coreo and would like to reap the benefits of the integration, please contact [support@elationemr.com](mailto:support@elationemr.com). If your practice is not live on the Elation-Coreo integration, some of the workflows described in this document will not lead to compliance in Payment Transformation measures in Coreo.
* **Elation Coreo Workflow Guide**: an in-depth workflow guide with screenshots that goes through the steps needed to get credit for each measure in the HMSA Payment Transformation program in Elation.
* Elation Coreo Cheat Sheets: cheat sheets on what actions to take and codes to enter to get credit for measures in Coreo
\*Please refer to Elation provider workflow guide for information on what clinical data are leveraged by Coreo today. Not all clinical data present in the patient chart in Elation will be used towards measure compliance
**Attachments**
* [Elation-Coreo\_Cheat\_Sheets.pdf](http://help.elationemr.com/customer/portal/kb_article_attachments/138647/original.pdf?1543518889)
* [Elation-Coreo\_Workflow\_Guide.pdf](http://help.elationemr.com/customer/portal/kb_article_attachments/140014/original.pdf?1548182915)
# Using Elation to document and code for COVID-19
Source: https://help.elationhealth.com/articles/Using-Elation-to-document-code-for-COVID-19
In this article, you will learn how to document COVID-19-related visits in Elation, and how to code for COVID-19 and COVID-19-related diagnoses.
In this article, you will learn:
* [how to document COVID-19-related visits in Elation](#Header1)
* [how to code for COVID-19 and COVID-19-related diagnoses](#Header2)
* [how labs code for the SARS-CoV-2 lab test](#Header3)
## How to document COVID-19-related visits in Elation
Elation has created a COVID-19 visit note template, named as\*\* COVID-19\*\*, to assist with documentation and coding recommendations related to COVID-19. This template includes triage questions to assess COVID-19 risk and exposure as well as COVID-19-related coding recommendations from the CDC to help you document COVID-19-related visits in Elation visit notes. In order to add this template to your account, please request it by reaching out to our Support Team via the **I need help** button within Elation. Once it has been added to your account, you may follow the below instructions.
To access this template:
1. Click **Visit Note Templates** within your visit note
2. Within the window that appears, search for the COVID-19 template and click **Export to Note** to apply this template to your visit note
3. Within the template, you’ll find triage questions to assess COVID-19 risk and exposure. Click into any cell to add/edit text. The brackets \[ ] are intended to serve as checkboxes - you can indicate a ‘yes’ answer by placing an ‘x’ within the brackets.
4. In the assessment section, we have populated the CDC’s coding recommendations for COVID-19. Please click the **x** next to any entry that does not apply to remove it from your visit note.
5. Click **Edit Billing** to update your bill in the window that appears.
* Add any Dx codes and CPT® codes based on your assessment and plan.
* For telehealth billing guidance, please see our help center article here.
This template was created as a starting point to help your practice with COVID-19 documentation. Please feel free to edit this template as needed based on your practice’s unique needs and preferences. To edit a visit note template, view [this help center article](/articles/elation-visit-note-templates#4).
## How to code for COVID-19 and COVID-19-related diagnoses
The World Health Organization (WHO) has added U07.1 (2019-nCoV acute respiratory disease) as an international ICD-10 code.
**UPDATE! The U07.1 code is effective for dates of service April 1, 2020 going forward.**
The CDC has provided the following coding recommendations based on clinical criteria, as noted below:
| Criteria | Coding Recommendation |
| ----------------------------------------------------------------- | --------------------------------------------------------------------------------------------------- |
| Diagnosis of COVID-19 | U07.1 |
| Suspected COVID-19, not confirmed or ruled out | Code for the presenting signs and symptoms |
| Known exposure to COVID-19 (without diagnosis of COVID-19) | Z20.828, **Contact with and (suspected) exposure to other viral communicable diseases.** |
| Suspected exposure to COVID-19 that is ruled out after evaluation | Z03.818, **Encounter for observation for suspected exposure to other biological agents ruled out.** |
## How to code for the SARS-CoV-2 lab test
The American Medical Association (AMA) announced a new CPT® code for the novel coronavirus (SARS-CoV-2), effective March 13, 2020.
```
Code 87635: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique.
```
Please note that CMS also recently published a [Frequently Asked Questions](https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf) document regarding billing for COVID-19 lab tests through two new HCPCS codes:
* (U0001): Used to bill for the Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel.
* (U0002): Used to bill Medicare and other health insurers for non-CDC 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) tests using any technique, multiple types or subtypes (includes all targets).
These codes are intended to be billed for by laboratory testing centers. The Medicare claims processing system will be able to accept these codes on April 1, 2020 for dates of service on or after February 4, 2020.
*CPT copyright 2019 American Medical Association. All rights reserved.*
# Using Elation to address COVID-19 with your patients
Source: https://help.elationhealth.com/articles/Using-Elation-to-help-you-address-COVID-19-with-your-patients
Learn how to use Elation's messaging tools to reach out to your patients en masse with COVID-19 prevention recommendations, latest news, and health updates.
In response to the growing concern around COVID-19 in the United States, the Elation team has outlined a few ways that your practice can leverage Elation to reach out to your patients en masse.
Whether your objective is to share prevention recommendations or latest news, Elation’s built-in messaging functionality will allow you to push announcements to your patients to ensure they have the information they need to stay healthy, regardless of whether or not they use Passport.
In this article, you will learn how to:
* [Communicate with your patients on Passport](#Header1)
* [Bulk invite your patients to Passport and message them](#Header1)
* [Easily generate mailable PDFs to send communication to your patients via USPS/mail service](#Header1)
* [Use email to communicate with your patients, including non-Passport users](#Header2)
## Using Elation’s Bulk Letter feature to reach out to your patients
Bulk Letters allow you to send personalized messages to all patients who have registered [Passport accounts.](https://www.elationhealth.com/passport/) For any patients without Passport, the bulk letters feature gives you the option to bulk invite these patients to Passport as long as they have an email and phone number in their chart.
For non-Passport users, you can also print out a PDF copy of your message for these individuals to hand deliver or mail out. Elation’s Bulk Letters feature will automatically populate the patient’s mailing address (if available in the patient chart) on a separate piece of paper, positioned perfectly so you can trifold the page and ensure the address appears in a standard envelope (#10) with a window.
1. Run a Patient List to see all patients in your panel.
* Click **Generate List**. If you would only like to see patients with Passport accounts, you can check-off the **Patient passport status** filter and choose **Registered users**
* Once your Patient List is generated, check the box for **Select All**
* Click **Send Bulk Letter**
2. Complete the Bulk Letter form to the right of your screen and click Next.
* You can compose a custom message to your patients. You may also choose you apply a Letter Template. Elation has populated a **COVID-19** letter template as a sample to help get you started. Please feel free to edit this template as needed based on your practice needs!
* You may also choose to add handouts as attachments to your message to patients. Elation has populated 3 COVID-19 CDC handouts in your account, which you can easily access by clicking **Attach Handouts**
3. Specify how you’d like to send the letter to patients (with and without Passport accounts).
4. Review the confirmation page and click **Send Bulk Letter**
5. You’ll be redirected to a Dashboard view where you can track who has received and opened your message.
6. Click **Open PDF of Letters** to view and print the addressed letters. Patient name and address will appear on a separate page in the downloaded PDF, as long as the patient has an address stored in the demographics window of the patient’s chart. 
7\. From here you can trifold your letters on the dotted line and stuff your envelope.
Please note: Elation’s address letters are compatible with #10 window envelopes:
* Envelope size: 4 1/8 x 9 1/2
* Standard window: 1-1/8 inches high and 4-1/2 inches wide
* Window placement: 1/2 inch from the bottom edge of the envelope, 7/8 inch from the left edge.
For additional instructions, please visit our help center article on Bulk Letters [here](/articles/introduction-to-bulk-letters). Watch our video [here](https://vimeo.com/398316737) for a quick walkthrough on bulk letters.
If you are interested in inviting your patients to register for Passport on an individual basis, please visit our help center article on Passport [here](/articles/Passport--Communicating-with-patients).
If you don’t want your patients to be able to send messages back to you via Passport, you can disable this. Elation allows you to control whether your patients can initiate messages back to you through Passport in [your Settings page](/articles/Passport--Communicating-with-patients), so that you can leverage Passport as a notification system to alert your patients about key COVID-19 updates without having to track responses. Watch our video [here](https://vimeo.com/398319173) for a quick walkthrough on Passport settings.
## Using Elation’s Patient List feature to reach out to your patients via email
Elation’s Patient List allows you to easily pull a comprehensive list of email addresses and mailing addresses for mass communication to those patients who may not have Passport accounts.
For HIPAA compliance reasons, you are not able to send messages directly to a patient’s email from within Elation. However, if you’d like, you can download a spreadsheet of patient email addresses from our Patient List to email them outside of Elation, using the steps below:
1. Go to **Reports > Patient List**
2. Generate a list of your patients
3. Check “Select all”
4. Click **Download > Download CSV**
5. Select all and copy the **Email** column
6. Paste into the bcc’ of your email
7. Compose message and send
Watch our video [here](https://vimeo.com/398317482) for a quick walkthrough on how to email your patients.
# Letter & Referral Guide - Managing & searching the provider directory
Source: https://help.elationhealth.com/articles/Using-the-Provider-Directory
This article describes Elation Provider Directory and reviews the actions you can take to manage and search the database for providers or organizations to collaborate with.
## Overview
### What is the Elation Provider Directory/Care Team?
The Provider Directory (also known as Care Team for customers using the [Collaborative Health Record](/articles/the-collaborative-view-hi-only) feature) is a centralized database of Providers and Organizations used for sending [a Provider Letter or Referral](/articles/letter-and-referral-introduction).
The Provider Directory is composed of **Elation Contacts** and **Custom Contacts**. Details about each contact type are provided below.
### What are the benefits of the Provider Directory/Care Team?
The Provider Directory/Care Team database is equivalent to a Contacts List or Address Book. The database offers access to contact information for thousands of Providers and Organizations, allowing you to seamlessly use their details when sharing patient information via any method supported by the [Letter & Referral features](/articles/letter-and-referral-introduction).
### What are the differences between an Elation Contact and a Custom Contact?
The following table outlines the differences between **Elation Contacts** and **Custom Contacts**.
| | **Elation Contact** | **Custom Contact** |
| -------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **Indicator** | Indicated by a blue Elation E\* label next to their name. ![Blue Elation "E" logo icon indicating an Elation Contact in the Provider Directory]()
| Indicated by a blue ‘Custom Contact’ label in their contact details and **P**\* Passport logo next to their name. ![Blue "Custom Contact" label indicator shown in a contact's details panel]()
and ![Blue "P" Passport logo indicator shown next to a Custom Contact's name in the Provider Directory]()
|
| **Source** | Providers using Elation EHR. • Providers or Organizations with [Elation Connect](/articles/secure-Provider-Portal) accounts. • Providers or Organizations in the National Provider Identifier Registry Public Search (NPPES NPI Registry). | Created by your practice. |
| **Access & visibility** | Available to all Elation users. • Can be found in both the Provider Directory and while drafting a Letter or Referral | Available only to your practice. • Can only be found when drafting a Provider Letter or Referral |
| **Maintenance** | Maintained by Elation. | Maintained by your practice. |
| **Editable Contact information** | **Speciality** • **Direct message address** • **Address** • **Ste or apt #** • **City** • **State** • **Zip** • **Phone** • **Fax** • **Cell Phone** • **Preferred fax** • **Email** • **Notes** | **Contact type** (Individual Provider or Organization) • **First Name**(For Individual Providers Only) • **Last Name**(For Individual Providers Only) • **Middle Name**(For Individual Providers Only) • **Credentials** (For Individual Providers Only) • **Organization Name** (For Organizations Only) • **Speciality** • **Direct message address** • **Address** • **Ste or apt #** • **City** • **State** • **Zip** • **Phone** • **Fax** • **Cell Phone** • **Preferred fax** • **Email** • **Notes** |
**Contact Details vs. Delivery Method**
How will a contact with multiple contact methods receive information?
* If the Contact has an Elation logo in their profile then they will only receive information in their Elation account, regardless if other contact information is available.
* For all other contacts, the chart below shows how information will be delivered, based on the information in their contact details.
| **Contact has...** | **Fax** | **Direct Message** | **Provider Portal** |
| ------------------------------------------------ | ------- | ------------------------------------------------------------------------------------------------------------------------- | ---------------------------- |
| Fax number **only** | X | | X (Fax notification) |
| Email **only** | | | X (Email notification) |
| Direct message address **only** | | X | |
| Fax number **AND** email | X | | X (Fax & email notification) |
| Fax number **AND** Direct message address | X | X (\*If recipient has an **active** Provider Portal account then the message will only be delivered via Provider Portal.) | X (Fax notification) |
| Email **AND** Direct message address | | X (\*If recipient has an **active** Provider Portal account then the message will only be delivered via Provider Portal.) | X (Email notification) |
| Fax number, email **AND** Direct message address | X | X (\*If recipient has an **active** Provider Portal account then the message will only be delivered via Provider Portal.) | X (Fax & email notification) |
| **(NO CONTACT)** Fax number **only** | X | | |
## Workflow Instructions
### Searching for Contacts
#### Searching while drafting a Provider Letter or Referral
This method shows results for **Elation Contacts** and **Custom Contacts**:
| **1** | [Create a new Provider Letter or Referral](/articles/letter-and-referral-introduction#initiation) . |
| ----- | --------------------------------------------------------------------------------------------------- |
| **2** | Type the recipient’s name in the **To** field. |
| **3** | Select a match from the search results. |
#### Searching in the Provider Directory window
This method shows only results for **Elation Contacts**:
| **1** | Click **Directory** from the top of the patient’s chart (or the **Care Team** button if you’re using the [Collaborative Health Record](/articles/the-collaborative-view-hi-only) feature). |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click into the **Provider Search** section on the right. |
| **3** | Use any of the following fields to search for the Provider/Organization: **Type a Specialty or Provider Name…** - Their name or speciality. • **City** - The City they are practicing in. • **State** - The State they are practicing in. |
| **4** | When you find the contact, click **Letter** or **Referral** under their name to start drafting a message. |
If you cannot find the **Contact** in the current City\*\* or\*\* State they are practicing in, try entering the City or State they have previously practiced in.
If you are still unable to find the Provider/Organization in the Provider Directory, then [create a Custom Contact](#create_custom_contact) for them.
### Managing Elation Contacts
**Exception:** You cannot create or delete Elation Contacts—but you can make edits that are visible to your practice only.
#### Updating an Elation Contact
| **1** | Locate the **Contact** using one of the methods [outlined above](#searching-for-contacts) . |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Open their contact details using one of the following methods: If you are in a Letter or Referral, click **Edit Contact** next to the contact’s name. • If you are in the Provider Directory window, click on the contact’s name. |
| **3** | Click **Edit** **Contact** to edit the contact's information. [Refer to the table above to see what information is editable](#differences). |
| **4** | Complete your updates and click **Update Directory** . |
Deleted contact information cannot be restored.
Changes you make only apply to your practice.
### Managing Custom Contacts
#### Creating a Custom Contact
| **1** | [Create a new Provider Letter or Referral](/articles/letter-and-referral-introduction#initiation) . |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Type the contact’s name in the **To** field and then click into any other field (e.g. **Subject** ). |
| **3** | Click **Add Details** next to the contact’s name. |
| **4** | Add profile or contact information to their contact details. Enter at least a **Direct message address**, **Fax**, or **Email** to save the contact. |
| **5** | Click **Create Contact**. |
#### Updating a Custom Contact
| **1** | [Create a new Provider Letter or Referral](/articles/letter-and-referral-introduction#initiation) . |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Type the recipient’s name in the **To** field. |
| **3** | Select a match from the search results. |
| **4** | Click **Edit Contact** next to the contact’s name. |
| **5** | Click the **Edit** **Contact** to edit the contact's information. [Refer to the table above to see what information is editable](#differences). |
| **6** | Complete your updates and click **Update Directory** . |
#### Deleting a Custom Contact
| **1** | [Create a new Provider Letter or Referral](/articles/letter-and-referral-introduction#initiation) . |
| ----- | --------------------------------------------------------------------------------------------------- |
| **2** | Type the recipient’s name in the **To** field. |
| **3** | Select a match from the search results. |
| **4** | Click **Edit Contact** next to the contact’s name. |
| **5** | Click the **Edit** **Contact** to edit the contact's information. |
| **6** | Click **Delete Custom Contact** . |
| **7** | Click **Delete** to confirm deletion. |
Deleted contact information cannot be restored.
Changes you make only apply to your practice.
## Frequently Asked Questions
### Why is a provider’s information from the NPPES NPI Registry incorrect?
Elation imports contact information from the NPPES database periodically. If the registry has been updated since the import, existing contacts won’t reflect those changes automatically. You can [manually update the contact information for that Elation Contact](#update_Elation_contact) to reflect the most current information.
### Why are some provider names not clickable in the Elation Directory?
If a Provider’s/Organization's name appears in plain, black text (and not blue text that is clickable), it means they have never communicated with Elation users before. Click **Letter** or **Referral** under their name, and then click **Edit** to view or update their contact information.
### What happens when I can’t find the provider I am looking for?
If you have tried various search parameters and you are unable to find a specific Provider/Organization in the database, [create a Custom Contact](#create_custom_contact).
### Will changes made to Elation Contacts affect other practices?
No, changes made to Elation Contacts are only visible within your practice.
### Can I update the clinic name or NPI for a Contact?
No, the clinic name and NPI cannot be edited.
### Can I delete an Elation Contact?
No, **Elation Contacts** are managed by Elation and cannot be deleted. Only **Custom Contacts** can be deleted.
### Why can’t I save a Custom Contact?
Add a **Direct message address**, **Fax**, or **Email** to save a **Custom Contact**.
### Do contact updates apply across Workspaces?
Yes, contact updates show in all Workspaces within your Elation account.
### Can I see who edited a contact?
No, there are no audit logs for contact edits.
### If different users make changes to the same contact, will they create duplicates?
No, when multiple users edit a contact, only the last saved changes are kept. No duplicates are created.
### Can I add new specialties to the database?
No, specialties are managed by Elation and cannot be added manually.
### Can I store more than one address for a contact who has multiple locations?
No, each contact has a single **Address** field. As a workaround, note the additional location(s) in the contact's **Notes** field.
### Can I export or print my full list of Directory contacts?
Not at this time — there's no built-in option to export or print your complete list of Custom Contacts from the Directory. You can still view and edit contacts individually: from a Letter or Referral, search for the contact in the **To** field and click **Edit Contact**, or from any patient chart, click **Directory** and search for the contact.
If you're looking to export patient contact details instead of Directory contacts, use the [Patient List Report](/articles/find-patients-with-elations-patient-list) and click **Download CSV**.
### How do I find a provider's Direct message address?
Locate the contact using [either search method above](#searching-for-contacts), then open their contact details—from a Letter or Referral, click **Edit Contact** next to their name; from the Provider Directory window, click their name. Their **Direct message address** appears in their contact details if one is on file. See the [Direct messaging guide](/articles/how-to-use-direct-messaging#how-do-i-find-another-providers-direct-address) for the full step-by-step workflow.
## Related Articles
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
* [Letter & Referral Guide - Sending correspondences to other Elation EHR Users](/articles/share-documents-between-other-elationemr-users)
* [Letter & Referral Guide - Sending and receiving Direct messages](/articles/how-to-use-direct-messaging)
* [Letter & Referral Guide - Sending a fax](/articles/letter-and-referral-introduction)
* [Letter & Referral Guide - Sending correspondences via a secure Provider Portal](/articles/secure-Provider-Portal)
* [Letter & Referral Guide - Accessing patient information sent by an Elation EHR user](/articles/access-patient-information-securely-shared-by-an-Elation-EHR-user)
* [Letter & Referral Guide - Fax Usage Settings](/articles/fax-usage)
# Utah State- USIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Utah-State-USIIS-Immunization-Registry-Interface
This article will describe how you can submit vaccination data to the Utah Statewide Immunization Information System [USIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Utah State Immunization Registry known as USIIS.
## What is the USIIS Immunization Registry Interface?
The USIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to USIIS; the Utah Statewide Immunization Information System. Practices can also query VIIS for vaccination history or forecast.
## Why is the USIIS Immunization Registry Interface valuable?
With the USIIS Immunization Registry Interface, practices no longer need to separately log in to USIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to USIIS. You can also pull vaccination history for specific patients from USIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & USIIS
The Elation Team will assist you with initiating interface with USIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**.
## How to submit vaccination data to USIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to USIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using USIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
*'Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide.*
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
*'Managing querying errors' section of the Vaccination Documentation Guide.*
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Utilizing in-app Chronic Condition Alerts to manage your MDX patient panel
Source: https://help.elationhealth.com/articles/Utilizing-in-app-Chronic-Condition-Alerts-to-manage-your-MDX-patient-panel
For Hawaii Customers Only. Through participation in the MDX Hawai'i-Elation Health program, receive in-app Clinical Reminders to address MDX patients' chronic conditions within your visit note.
## MDX Hawai'i-Elation Health Program
Through your participation in the MDX Hawai'i-Elation Health program, you are now part of a select group of providers that will receive Clinical Reminders to address MDX patients’ chronic conditions within your visit note. These alerts are pulled directly from your patients’ MDX Member Information Profile forms and are now available in real-time, within the context of the patient's chart.
The solution will also allow you to take advantage of Elation's existing HCC scoring functionality so that you are more easily able to identify high-risk patients and assess chronic conditions that are due for annual review. To learn more about Elation's HCC feature, please see [Risk Assessment Introduction- Risk Assessment Factors (RAF) and Hierarchical Condition Categories (HCC)](/articles/what-is-risk-assessment).
## When will I see these chronic condition alerts?
The clinical reminders will appear for all chronic disease diagnoses made through claims for your MDX Patients in the previous calendar year that have not been addressed yet in the current calendar year. Through these alerts, you’ll have easy access to the chronic disease diagnoses made not only by your practice but also by other providers or facilities who care for your patients, promoting improved care coordination.
Additionally, Elation will use the data present in your patient chart to automatically close out clinical reminders for conditions that have already been assessed in the current calendar year, reducing the administrative burden on your practice!
The alerts will appear in the visit note:
1. if the chronic condition has not yet been addressed in this current calendar year (i.e. Dx code does not appear within a bill of an Elation visit note in the current calendar year), and
2. if the chronic condition is not present within the patient's problem list with a Dx date in the current calendar year
## How do I use the chronic condition clinical reminders?
To view and address the chronic condition clinical reminders, follow the steps below:
1. Open a visit note to see the chronic conditions that need to be reviewed for the MDX patient during the current calendar year in the Clinical Reminders section. These alerts will include an **MDX** prefix.
2. Review the patient’s problem list in the Clinical Profile and import any chronic condition diagnoses still active for the patient into the visit note by clicking **Actions > Export to Note (A, Billing)**. Doing so will automatically address the corresponding clinical reminders at the top of the patient’s visit note.
*
**Please Note** : You should only export the problem into the assessment/bill to resolve the clinical reminder if you have assessed the patient for the diagnosis and determined that the patient has the condition.
![Visit note Assessment section showing 6 chronic conditions (Nephropathy, History of colon cancer, Hyperacidity, Hypertension, Cardiomyopathy, Hyperlipidemia) highlighted, with arrow pointing from Problem List Actions menu showing "Export All Crosswalked (A, Billing)" selected.]()
1. For the remaining clinical reminders, click **Address** to take action on the alert and indicate the outcome of the assessment.
!["Actions to Resolve Clinical Reminder" dialog open after clicking Address on the "MDX: Assess Type 2 diabetes mellitus without complications" reminder, showing two resolution options: confirm or disconfirm the condition.]()
1. If you have completed the review and confirmed that the patient still has this condition, click the clinical action "Yes, review completed and patient has this condition"
* You will be prompted to add the problem in the **Add a Problem** window that appears, which will automatically add the Dx code to the Assessment and Billing section of the Visit Note, as well as automatically add the Dx to your Problem List in the Clinical Profile to streamline documentation and coding.
2. To disconfirm condition (upon review, patient does not have this condition), click **No, review completed and patient does not have this condition** to remove the alert, and tag the visit note to track the date you disconfirmed the condition.
* A document tag will be automatically added to your visit note to track disconfirmed conditions.
## Quick Tips!
### Quick Tip #1- To read the full description of the alert, click on the alert name to view an expanded view:
![Clinical Reminder Details popup for "MDX: Assess Type 2 diabetes mellitus without complications," shown after clicking the alert name to expand its full description.]()
### Quick Tip #2: Coding to reflect your patient’s true conditions!
Elation will recognize and close out clinical reminders for a patient when a related condition is coded for in the current calendar year, enabling you to focus on assessing the patient and coding to the highest specificity, while we help you get credit for the services you provide!
Related conditions are defined as conditions that are part of the same hierarchical condition category \[HCC].
For example: Let’s say an endocrinologist coded E11.8 (Type 2 diabetes mellitus with unspecified complications) last year for your patient, Daffodil Duck.
* This year, Elation will display a clinical reminder to remind you to assess the patient for E11.8 Type 2 diabetes mellitus with unspecified complications.
* Upon review, you discover that the patient has type 2 diabetes mellitus with hypoglycemia without coma (E11.649).
* If you code for E11.649, Elation will automatically close the clinical reminder for E11.8 because the two diagnoses are related!
### Quick Tip #3: Addressing conditions that are part of multiple CMS Hierarchical Condition Categories (HCCs)
If a condition is part of multiple HCCs, Elation will display a clinical reminder for each HCC that is due. You can distinguish between the two clinical reminders through the notes section, pictured below. This is to ensure that, if a condition is tied to two risk factors, you are able to assess both individually. If you code a diagnosis that is part of both risk factors, Elation will automatically recognize this and close both clinical reminders on your behalf.
![Clinical Reminders section showing two MDX alerts for the same condition—Type 1 diabetes mellitus with foot ulcer—each listing a different HCC (HCC 18 and HCC 161) to distinguish between multiple associated risk categories.]()
## Additional Elation Tools
Additional tools are available to your practice to help manage your MDX patient panel, including:
* Post-discharge follow-up and medication reconciliation
* Integrated MDX-approved Annual Health Assessment Template
* In-app identification of MDX patients
* Ability to mass recall MDX patients via Bulk Letter Feature
# Vaccination Documentation Guide - Managing vaccination information
Source: https://help.elationhealth.com/articles/Vaccination-Form-Guide
This article reviews the various methods of recording vaccination data in the patient chart including how to use the Document Vaccination form and Immunization Table.
## Overview
### What are the various ways to document vaccinations in Elation?
You can document vaccinations using one of the following methods:
1. From a **visit note** or **note**: click **Vaccination**.
2. From the Clinical Profile **Other Info** section: click **+ Add Vaccination**.
3. From the **Immunization Table**: click **Actions** -> **Add Details**.
4. From an **Immunization Registry Integration**: import immunization records.
### Why is vaccination documentation important?
Vaccines provide patients with active acquired immunity to a particular infectious disease to help reduce the risk of health complications, or even death, when a patient is exposed to the real causative agent of the disease. It is important to document vaccination information, or lack of, in the patient's chart to enable you to make the best healthcare decisions for the patient.
## Workflow instructions
### Documenting vaccinations
#### Opening the Document Vaccination form
Open the Document Vaccination form using one of the following methods:
* From a **visit note** or **note**: click **Vaccination**.
* From the Clinical Profile **Other Info** section: click **+ Add Vaccination**.
* From the **Immunization Table**: click **Actions** -> **Add Details**.
#### Documenting vaccinations in the chart
![Document Vaccination form with "New Record" tab selected, showing empty Vaccine and Vaccine Details fields, and Registry section configured with "Send to Immunization registry" set to Yes, Registry Recall set to "No reminder/recall," and destination set to ImmTrac Texas State Immunization Registry (DE-001876).]()
At the top of the Document Vaccination form, select the record type:
* **New record** — The vaccination was administered by you or another user in your practice.
* **Historical record** — The vaccination was previously administered to the patient, potentially by another practice.
* **Declined by the patient** — The patient declined the vaccination. This option is only available for CDC scheduled immunizations (e.g., polio).
In the **Vaccine** field, enter the name of the vaccine that was administered or declined. Vaccines are pulled from the Medi-Span database. If you are not submitting to a registry, you can also select from user-created vaccines.
Vaccines without CVX codes are not eligible for submission to the immunization registry but can be used if not submitting to a registry.
Complete the following fields:
* **Dose** — The quantity of the vaccine administered. If the vaccine has been previously documented in the practice, the dose auto-populates with the previous value.
* **Unit** — The unit of the vaccine administered. Defaults to mL. Available units include dL, g, kg, kL, L, mg, mL, ug, uL, and tab.
* **In series** — The number in a vaccine series (e.g., the second HPV vaccination). This is not transmitted to the registry.
* **NDC** — The National Drug Code. If a known vaccine is selected, the NDC auto-populates from the Medi-Span database.
* **Lot #** — The lot number of the vaccine. Auto-populates from previous documentation if available.
* **Expiration Date** — The expiration date of the vaccine. Auto-populates from previous documentation if available.
* **Manufacturer** — The vaccine manufacturer. Select from the manufacturer list, or choose **Other manufacturer** or **Unknown manufacturer** if needed.
* **Ordered By** — The provider who ordered the vaccination. Select from provider search or free-text a name.
* **Administered By** — The person who administered the vaccine. Select from provider search or free-text a name.
* **Date** — The date the vaccination was administered.
* **Time** — The time the vaccination was administered.
* **Method** — How the vaccine was administered.
* **Site** — The specific body site where the vaccine was administered. This field only appears if the selected method has more than one possible site.
* **VIS** — The Vaccine Information Sheet (VIS) shared with the patient.
* **VIS Given Date** — The date the Vaccine Information Sheet (VIS) was provided to the patient (or their guardian). Defaults to the administered date, but you can select a different date if appropriate.
* **Notes** — Additional notes about the vaccination. This field is not submitted to the registry.
* **Program** — The VFC or other program used to purchase the vaccine lot.
* **Funded by** — Whether the vaccine was privately or publicly funded.
By default, Elation saves and auto-fills the lot number, expiration date, and dose after a vaccine has been previously documented in your practice. For example, the first time you select the Comirnaty (Pfizer COVID) vaccine, these fields will be blank. After documenting it once with this information, the next time you select Comirnaty, these fields will auto-populate.
Click **Save** to save the vaccination to the patient's chart.
To document multiple vaccinations at once, click **+ Add Another Vaccination** to open the vaccination queue. You can add multiple vaccinations and save them all together.
![Document Vaccination form showing two vaccinations queued: "Vimkunya Intramuscular Suspension Prefilled Syringe 40 MCG/0.8ML" and "New Vaccine" (both marked Incomplete), with the New Vaccine form open for data entry.]()
For pediatric patients, the vaccination queue automatically opens when the Document Vaccination form is launched.
**PREMIUM EHR ONLY** [Premium EHR Users](/articles/Premium-EHR-Features-Guide) can enable a feature for prior **Manufacturer**, **Lot #**, and **Expiration** to populate based on the **Service Location** selected. This ensures the correct vaccination details are entered when different Service Locations have different supplies of the same vaccine. A required **Service Location** field will appear in the form when this feature is enabled.
#### Documenting vaccinations and sending the data to your connected Immunization Registry
When you are connected to an Immunization Registry, the Document Vaccination form includes additional fields to support registry reporting.
Follow the same steps as [documenting vaccinations in the chart](#documenting-vaccinations-in-the-chart) to select the record type and vaccine.
Complete the following registry-specific fields:
* **Send to an Immunization Registry?** — Select **Yes**. to send the vaccination record to a connected registry interface.
* If your practice does not have a submission interface, this field is automatically set to **No**.
* **Registry Recall** — Indicate when the patient needs to be recalled or reminded, if applicable. The immunization registry will contact the patient with updates regarding this vaccination record (this communication is not through Elation).
* **Where should the record be sent?** — Select the destination registry.
* **Patient consents to sharing Personally Identifiable Information?** — Indicate whether the patient consented to sharing vaccination information with the registry.
Complete the same administration detail fields as described in [documenting vaccinations in the chart](#documenting-vaccinations-in-the-chart).
When submitting to the registry, you must select a manufacturer from the list — free text is not allowed. Additionally, only names from provider search should be used for the **Ordered By** field when submitting to the registry.
If patient demographics are incomplete, a warning will appear before submission. Make sure the patient's demographic information is complete before submitting to the registry.
Click **Save** to save the vaccination and submit it to the selected registry.
To document multiple vaccinations, click **+ Add Another Vaccination** to open the vaccination queue.
All registry submissions are one-time only. If you need to edit any vaccination data after clicking **Save**, you will need to update the data in both the patient chart and the Immunization Registry directly.
**PREMIUM EHR ONLY** [Premium EHR Users](/articles/Premium-EHR-Features-Guide) can enable a feature for prior **Manufacturer**, **Lot #**, and **Expiration** to populate based on the **Service Location** selected. This ensures the correct vaccination details are entered when different Service Locations have different supplies of the same vaccine. A required **Service Location** field will appear in the form when this feature is enabled.
#### Using a barcode scanner to fill in vaccine fields
The Document Vaccination form supports barcode scanning to speed up documentation and reduce data entry errors. When you scan a 2D vaccine barcode while the form is open, Elation reads the barcode and automatically populates the following fields:
* **Vaccine** (NDC)
* **Lot #**
* **Expiration Date**
##### What your scanner needs to send
Most vaccine vials use a **GS1 DataMatrix** barcode that packs several values (NDC, lot number, expiration date) into a single code. To separate those values, the barcode uses a hidden **Group Separator (GS)** character between fields. For Elation to read the barcode correctly, your handheld scanner must be programmed to:
* **Transmit the Group Separator (GS)** between fields, and
* **End each scan with a terminator** (Enter or Tab).
If your scanner is not sending the GS character or a terminator, Elation cannot reliably parse the barcode, and the vaccine, lot, and expiration fields may not fill in. Most scanners support these settings but are not configured for them out of the box.
Any 2D barcode scanner will work with this feature as long as it is programmed to transmit the Group Separator and a terminator. Elation does not recommend a specific brand.
### Scanning a vaccine barcode
Open the form using any of the methods described in [Opening the Document Vaccination form](#opening-the-document-vaccination-form).
With the form open, scan the 2D barcode on the vaccine packaging. Elation listens for the scan and automatically fills in the corresponding fields.
Verify the auto-populated values and complete any remaining fields (such as **Dose**, **Administered By**, **Date**, and **VIS Given Date**) before saving.
### Confirming your scanner is set up correctly
Before relying on scanning in a live patient encounter, you can verify your scanner is programmed correctly using the standalone [Barcode Scanner Calibration tool](/articles/Barcode-Scanner-Calibration-Guide). It requires no login, stores no patient data, and tells you immediately whether your scanner is sending the Group Separator and a terminator. This is the fastest way for front-desk and IT staff to troubleshoot scanner setup.
Because the calibration tool uses the same barcode detection and parsing logic as the Document Vaccination form, a successful calibration scan means scanning will work in the chart.
#### Editing a vaccination
![Edit Vaccination dialog showing a registry-submitted Priorix record with a warning that edits must be made in both Elation and the registry directly.]()
When you open an existing vaccination record, the dialog displays as **Edit Vaccination.** In edit mode:
* You cannot add vaccinations to the queue — only the selected vaccination can be edited.
* If the vaccination was already submitted to the registry, a warning is displayed indicating that the submission was a one-time event.
#### Using the Immunization Table
Go to **Clinical Profile** → **Other Info** → **Vacc** → **Immunization Table** to open the Immunization Table. The Immunization Table gives you a visual representation of the patient's vaccine history based off the CDC Schedule. Some additional features of the Immunization Table are:
* Click **Immunization Hx** to print the patient's immunization table and vaccine history.
* Click on the **AAP Schedule: 0-18**, **CDC Schedule: 0-18**, **CDC Schedule: Adult** buttons to see the vaccine schedule recommendations from the American Academy of Pediatrics or Center for Disease Control and Prevention.
* Click **Actions** -> **Add Details** in any **Dose** box to open the Document Vaccination form.
**How the patient's name appears on the printed immunization record**
The patient's preferred name (documented in **Patient Demographics** → **Patient Details** → **Full Name (if different from legal)**) is shown as the primary name at the top of the printout, with the legal name in smaller text just beneath it. If the patient has no preferred name on file or their preferred name matches their legal name, only the legal name is shown — no separate "Legal Name" line is included.
The legal name is always retained on the printout so the record remains valid for schools, employers, travel, insurance, and other official uses. The same behavior applies to the immunization history a patient downloads from Patient Passport.
##### Minimal documentation options:
* To store a basic, non-detailed vaccination record for the patient for that vaccine, enter a date in the corresponding **Dose** boxes for the vaccine.
* To record that a patient declined a specific vaccine, click **Actions** -> **Patient Declined**.
* To record that patient is immune to a specific infectious disease, click **Actions** -> **Patient has immunity**.
### Querying for vaccination history and/or forecast using a connected Immunization Registry Interface
#### Demographic requirements
To ensure successful queries for vaccination history, please make sure the following demographics information is stored in the patient's chart.
* **Legal First Name**
* **Legal Last Name**
* **Date of birth**
* **Sex at Birth**
* **Address**
* **Phone Number** (first number)
* **Mother's Maiden Name**
* The **Mother's Maiden Name** field is next to the **SSN** field and can be found by clicking **+ add additional details** in the Patient Details section of their demographic.
#### Querying for vaccination history
There are two options for querying for vaccination history for a given patient:
1. Click on the **Check Registry** button in the Vaccination section of the Clinical Profile.
2. Click **Actions** -> **Check Registry** next to the Other Info section header in the Clinical Profile.
* Elation only allows querying for vaccination history every 15 minutes. If you click **Check Registry** and successfully retrieve Vaccination History for the patient, you will not be able to query again for another 15 minutes.
##### Viewing vaccine history results
Once the request is successful, you will see the patient's vaccination history as available within the connected Immunization Registry. The most recent vaccination records will be at the top of the list and you can click on the header of any column to filter by specific details of the record. Vaccination History records include the following details:
1. A **View Registry** button will be available for registries that allow you to directly log in to the registry.
2. Vaccine Group
* The Vaccine Group is designated by the registry. **NOS** stands for 'Not Otherwise Specified".
3. Vaccine Name
4. Date Administered
* Declined vaccines may also be available and will have the word **Declined** next to the date.
##### Importing vaccination history into a patient's chart
The last column "Chart Status" of the Vaccine History will tell you whether or not the vaccination record exists in the Vaccination section of the patient's chart. Elation will also automatically pre-select the records that are not in the patient's chart to allow you to easily import those records if desired. Click **Sign Off & Import** at the bottom of the Vaccine History to sign off on the Vaccination History and import any selected records into the patients Clinical Profile.
![Vaccine History dialog showing 5 pre-selected "Not in chart" records from ImmTrac registry, with "Sign Off & Import (5 items)" button ready to import all into the patient chart.]()
Imported vaccine records will have language in the **Notes** section of the record to indicate which Registry the record originated from, the name of the user in the practice who signed off on the record, and the date the record was imported - for example "Imported from ImmTrac by Beverly Crusher on 6/12/2022".
#### Querying for vaccine forecast
There are two options for checking the vaccination forecast using a connected Immunization Registry for a given patient:
1. Click **Actions** -> **Check Forecast** next to the Other Info section header in the Clinical Profile.
2. Click **Immunization Table** and then **Check Forecast** in the Immunization Table view.
##### Viewing forecast results
Once the request is successful, you will see the vaccination forecast for the patient in the Vaccine Forecast dialog. The vaccines forecasted will be listed in alphabetical order and you will see the following:
* Due Date
* Earliest Date to Give
* Latest Date to Give
![Vaccine Forecast dialog showing ImmTrac registry selected, with 8 vaccines listed including due dates and earliest dates to give, ranging from 1994 to 2059.]()
#### Managing querying errors
If the request does not return a vaccination history you will see one of the following reasons noted in the Vaccine History dialog:
1. Immunization registry setup is incomplete
* Additional actions are required to connect you to the Immunization Registry. Contact Support for assistance with this issue.
2. Unable to connect to immunization registry
* The registry is not responding during this time. Please try again in 30 minutes or Contact Support if the issue persists.
3. No matching patient
* The registry was unable to find any matching patients based on the demographics information in their chart. Double check the [Demographic Requirements](#requirements) for the patient and then try again.
4. Too many patient matches
* The registry found too many matching patients based on the demographics information in their chart. Double check the [Demographic Requirements](#requirements) to see if more information (such as Mother's Maiden Name) can be supplied to narrow down the search and then try again.
5. Missing patient information
* You must fill out all [Demographic Requirements](#requirements) for the patient and then try again.
#### Troubleshooting the Check Registry button
If the **Check Registry** button is missing from the patient's Clinical Profile or not working as expected, follow these troubleshooting steps:
Verify that your practice's Immunization Registry Interface is enabled and properly configured. If you are unsure whether your practice is connected to a registry, please reach out to the Support team via the **I need help** button in the blue navigation bar.
Successful registry queries require specific patient information. Confirm the following demographics are complete and accurate in the patient's chart: If any required information is missing or incorrect, update the patient's demographics and try again.
* **Legal First Name**
* **Legal Last Name**
* **Date of birth**
* **Sex at Birth**
* **Address** (including state)
* **Phone Number** (first number in the demographics)
* **Mother's Maiden Name** (for certain registries)
Do not include PHI in your support request.
If errors persist after clicking the **Check Registry** button, even after confirming the patient demographics, please contact Elation Support for assistance. When reaching out, include the following details:
* The name of the Immunization Registry you are trying to use
* A description of the issue (for example, **Running into \[insert error] when checking the registry**)
* The approximate time the option last worked (if applicable)
* Patient ID example
## Frequently asked questions
### I cannot find the vaccine I am looking for. How do I document this vaccine?
All currently available vaccines are available for selection. Please try searching for the vaccine using other commonly known names.
If you cannot find the vaccine you are looking for, you can enter any text in the *Vaccine* field and store that as a vaccine in your own custom vaccine database. Once you save a vaccine record with the *Vaccine* you created, you will be able to select that same vaccine again in the future.
### Can I send vaccination data to my state or regional immunization registry from Elation?
Elation is interfaced with state and local registries in the United States. Learn more registry interfaces [here](/articles/Immunization-Registry-Interface-Introduction).
### Why are certain vaccines missing from the Immunization Table?
The Immunization Table only displays CDC Schedule vaccinations. Vaccines that are not on the CDC Schedule can be recorded using the Document Vaccination form, will be visible in the Clinical Profile and will display under *Other Vaccines Documented* when printed.
Only vaccines with known specified formulations will appear in the Immunization Table. Without formulation we will not be able to accurately tie a vaccine to the correct immunization in the Immunization Table. Recorded vaccines with unspecified formulations will be visible in the Clinical Profile and will display under *Other Vaccines Documented* when printed.
### Why does the Immunization Table show a different lot number, expiration date, or manufacturer than what I just entered?
Elation automatically saves and auto-fills the Lot #, Expiration Date, and Dose fields in the Document Vaccination form based on the last time that vaccine was documented at your practice. If your practice administers multiple lots of the same vaccine at once (for example, during flu season), the auto-filled values may reflect a previous lot rather than the one just given. Always review the Lot #, Expiration Date, and Manufacturer fields before saving to confirm they match the vial actually administered.
If you entered a vaccine directly in the Immunization Table by adding a date in the Dose box (rather than through the full Document Vaccination form), only the date is stored. Lot number, expiration date, and manufacturer are not captured for that entry, so there is nothing further to reconcile for vaccines documented this way.
### Can I change the vaccines that display in the Immunization Table?
Elation's Immunization Table is designed to match the Center for Disease Control and Prevention's recommendations for vaccinations based off of the patient's age. You cannot change the vaccines that display in the Immunization Table. Vaccines that are not on the CDC Schedule can be recorded using the Document Vaccination form, will be visible in the Clinical Profile and will display under *Other Vaccines Documented* when printed.
### Can I see more than 6 doses of a given vaccine in the Immunization Table?
The Immunization Table can only display up to 6 (six) doses of a given vaccine. Any additional vaccines will not be displayed in the Immunization Table but it will be visible in the Clinical Profile and will display under *Other Vaccines Documented* when printed.
### Can I document multiple vaccinations at once?
Yes. Click **+ Add Another Vaccination** in the Document Vaccination form to open the vaccination queue. You can add multiple vaccinations and save them together. For pediatric patients, the queue automatically opens when the form is launched.
**Next Step**: Open the Document Vaccination form in your patient's chart to start recording immunization history.
## Related articles
* [All available State Immunization Registry Interfaces](/articles/Immunization-Registry-Interface-Introduction)
* [Pediatric Features Guide](/articles/Pediatric-Features)
# Vermont - IMR - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Vermont-IMR-Immunization-Registry-Interface-User-Guide
This article describes how you can submit vaccination data to the Vermont Immunization Registry [IMR] directly within Elation.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Vermont Immunization Registry known as IMR.
## What is the IMR Immunization Registry Interface?
The IMR Immunization Registry Interface allows connected practices to
**send**
vaccination information from their Elation EHR directly to IMR, the Vermont Immunization Registry.
## Why is the IMR Immunization Registry Interface valuable?
With the IMR Immunization Registry Interface, practices no longer need to separately log in to IMR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to IMR. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & IMR
The Elation Team will assist you with initiating an interface with IMR. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry would you like to connect to?
* Does your practice administer vaccines? If so, do you document the administered vaccines in IMR?
* Does your practice document historical vaccinations in IMR?
* What is your VACMAN PIN?
* Who at your practice will sign the Vermont Service Agreement?
* Who at your practice will attend the required Vermont IMR onboarding call?
* Does your practice receive 42 CFR Part 2 funding? (If you are not sure what this is, you likely are not receiving this funding.)
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to send vaccination data to IMR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit the data to IMR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## Frequently Asked Questions (FAQ)
### Can I retrieve immunization history from IMR in Elation?
You can only send vaccination history from Elation to IMR using this current interface. In the future Elation will work with IMR to also allow you to retrieve immunization history from IMR.
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
## Related Articles
* [Vaccination Documentation Guide- Managing vaccination information](/articles/Vaccination-Form-Guide)
# Lab Orders & Results - Managing electronic lab results
Source: https://help.elationhealth.com/articles/Viewing-results-from-lab-interfaces
Learn how to receive and review electronic lab results from lab vendors connected to Elation.
## Overview
### What are electronic lab results in Elation?
Electronic lab results are test results that are formatted as individual data points, known as structured data. This structured test data is sent directly from the lab vendor to your patient charts in Elation through an interface.
### What are the benefits of receiving structured lab results in Elation?
Structured lab results:
* **Improve data accuracy** - Uses standardized vocabularies to eliminate transcription errors.
* **Enhance data organization** - Stores results in a standardized format, making it easier to review and trend over time.
* **Reduce paperwork** - Minimizes the need for faxed or printed reports, streamlining workflow efficiency.
### How can I receive electronic lab results in Elation?
Electronic lab results can be transmitted to Elation once a lab interface is activated for a lab vendor. Follow the [set-up steps below](#Set-up) to set up this type of interface for each of your lab vendors.
## Set-up
[Set up lab vendors (mandatory)](https://help.elationhealth.com/articles/Managing-lab-vendors)
## Workflow Instructions
### Receiving electronic lab results
Once an interface between your practice and a lab vendor is live, the lab vendor will automatically send lab results electronically to the patient’s chart.
Electronic lab results are routed to patient charts by matching first name, last name, date of birth, and sex at birth and assigned to the Ordering Provider for review and sign off. If the interface is unable to find an exact patient match, then it will automatically create a new patient chart in Elation to house the lab results.
By default, lab vendors will send the electronic report once all tests are finalized across a single lab panel or lab order, but you can ask a lab to send partial results if preferred.
### Viewing electronic lab results in Elation
View electronic lab results in any of the following places:
* In the Practice Home **Reports** inbox of the Ordering Provider if the report is unsigned.
* In the patient’s chart under **Requiring Action** if the report is unsigned.
* In the patient’s chart under the **Reports** -> **Lab** tab regardless of whether it's been signed.
#### Viewing electronic lab results on the Practice Home
Unsigned electronic lab results will appear in the Practice Home **Reports** inbox of the Ordering Provider. Results are listed in order of your sort preferences, either **Oldest First** or **Newest First**. Reports with abnormal results will show the corresponding test names in red t (shown in the image below).
Click the patient's name to open their chart and view the full report.
#### Viewing electronic lab results in the patient’s chart
Unsigned electronic lab results will appear in the **Requiring Action** section of the patient’s chart. You will see the following details in Requiring Action:
* The date of the report.
* The Provider or Delegate the report is assigned to.
* The date and time the results were collected.
* **Sign Off** options, including the options to sign off and attach the Report to a new Patient Letter or Provider Letter.
Click on the name of the report to open the full report view to see the following details:
* Report details:
* **Requisition No.** - The unique lab order ID assigned by the lab vendor.
* **Order by** - The name of the Provider that ordered the tests.
* **Vendor** - The name of the lab vendor.
* **Document Date** - The date of the report.
* **File Received** - The date the report was transmitted to Elation.
* **Collected** - The date the lab specimens were collected.
* **Completed** - The date the test results were completed.
* **Status** - The status of the results
* **Accession No.** - The unique ID assigned to the lab specimens associated with the results.
* Test result details:
* The test name and test value.
* The last 3 values for the same test from previous results, if available. Trending only occurs among results from the same lab vendor and requires the test to have a LOINC code — a value sent by one vendor doesn't trend together with the same test sent by a different vendor, and a value without a LOINC code won't trend at all.
* Abnormal test results - Look for abnormal test results in red, bold text.
* The reference range for the test - Position your cursor over the test value to see reference ranges, if available.
* Any notes as shared by the lab.
* A PDF version of the report - Click the **Download PDF version of report** button at the bottom of a report to download a PDF version of the report. Only some lab vendors (e.g. Quest and Genova Diagnostics) send the PDF version of the report along with the electronic version. Consult your lab representative if you have any questions about this behavior.
### Signing electronic lab results
Any Provider Level User can sign off on any electronic lab results, even if the results are assigned to a different provider in the practice. Staff Level Users can sign off on electronic lab results if they were delegated sign off permissions. [Click here for instructions on how to reassign lab results to a Delegate](#reassign).
To sign off on electronic lab results:
Locate the electronic lab result in the Practice Home or patient’s chart.
Click **Sign Off**.
### Moving an electronic lab result to a different patient chart
To move an electronic lab result to a different patient’s chart:
Locate the electronic lab result in the Practice Home or patient’s chart.
Click **Actions** → **Refile to Other Patient Chart**.
Search for the patient’s chart by their name and then select their name from the search results.
Click **File**. The report will now appear in the other patient chart.
### Reassigning electronic lab results to a different Provider or Delegate
To reassign electronic lab results to a different Provider or Delegate for sign off:
Locate the electronic lab result in the Practice Home or patient’s chart.
Click **Actions** → **Reassign to Provider** or **Actions** → **Reassign to Delegate**.
Search for and select the name of the Provider or Delegate you want to assign the report to.
Click **Assign**. The report is now assigned to a new Provider or Delegate.
### Removing a duplicate or incorrectly filed electronic lab result
If a lab result was filed to the wrong chart entirely, use [Refile to Other Patient Chart](#moving-an-electronic-lab-result-to-a-different-patient-chart) instead of removing it. Removing a result only makes sense when the result itself — not the chart it's filed in — is the problem, such as a true duplicate within the same chart.
To remove an electronic lab result from a patient's chart:
Locate the electronic lab result in the Practice Home or patient’s chart.
Click **Actions** → **Remove**.
Confirm the removal.
If you remove a lab result by mistake, recover it from **I need help** → **I accidentally deleted a note or report**, or from the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice).
### Exporting lab results to visit notes
To export lab results to a visit note:
Open the lab report in **Reports** → **Lab** **Reports** window.
Use any of the workflows below based on what you’d like to export:
* To export a single test value, position your cursor over the test value and click **Actions** and choose one of the export locations.
* To export all abnormal values, go to the bottom of the report and click **More Actions** → **Reference All Abnormal Values in Note**.
* To export multiple test values:
1. Click the **star** next to each value you want to export.
2. Click **More Actions** → **Reference All Starred in Note**.
If you use one of the 2-column visit note formats, you can also click **Import Labs & Associated Problems** in the note to import a patient's active problems along with their associated lab values, instead of exporting values from the Lab Reports window one at a time.
### Managing duplicate charts created when receiving electronic lab results
Electronic lab results are routed to patient charts by matching `first name`, `last name`, `date of birth`, and `sex at birth`. If the interface is unable to find an exact patient match, then it will automatically create a new patient chart in Elation to house the lab results.
Charts that Elation automatically creates show a pink banner at the top to indicate they were auto-generated. If you find that it’s a duplicate of an existing chart, [you can merge it](/articles/merging-duplicate-charts), along with the lab results, into the patient’s actual chart. Once you merge the charts, Elation routes that patient's future results from the same lab vendor to the correct chart, as long as the vendor keeps sending the same patient details it used before.
If the vendor later sends different identifying information for the patient (for example, a changed name spelling), a new duplicate chart can still be created.
### Sharing electronic lab results with patients
Manually share electronic lab results with patients via their Patient Passport account. [Click here for instructions on how to manually send patients their lab results via a Patient Letter](/articles/elation-patient-passport-an-introduction#attaching).
## Frequently Asked Questions
### How do I prevent electronic lab results from creating new patient charts for patients that do not belong to my practice?
Sometimes lab vendors may accidentally send you a report for a patient that is not yours or send you a report for a patient that is no longer active in your practice.
If the interface is unable to find an exact match based on the patient’s first name, last name, date of birth, and sex at birth, then it will automatically create a new patient chart in Elation to house the lab results. This feature cannot be disabled.
If the patient has an existing chart then you can merge the charts together by following the instructions in [this article](/articles/merging-duplicate-charts).
If the patient does not belong to your practice you can choose to delete the patient chart at your discretion.
### Why do lab reports from the same order show different dates?
A lab report's **Document Date** reflects when that specific report's results were collected, not the date the original order was signed. If a lab vendor splits one signed order into multiple collection trips — for example, because not every test could be drawn on the same day — each trip usually comes back as its own separate report, with its own Document Date matching when that portion was collected. Check the **Collected** field on each report to confirm exactly when that report's specimen was drawn.
### Does Elation call or send an alert to my practice when a critical lab result comes in?
No. Elation does not place phone calls or send automatic alerts when a critical result is received. The lab that runs the test assigns the critical or abnormal designation and sends it along with the result — Elation then displays it in the patient's chart, with abnormal values shown in red and unsigned results placed in the ordering provider's **Requiring Action** queue for review.
If your practice wants an automated alert outside of the chart, that would need to be built as a custom integration using Elation's API. See [Self-Service API Credential Management](/articles/self-service-api-credential-management) to get started.
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Managing lab vendors](/articles/Managing-lab-vendors)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Practice Home Guide- Checking for requiring action items](/articles/check-for-your-offices-daily-to-do-list)
* [Chronological Record Search Guide- Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
* [Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
* [Document Tags for Visit Notes & Reports Guide](/articles/tag-reports-and-notes-with-document-tags)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
# Virginia State- VIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Virginia-State-VIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Virginia State Immunization Registry [VIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Virginia State Immunization Registry known as VIIS.
## What is the VIIS Immunization Registry Interface?
The VIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to VIIS; the Virginia Immunization Information System. Practices can also query VIIS for vaccination history or forecast.
## Why is the VIIS Immunization Registry Interface valuable?
With the VIIS Immunization Registry Interface, practices no longer need to separately log in to VIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to VIIS. You can also pull vaccination history for specific patients from VIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & VIIS
The Elation Team will assist you with initiating interface with VIIS.To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**.
## How to submit vaccination data to VIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to VIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using VIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
*'Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide.*
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide.](/articles/Vaccination-Form-Guide#query_errors)
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Visit Note Documentation Guide- Amending signed Visit Notes
Source: https://help.elationhealth.com/articles/Visit-Note-Documentation-Guide-Amending-signed-Visit-Notes
This guide details how to amend signed Visit Notes.
## What is amending visit notes in Elation?
Amending visit notes in Elation allows Provider Level Users to make changes to signed visit notes and should be used with discretion. Best practice for clinicians is to always review their encounter documentation for accuracy and completion before signing visit notes. Provider Level Users can only amend visit notes that they have personally signed. Signing a visit note signifies that the Provider Level User has determined the visit note is complete and using one of the **Sign Note** options acts as an electronic signature to finalize the note.
## Why is amending visit notes useful?
Amending visit notes is useful as it allows Provider Level Users to make changes if necessary to previously signed visit notes. Elation helps track the amendments made and provides an audit trail of the amendments. Some examples of cases when a visit note needs to be amended are when a patient is correcting a date of injury, or generally improving details of documentation.
## How to amend a visit note
Provider Level Users can only amend visit notes that they have signed. Visit notes can be saved as drafts so that you, or other users at your practice, may add additional information to the visit notes if needed. Click **Save as Draft & Close** to save and close the draft.
Provider Level Users can amend visit notes that they have signed through the following steps:
1. Click **Actions** on the right hand side of the visit note
2. Click **Amend Note**
3. A window will appear asking you to confirm that you would like to proceed with amending the note
*
All changes will be tracked and logged for auditing and legal purposes.
4. Make the changes you wish to make on the visit note and select **Sign Amended Visit Note**
*
If you decide you do not need to amend the note after opening the amendment, select **Discard Amendment** to cancel.
The note will appear in the Requiring Actions section of the chart for the Provider Level User making the amendment if it is saved as a draft or if the user exits the chart before signing off on the amendment.
A receipt of the amendment will appear at the bottom of the amended visit note with the date and time that the visit note was amended.
![Actions menu open on a signed visit note, with "Amend Note" highlighted and an arrow pointing to it. The note shows amendment receipt: "Amended and signed by Sara Smith, MD on 12/08/2022 9:55 am view changes."]()
## Viewing amendments made to the visit note
Elation helps track amendments made and provides an audit trail of the amendments. There are a few ways to view amendments made to visit notes:
* View Changes
* Audit Log
### View Changes
The specifics of the amendments can be found by clicking **View Changes** at the bottom of the visit note next to the receipt of the amendment. In the window that appears, deletions will be displayed as
strikethroughs
and additions will be displayed in
blue
font.
![Amended visit note showing a red arrow pointing to the amendment receipt: "Signed by Sara Smith, MD on 12/08/2022 9:06 am" and "Amended and signed by Sara Smith, MD on 12/08/2022 9:55 am view changes" link.]()
!["View Changes" dialog showing deleted text ("Patient came in with a headache and sore throat") as strikethrough and added text ("Negative PCR for COVID-19") in blue.]()
### Audit Log
Admin Level Users can view a log of amendments to the visit note through the Audit Log feature. Please reference the
[Patient Chart Guide- Audit Logs](/articles/Patient-Chart-Guide-Audit-Logs)
for more information on this feature. The action of starting and completing an amendment to a visit note is displayed in the Audit Log as a
\*VisitNoteEdit \*
Record Type.
![Audit Log showing two highlighted VisitNoteEdit entries for patient Katie Williams: "add" action at 14:21:03 and "sign" action at 14:22:02, both performed by Sara Smith on 12/06/2022.]()
## Frequently Asked Questions
### Can supervising providers or authorized staff delegates amend visit notes on behalf of other providers?
No, supervising providers or authorized staff delegates cannot amend visit notes on behalf of other providers. Provider Level Users can only amend visit notes that they have personally signed. However, authorized staff delegates are able to
[edit billing information](/articles/billing)
on a visit note if they have been designated as a
[Billing delegate](/articles/staff-permissions--staff-delegates#billing)
by the Provider Level User. Please note that billing edits will not have the same annotations that amendments do.
### If the wrong provider signed off on a note, how do I correct that?
Amending a note doesn't change which provider signed it. To have the correct provider sign the note instead, use **Actions > Export to New Note** to create a draft with the same content, have the correct provider review and sign the new note, and then delete the original note that has the incorrect signature.
### How are amended visit notes displayed when printed or shared?
When amended visit notes are printed or shared, they will display the most recent information within the visit note, and will also display the receipts of amendments made. These receipts show the date and time of the amendment and the name of the Provider Level User who made the amendment.
![Printed Office Visit Note for Katie Williams showing two signature lines: original electronic signature by Sara Smith, MD on 12/08/2022 at 9:06 am, and a highlighted amendment receipt "Amended and electronically signed by Sara Smith, MD on 12/08/2022 9:55 am" with a red arrow pointing to it.]()
### How do I share the amendments for auditing purposes?
We recommend taking a screenshot of the window that appears when clicking **View Changes** and sharing that screenshot. Deletions will be displayed as
strikethroughs
and additions will be displayed in
blue
font in the window.
### Can I amend a signed Phone Note?
No, the Amend Note option is not available for Phone Notes — it only appears for signed Visit Notes/Elation Notes. To document a correction or addendum to a signed Phone Note, create a new phone (chart) note in the same patient's chart, state in the body that it's an addendum to the original phone note (including its date), describe the correction, and sign the new note. This keeps the original phone note intact while recording the update.
### Can I remove just one attachment from a signed note without deleting the others?
You can't remove a single attachment from a signed note and keep the rest. Use **Actions → Export to New Note** to create a new note with the same content, minus the bad attachment. Sign the new note, then delete the original.
**Actions → Remove & Refile Images** exists on some notes, but it removes the whole note and sends every attachment back to **Incoming Documents** — it's not a selective option, and you'd need to refile everything to rebuild the note.
If you delete a note by mistake, recover it from **I need help → I accidentally deleted a note or report**, or from the [User Activity Log](/articles/User-Accounts-Guide-Viewing-activity-logs-for-users-in-your-practice).
### How do I document an amendment requested by a patient?
Please reference the
[Visit Note Documentation Guide- Documenting amendment requests from patients](/articles/documenting-amendment-requests-from-patients)
for detail on how to document an amendment requested by a patient.
### Can I create a referral from within an amended visit note?
You can open the Referral button from an amended visit note, but the resulting referral does not link back to that visit. To keep a referral properly linked to a visit, use one of these approaches instead:
* Create the referral from a new, unsigned visit note: start the new note, use the **Referral** button, sign and send the referral so it links to that visit, and then sign the visit note.
* Create the referral separately, then use **Select chart items to attach** on the referral to manually attach the signed or amended visit note.
### Does a saved amendment draft appear in my Draft Notes inbox on Practice Home?
No. An amendment saved as a draft appears only in the Requiring Actions section of the patient's chart — it does not appear in the Practice Home **Draft Notes** inbox. It's removed from the Requiring Actions section once the amendment is signed or discarded. The **Draft Notes** inbox only lists notes that have never been signed.
## Related Articles
* [Patient Chart Guide- Audit Logs](/articles/Patient-Chart-Guide-Audit-Logs)
* [User Accounts Guide- Utilizing authorized staff delegates](/articles/staff-permissions--staff-delegates)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Visit Note Documentation Guide- Documenting amendment requests from patients](/articles/documenting-amendment-requests-from-patients)
# Visit Note Documentation Guide- Best practices for co-signing visit notes
Source: https://help.elationhealth.com/articles/Visit-Note-Documentation-Guide-Best-practices-for-co-signing-visit-notes
This is a best practice guide on how non-physician practitioners and practitioners can co-sign visit note documentation.
## Who needs to co-sign visit notes?
If your practice employs non-physician practitioners (NPPs), a supervising physician is responsible for reviewing the work, records, and practice of the NPP to ensure that appropriate treatment is rendered and appropriate directions are given and understood as applicable to the law. Supervising physicians are required to note that they reviewed an NPP's work or include their name/signature in the clinical documentation for proper legal documentation purposes. Each state has different co-signature requirements that need to be followed.
Elation currently allows one provider-level user to sign each visit note which then captures one signature in a 'structured' manner in the visit note. The physician/practitioner that signs the visit note is typically the provider you are billing the encounter under. Then, to capture a co-signature, there are subsequent workflows that can be completed depending on how you plan to bill:
1. For ‘Direct Billing’
* The NPP performs the visit, and the visit is billed under the NPP's NPI number. There must be documentation that the supervising physician reviewed a certain percentage of encounters.
2. For ‘Incident-To Billing’
* The NPP performs the visit, and the visit is billed under the supervising physician's NPI number. There must be documentation of which NPP saw the patient and who rendered the encounter.
## Direct Billing
For Direct Billing, the NPP is billing under their own NPI number. Different states require a different percentage of a NPP's encounter documentation to be reviewed by their supervising physician for clinical appropriateness. The co-sign workflow in Elation can be divided into two main steps:
1. Identifying the visit notes that a supervising physician needs to review
2. Documenting that a review was completed
### Identifying visit notes for review
After the NPP signs off on the visit note documentation, there are two options for identifying visit notes for supervising physician review and/or sign off:
1. The NPP can flag specific visit notes for the supervising physician
2. The supervising physician can randomly select visit notes themselves
#### NPP flags specific visit notes
The NPP can identify and route visit note(s) to the supervising physician for review and/or sign off using the office message feature in Elation. To do so:
1. The NPP locates a signed visit note in the patient's chart
2. The NPP clicks **Actions** >> **Send: Office Message** at the top of the visit note
3. The NPP enters the supervising physician's name in the **To** field and enters a short message in the **Body** (ex. 'Please review' or 'Please review & sign')
4. The NPP clicks **Send**
5. The supervising physician then checks their **Office Messages** inbox daily for messages from the NPP
6. The supervising physician clicks on the patient's name to open the chart to view the visit note and review the documentation
7. The supervising physician then replies to the office message to close the loop (ex. **Review complete** or **Approved**) and clicks **Send and Sign Off**.
8. There is now documentation in the patient's chart that states the supervising physician reviewed a specific visit note signed by the NPP.
#### The supervising physician selects visit notes
The supervising physician can log in to Elation and use the
**Billing Report**
to select visit notes for review and then they can use the
*Office Message*
or
\*\* Non-Visit Note\*\*
features to document their review and/or sign off.
*
This workflow requires the NPP to enter billing information for each visit note prior to the NPP signing off on the visit note.
To use this workflow:
1. The supervising physician opens the \*\*Billing Report \*\* using one of the following options:
2. Click on the **Billing** button at the top of the Practice Home
3. Click **Reports** >> **Billing Report** at the top of any page in Elation
4. The supervising randomly selects signed visit notes completed by the NPP by clicking on a patient under one these sections
5. the **Signed Visit Notes Not Yet Billed** section for customers who do not have a Practice Management System (PMS) integration with Elation
6. the **Visit Notes with Bills Pending Sync to PMS** section for customers who have a Practice Management System (PMS) integration with Elation
7. The supervising physician reviews the visit note documentation for that date of service
*
If the supervising physician needs additional clarification from the NPP about any contents of the encounter, they can send an **Office Message** to the NPP for additional clarification before signing off on the visit note draft.
4. After the supervising physician reviews the visit note documentation, the supervising can use one of the following features to make note of their review and/or sign off:
5. Office Message:
6. Click **Actions** >> **Send: Office Message** at the top of the visit note they reviewed
7. Enter the NPP's name or their own name (depending on preference) in the **To:** field
8. Enter a short message in the **Body** (ex. **Review complete** or **Approved**)
9. Click **Send**
10. Locate the message in the **Requiring Action** section of the patient's chart & click **Sign** at the top of the message
11. Non-Visit Note:
12. Click **Notes** >> **Non-Visit Note** at the top of the patient's chart after reviewing the NPP's visit note
13. Enter a short message in the body of the **Non-Visit Note** (ex. **I reviewed the visit note for Date of Service 04/01/2022** or 'I reviewed the visit note for Date of Service 04/01/2022 and sign off on the work.')
14. Click **Sign Note**
## Incident-To Billing
Incident-To Billing means the non-physician practitioner (NPP) sees the patient and documents the encounter and is billing under their supervising physician's NPI number. The documentation must capture the NPP's name in order to meet a requirement about documenting who saw the patient and who rendered the encounter.
We recommend the NPP uses a Visit Note Template to capture their name and statement in regards to seeing the patient and rendering the encounter. For example, the statement can be 'Visit was rendered and documented by Jane Doe, NP and completed under supervising physician James Hibbert, MD'.
### Creating the Visit Note Template for attestation
1. Open the Visit Note Templates management window using one of the following methods:
2. Click the **Visit Note Templates** button at the top of any visit note draft
3. Click **Templates** >> **Visit Note Templates** at the top of any patient's chart
4. Click the **+New Template** button at the top of the Visit Note Templates management window
5. Enter a name for the template in the **Template Name** field (ex. **Visit Attestation**)
6. Select a section for storing your attestation. We recommend the **Procedure** section because it usually stores actions taken during the encounter.
7. Enter your attestation language in the **Procedure** section of the Visit Note Template. (ex. 'Visit Attestation: Visit was rendered and documented by Jane Doe, NP and completed under supervising physician James Hibbert, MD'.)
8. Click **Save Template**
### Completing the encounter
After the NPP completes the encounter documentation in the Visit Note draft, the NPP will enter the visit attestation and then re-assign the visit note draft to their supervising physician for final review and sign off:
1. The NPP completes documentation of the encounter in the visit note draft
2. The NPP clicks the **Visit Note Templates** button at the top of any visit note draft
3. The NPP clicks the **Export to Note** button next to the visit attestation template to export the visit attestation template into the visit note draft
4. The NPP changes the provider at the top of the visit note draft to the supervising physician's name
5. The NPP clicks **Save as Draft & Close** to drop the visit note draft in the supervising physicians's **Draft Notes** inbox
6. The supervising physician then checks their Practice Home **Draft Notes** inbox daily for visit notes to review
7. The supervising physician clicks on the patient's name to open the chart and clicks on the 'In Progress...' visit note
8. The supervising physician reviews the visit note draft and then clicks the **Sign Visit Note** button once they have approved the contents of the encounter.
*
If the supervising physician needs additional clarification from the NPP about any contents of the encounter, they can send an **Office Message** to the NPP for additional clarification before signing off on the visit note draft.
## Using Templating software to facilitate co-signing
Using a
[templating software](/articles/using-templating-softwares-with-elation)
will allow the NPP or supervising physician to drop text on-demand into records in Elation. The text can dictate:
1. that the NPP rendered a visit
2. that the NPP is requesting their supervising physician to review a visit note they signed
3. that the supervising physician reviewed the encounter and is co-signing a visit note
## Related Articles
* [Office Message Feature Guide](/articles/How-to-use-Office-Messages)
* [Practice Home Guide- Checking for requiring action items](/articles/check-for-your-offices-daily-to-do-list)
* [Templates Guide- Using templating softwares with Elation](/articles/using-templating-softwares-with-elation)
# Visit Note Documentation Guide- Visit Note Formats
Source: https://help.elationhealth.com/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats
This article describes the various visit note formats in Elation, what they offer and how to set your default visit note format.
## What are Visit Note Formats?
In Elation, there are 6 different Visit Note Formats that provide you with different layouts for storing clinical information when documenting a clinical encounter. Each layout has its own characteristics that makes it suitable for different documentation workflows and preferences. You can find the different visit note formats under the **Visit Note** button in the gray navigation bar.
![Visit Note button dropdown menu expanded in the navigation bar, showing all 6 note format options: Simple Note, SOAP Note, Complete H&P Note (1 column), Complete H&P Note (2 column), Complete H&P Note (2 col-A/P), and Pre-Op Note.]()
## Default Sections & Fields
Every Visit Note Format has the following default sections and fields:
* Visit Note Date & Time
* [Visit Note Category](/articles/visit-note-categories)
* Assigned Provider
* [Visit Note Templates](/articles/elation-visit-note-templates) shortcut button
* [Clinical Reminders](/articles/clinical-reminders-for-clinical-quality-measures) section
* Exam Reason (CC) field
* Shortcuts to documenting vaccinations, creating referrals, orders and prescriptions and printing Handouts.
* Follow Up field
* [Billing Information](/articles/billing) section
## Simple Note
The Simple Note contains a single blank text box that is ideal for customers who are free-texting a long narrative or for use with dictation softwares or external templating softwares. You can also
* click **+ Add Vitals** to separately record patient vitals
* click **+ Add procedure** button to separately record detailed [procedure information](/articles/documenting-procedures)
* click **+ Add instr** to separately note instructions to patients
![Simple Note format showing a single HPI narrative text box, with Add Vitals, Add procedure, and Add instr links, and order shortcut tabs including Referral, Rx/OTC, Lab, and Imaging.]()
## SOAP Note
The SOAP Note is broken down into 4 text boxes, Subjective (Prob), Objective, Assessment & Plan. This allows you add more granularity to your narrative than a
[Simple Note](#Simple)
would while still allowing you to easily utilize dictation softwares or external templating softwares. You can also:
* click **Import Current Meds** to easily reference patient medication information into the Problem box
* click **+ ros** to separately record [Review of Systems](/articles/physical-exam-pe-and-review-of-systems-ros-templates) information
* click **+ Add Vitals** to separately record patient vitals
* click **+ pe** to separately record [Physical Exam](/articles/physical-exam-pe-and-review-of-systems-ros-templates) information
* click **+ Add procedure** button to separately record detailed [procedure information](/articles/documenting-procedures)
* click **+ Add instr** to separately note instructions to patients
![SOAP Note format showing four separate text boxes: Prob (subjective), O (objective), A (assessment), and Plan, with Import Current Meds, Add ROS, Add Vitals, Add PE, and Add procedure links visible.]()
## Complete H\&P Note (1 column)
The Complete H\&P Note (1 column) allows you to store detailed history and physical examination information in a single column format and allows you to import data directly from the Clinical Profile into your visit note with the various **Import** buttons in each section of the note. You can also:
* separately [record assessments with diagnosis codes](/articles/visit-note-assessments)
* click **+ Add Vitals** to separately record patient vitals
* click **Enter Point-of-Care Lab Results** to [record results from in-house labs](/articles/point-of-care-labs)
* click **+ Add procedure** button to separately record detailed [procedure information](/articles/documenting-procedures)
* click **+ Add instr** to separately note instructions to patients
![Complete H&P Note (1 column) layout showing sections for HPI, Allergies (Penicillin = rash entered), PMH, PSH, FH, SH, Habits, Current Medications, ROS, PE, Data, Assessment/Plan, and Follow Up, each with Import buttons.]()
## Complete H\&P Note (2 column)
The Complete H\&P Note (2 column) uses the traditional SOAP methodology but offers more structure for viewing everything on a single screen by placing the Subjective data on one side and Objective, Assessment and Plan on the other.
![Complete H&P Note (2 column) layout showing Subjective fields (Prob, Allergy, PMH, Meds, ROS) on the left and Objective, Assessment, and Plan sections on the right side.]()
You can click the **Import...** buttons to import information from the Clinical Profile into the visit note and you can also export data from your visit note back to the Clinical Profile. This way you never have to double document! Click the **add...** button that appears next to the new data you enter into any of the fields available in the Clinical Profile to add the new data to your Clinical Profile.
![Complete H&P Note (2 column) Allergy section showing "Penicillin = rash" imported, with "peanuts" entered and "add Allgy" button highlighted to save it to the Clinical Profile.]()
## Complete H\&P Note (2 col-A/P)
The Complete H\&P Note (2 col-A/P) is the same as the
[Complete H\&P Note (2 column)](#TwoColumn)
except the Assessment and Plan sections are combined.
![Assessment/Plan section in the 2 col-A/P note format, showing combined assessment and plan fields with order shortcut links and a Care Plan field.]()
## Pre-Op Note
The Pre-Op Note is the same as the
[Complete H\&P Note (1 column)](#OneColumn)
with the addition of the
*Date*
,
*Consultant*
and
*Attending*
fields to note additional details about the operation or procedure that the patient is scheduled for.
![Pre-Op Note format showing Date, Consultant, and Attending fields below the standard Exam Reason (CC) field, unique to this note type.]()
## Setting Defaults
Each provider can set their default Visit Note format by going to **Settings** >> **Preferences** >> **App Preferences**. They can also associate default Visit Note formats by their Encounter Types (Appointment Types) in the same page or in the Calendar & Booking Settings page under each Appointment.
![App Preferences page with Preferences tab selected, showing Default Visit Note Format dropdowns: Default set to "Complete H&P Note (2 col-A/P)", Follow-Up to "SOAP Note", Telemedicine to "Complete H&P Note (2 col-A/P)"]()
**Next StepReview the different visit note formats and choose your default!**
## Related Articles
* [Visit Note Documentation Guide- Best practices for documenting a patient encounter](/articles/Best-practices-for-documenting-a-patient-encounter)
* [Visit Note Documentation Guide- Procedures](/articles/documenting-procedures)
* [Visit Note Documentation Guide- Assessments](/articles/visit-note-assessments)
* [Visit Note Documentation Guide- Care Plans](/articles/Creating-and-Viewing-a-Care-Plan)
* [Visit Note Documentation- Physical Exam (PE) & Review of Systems (ROS) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
* [Visit Note Categories Guide](/articles/visit-note-categories)
* [Visit Note Documentation Guide- Documenting amendment requests from patients](/articles/documenting-amendment-requests-from-patients)
# Visit Note Documentation Introduction
Source: https://help.elationhealth.com/articles/Visit-Note-Documentation-Introduction
This article will introduce you to the Visit Note feature in Elation and the various functionalities it offers to allow providers to document patient encounters in Elation EHR.
## What is the Visit Note feature?
Elation's Visit Note feature is used to record a patient encounter. The Visit Note feature offers many structured fields for storing important details regarding a patient encounter.
## Why is the Visit Note feature valuable?
Storing patient encounter details in a structured way allows for better collaboration amongst various providers and organizations that are caring for the same patient. You can easily view visit notes within a patient's chart or share a copy of the structured visit note with any provider or organization. This will also help you comply with medical and legal standards for completing a patient encounter.
## Visit Note functionalities
### Visit Note Formats
In Elation, there are 6 different Visit Note Formats that provide you with different layouts for storing clinical information when documenting a clinical encounter. Each layout has its own characteristics that makes it suitable for different documentation workflows and preferences. You can find the different visit note formats under the **Visit Note** button in the gray navigation bar.
[Click here](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) to learn more about the various visit note formats. We recommend finding one or a few that align with your charting style.
### Visit Note Categories
The Visit Note Categories control the title or **heading** of your note, as well as whether or not that note will be counted in the denominator of eligible patient visits in Meaningful Use calculations.
[Click here](/articles/visit-note-categories) to learn more about how to manage your visit note categories and how to set defaults.
### Timer
Two timers will appear at the top of visit notes when Provider level users are drafting visit notes; *Time with patients* & *Time documenting*.
The **Time with patients** timer will start automatically when a new visit note draft is open for Provider level users. The **Time with patient** timer can be used to document the total amount of time spent with a patient. Providers can click **Pause** to pause this timer at any time and click **Resume** to resume the timer. If Provider level users save the visit note as a draft and open the draft again, they must click the **Resume** button to resume the **Time with patient** timer again.
The \*\*Time documenting \*\* timer is a timer that must be started manually. The **Time documenting** timer can be used to document the amount of time it takes providers to complete visit note documentation. Providers must click **Start** to start the **Time documenting** timer. Once the timer is started, providers can click **Resume**, **Pause** or **Stop** to manage the timer.
### Assessments section
Every [Visit Note Format](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) in Elation contains an **Assessment** field except for the Simple Note. There are two ways to document clinical assessments during a patient encounter.
1. You can type out a text narrative in any of the assessments fields in Elation
2. You can use the ICD database to enter coded assessments in any of the H\&P and Pre-Op Visit Note formats.
[Click here](/articles/visit-note-assessments)
to learn more about how to best utilize the Assessment field in your visit notes.
### Procedures section
There are two ways to document procedures performed during a patient encounter.
1. You can type out a text narrative in any of the procedure fields
2. You can use the CPT code database to enter coded procedure
[Click here](/articles/documenting-procedures) to learn more about how to best utilize the Procedure field in your visit notes.
### Care Plan section
The Care Plan is a patient-centered planning tool that focuses on your patient’s specific needs, goals, and preferences. It represents a **snapshot** of care at a single point in time to be easily shared with other providers and teams to ensure continuity of care. Each [Visit Note Format](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) has a **Care Plan** section except for the **Simple Note**.
[Click here](/articles/Creating-and-Viewing-a-Care-Plan) to learn more about how to best utilize the Care Plan field in your visit notes.
### Billing Section
Customers who submit claims to insurance payers for services rendered can use the Billing Section to store claims related details.
[Click here](/articles/billing)
to learn more about how to enter billing information in your visit notes.
## Template Options
You can utilize Visit Note, Physical Exam (PE) and Review of Systems (ROS) templates with your visit notes. Click on the relevant links below to learn more about each type of template:
* [Visit Note Templates](/articles/elation-visit-note-templates)
* [Physical Exam (PE) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates)
* [Review of Systems (ROS) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates)
You can also utilize external templating software alongside Elation. Click on the
[Templates Guide- Using templating softwares with Elation](/articles/using-templating-softwares-with-elation)
to learn more.
## Best Practices
We have compiled the best workflows related to patient encounter documentation for you to reference below:
* [Best practices for documenting a patient encounter](/articles/Best-practices-for-documenting-a-patient-encounter)
* [Using Clinical Profile documentation to facilitate charting](/articles/no-double-documentation-with-the-clinical-profile)
* [Best practices for co-signing visit notes](/articles/Visit-Note-Documentation-Guide-Best-practices-for-co-signing-visit-notes)
* [Using visit note automation for appointments](/articles/visit-note-automation)
* [Converting paper or other external visit notes into Elation visit notes](/articles/converting-paper-or-electronic-visit-note-to-elation)
## Related Articles
* [Visit Note Documentation Guide- Best practices for documenting a patient encounter](/articles/Best-practices-for-documenting-a-patient-encounter)
* [Visit Note Documentation Guide- Using Clinical Profile documentation to facilitate charting](/articles/no-double-documentation-with-the-clinical-profile)
* [Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Visit Note Categories Guide](/articles/visit-note-categories)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
* [Visit Note Documentation Guide- Assessments](/articles/visit-note-assessments)
* [Visit Note Documentation Guide- Procedures](/articles/documenting-procedures)
* [Visit Note Documentation Guide- Care Plans](/articles/Creating-and-Viewing-a-Care-Plan)
* [Visit Note Documentation Guide- Physical Exam (PE) & Review of Systems (ROS) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates)
* [Visit Note Documentation Guide- Best practices for co-signing visit notes](/articles/Visit-Note-Documentation-Guide-Best-practices-for-co-signing-visit-notes)
* [Visit Note Documentation Guide- Using visit note automation for appointments](/articles/visit-note-automation)
* [Visit Note Documentation Guide- Converting paper or other external visit notes into Elation visit notes](/articles/converting-paper-or-electronic-visit-note-to-elation)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
# Washington State- WAIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Washington-State-WAIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Washington Immunization Information System [WAIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Washington Immunization Information System (WAIIS).
## What is the WAIIS Immunization Registry Interface?
The WAIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to WAIIS; Washington Immunization Information System. Practices can also query WAIIS for vaccination history or forecast.
## Why is the WAIIS Immunization Registry Interface valuable?
With the WAIIS Immunization Registry Interface, practices no longer need to separately log in to WAIIS to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to WAIIS. You can also pull vaccination history for specific patients from WAIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & WAIIS
The Elation Team will assist you with initiating interface with WAIIS. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and let us know whether or not you have a OneHealthPort (OHP) agreement.
### OneHealth Port (OHP) Pricing Information
* OHP charges \$600 annually per practice for access to OHP, including for WAIIS interfacing and other services. If you already have an OHP agreement, you do not need to set up a new or additional agreement for the electronic immunization reporting interface.
If you choose to set up a Prescription Monitoring Program (PMP) integration between Elation and the Washington PMP **before** setting up the WAIIS integration, OHP will charge $100 for your first year and $600 annually thereafter. Please note, charges for the PMP integration are applied by our PMP partner **in addition to** OHP charges. Please refer to our [State Prescription Monitoring Program (PMP/PDMP)](/articles/Integrating-with-your-state-s-Prescription-Monitoring-Program-PMP-PDMP) guide for more information and pricing details.
## How to submit vaccination data to WAIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to WAIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
Parent recall historical vaccinations are not accepted by WAIIS.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using WAIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
*'Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide.*
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
*'Managing querying errors' section of the Vaccination Documentation Guide.*
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# West Virginia State- WVSIIS- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/West-Virginia-State-WVSIIS-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the West Virginia State Immunization Information System [WVSIIS] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the West Virginia State Immunization Information System (WVSIIS).
## What is the NDIIS Immunization Registry Interface?
The WVSIIS Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to WVSIIS, the West Virginia State Immunization Information System. Practices can also query WVSIIS for vaccination history or forecast.
## Why is the WVSIIS Immunization Registry Interface valuable?
With the WVSIIS Immunization Registry Interface, practices no longer need to separately log in to WVSIIS to enter vaccination records for their patients. Once the vaccination is recorded in WVSIIS during the patient encounter, the information can be sent immediately from the patient's chart in Elation to WVSIIS. You can also pull vaccination history for specific patients from WVSIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & WVSIIS
The Elation Team will assist you with initiating interface with WVSIIS. To notify us of your interest please complete [this form for WVSIIS](/files/immunization-wv-wvsiis-form.pdf) and then [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport) and select **Immunization Registry** as the **Request Type**. A member of the Elation team will collect the completed WVSIIS form from you.
## How to submit vaccination data to WVSIIS using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to WVSIIS. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using WVSIIS
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the
['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors)
.
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Wisconsin State- WIR- Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Wisconsin-State-WIR-Immunization-Registry-Interface-User-Guide
This article will describe how you can submit vaccination data to the Wisconsin State Immunization Registry [WIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Wisconsin State Immunization Registry (WIR).
## What is the WIR Immunization Registry Interface?
The WIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to WIR; the Wisconsin State Immunization Registry. Practices can also query ASIIS for vaccination history or forecast.
## Why is the WIR Immunization Registry Interface valuable?
With the WIR Immunization Registry Interface, practices no longer need to separately log in to WIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to WIR. You can also pull vaccination history for specific patients from WIR to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & WIR
The Elation Team will assist you with initiating interface with WIR. To notify us of your interest, please [click here to fill out our contact form](https://help.elationemr.com/s/contactsupport), select **Immunization Registry** as the **Request Type**, and send the following information to Elation:
1. Are you currently administering vaccines? If so
2. How often do you administer immunizations?
3. Are you administering COVID vaccines?
4. Do you have an account with WIR (or do you have a login to WIR)?
5. Do you want to set up Inventory Deduction?
* Inventory Deduction allows WIR to automatically deduct vaccine inventory after submitting a vaccination to the registry
4. Is your practice already registered with PHREDS (the Public Health Registration for Electronic Data Submission System)? If you are not, [follow the instructions below to register with PHREDS](#phreds)
5. Are you a VFC provider?
6. Will you be working to attest to Meaningful Use Stage 3?
7. How are you currently entering immunization data in WIR? What Organization are you recording under, if any?
8. There is a possibility that your staff will need to change their immunization documentation workflow. How long do you anticipate it will take you to update your staff on the new process?
## How to submit vaccination data to WIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to WIR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using WIR
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Registering with PHREDS
WIR requires you to have registered with PHREDS (the Public Health Registration for Electronic Data Submission System) in order to send immunization data electronically from an EHR to WIR. Follow the steps below to register with PHREDS.
1. You first need a Wisconsin Logon Management System (WILMS) account to access PHREDS.
2. If you already have a WILMS account and know your account information, send an email to the Wisconsin eHealth Program ([ehealth@wisconsin.gov](mailto:ehealth@wisconsin.gov)) with your WILMS account name and the subject line "PHREDS Access."
3. If you are not sure if you have a WILMS account, check the [Department of Administration account management](https://register.wisconsin.gov/AccountManagement/acctrecovery/EmailEntry.aspx) website to see if you have an account.
4. If you do have a WILMS account, you will receive an email with your WILMS account information. Send an email to the Wisconsin eHealth Program ([ehealth@wisconsin.gov](mailto:ehealth@wisconsin.gov)) with your WILMS account name and the subject line "PHREDS Access."
5. If you do not have a WILMS account, the following text will display: 'The E-Mail address you entered was not found. Please enter the correct E-Mail address.' Follow Step c below to register for a WILMS account
6. If you do not have a WILMS account, create a WILMS account on the [Self Registration](https://register.wisconsin.gov/AccountManagement/AccountCreationOverview.aspx) page.
7. Under **Systems You Will Access,** select **PHREDS** and proceed with creating a WILMS account
8. After you create a new WILMS account, an automated email will be sent to the Wisconsin eHealth Program to notify them of your account information
9. You will receive an email granting you access to the PHREDS within three business days. If you do not receive this email within three days, email the Wisconsin eHealth Program ([ehealth@wisconsin.gov](mailto:ehealth@wisconsin.gov)).
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record, [please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport) and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the ['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Workspaces Guide- Common Use Cases (Premium)
Source: https://help.elationhealth.com/articles/Workspaces-Use-Cases
This article describes a few common use cases for the Workspaces feature which can add a flexible organizational layer to the Elation ‘practice’ concept enabling you to deploy specific settings, resources, and configurations to different staff members.
## Recommended Reading
Before reading this article, we recommend reading the [Workspaces Introduction](/articles/workspaces-guide) article to learn about the Workspaces feature.
## When would I use the Workspaces feature?
Customers within a single practice can add a flexible organizational layer (known as Workspaces in Elation) to the Elation **practice** concept enabling them to deploy specific settings, resources, and configurations to different members of their organization based on different operational scenarios such as practice locations, clinical focus or role-specific responsibilities.
The Workspaces feature is a product for Premium EHR customers only.
## Workspaces Use Cases
This section will showcase a few common use cases for Workspaces configuration. The following use cases will be discussed in detail:
* [Primary Care Practice with a Mobile COVID Clinic](#secondary_clinical_focus)
* [A network of Primary Care clinics with locations across 3 states](#network)
* [A multi-speciality clinic with divided responsibilities](#multi_specialty)
### Primary Care Practice with a Mobile COVID Clinic
This use case is ideal for practices with more than one clinical focus or location. Horizon Medical is a Los Angeles based, 3 provider + 6 staff, Primary Care practice that runs a Mobile COVID Clinic. The Mobile COVID Clinic
1. operates with Jane Doe as the doctor every Tuesdays and Thursdays
2. offers COVID-19 testing at a local school
3. administers care for patients who are diagnosed with COVID-19
Based on the above scenario, Horizon Medical will set up 2 [User Groups](/articles/user-groups) with the following members:
1. User Group #1- Main Office
* John Smith, MD
* Sam Smith, MD
* Jane Doe, MD
* 4 main office staff
2. User Group #2- COVID Clinic
* Jane Doe, MD
* 2 mobile clinic office staff
Based on the above scenario, Horizon Medical will set up 2 Workspaces with the following resources. This will allow the Mobile COVID Clinic users (the third column) to see and use the resources specific to COVID-19 testing and care.
| Resources | Workspace #1- Main Office | Workspace #2- Mobile COVID Clinic |
| ------------------------------------- | ------------------------- | --------------------------------- |
| **Time Zone** | | |
| | (PDT -07:00) US - Pacific | (PDT -07:00) US - Pacific |
| **User Access** | | |
| COVID Clinic (User Group) | | X |
| Main Office (User Group) | X | |
| **Provider Lists** | | |
| COVID Clinic (User Group) | | X |
| Main Office (User Group) | X | |
| **Practice Locations** | | |
| Horizon Medical | X | |
| Horizon Medical COVID Clinic | | X |
| **Print Headers** | | |
| Horizon Medical | X | |
| Horizon Medical COVID Clinic | | X |
| **Lab Accounts** | | |
| Office location specific Lab Accounts | X | |
| Mobile clinic specific Lab Accounts | | X |
| **Physical Exam Templates** | | |
| General Well | X | X |
| Medical Annual Wellness Exam | X | |
| Welcome to Medicare | X | |
| Well Womens | X | |
| **Review of Systems Templates** | | |
| General Female | X | X |
| General Male | X | X |
| **Letter & Referral Templates** | | |
| Request for Medical Records | X | |
| Sick Note for Sick | X | X |
| **Visit Note Templates** | | |
| Annual Wellness Visit | X | |
| COVID 19 Follow Up | X | X |
| COVID 19 Mobile Clinic Billing | | X |
| COVID 19 Office Billing | X | |
| COVID 19 Screening | X | X |
| Hypertension Follow Up | X | |
| Telehealth Attestation | X | |
### A network of Primary Care clinics with locations across 3 states
This use case is ideal for large networks of clinics with multiple locations. Clean Health is a network of Primary Care clinics with 3 locations- Phoenix (Arizona), San Diego (California) and Las Vegas (Nevada). Clean Health, Inc. will set up 3 User Groups to separate the employees for each location and have the time stamps displayed in the appropriate time zones. Patients can visit locations across states when traveling for work. Additionally, the San Diego office offers civil surgeon services for United States Citizenship and Immigration Services (USCIS) and has additional resources they want to separate from other offices.
Based on the above scenario, Clean Health will set up 3 Workspaces with the following resources. This will allow each office to see only the resources that are relevant to their office/location.
| Resources | Workspace #1- Las Vegas | Workspace #2- Phoenix | Workspace #3- San Diego |
| ------------------------------- | ------------------------- | -------------------------- | ------------------------- |
| **Time Zone** | | | |
| | (PDT -07:00) US - Pacific | (MDT -06:00) US - Mountain | (PDT -07:00) US - Pacific |
| **User Access** | | | |
| Las Vegas (User Group) | X | | |
| Phoenix (User Group) | | X | |
| San Diego (User Group) | | | X |
| **Provider Lists** | | | |
| Las Vegas (User Group) | X | | |
| Phoenix (User Group) | | X | |
| San Diego (User Group) | | | X |
| **Practice Locations** | | | |
| Clean Health- Las Vegas | X | | |
| Clean Health- Phoenix | | X | |
| Clean Health- San Diego | | | X |
| **Print Headers** | | | |
| Clean Health- Las Vegas | X | | |
| Clean Health- Phoenix | | X | |
| Clean Health- San Diego | | | X |
| **Lab Accounts** | | | |
| LabCorp- San Diego | | | X |
| Quest- Las Vegas | X | | |
| Quest- Phoenix | | X | |
| Quest- San Diego | | | X |
| **Physical Exam Templates** | | | |
| General Annual | X | X | X |
| Medicare Annual Wellness | X | X | X |
| USCIS | | | X |
| Welcome to Medicare | X | X | X |
| Well Womens | X | X | X |
| **Review of Systems** | | | |
| General Female | X | X | X |
| General Male | X | X | X |
| **Letter & Referral Templates** | | | |
| Request for Medical Records | X | X | X |
| Sick Note for Work | X | X | X |
| **Visit Note Templates** | | | |
| Annual Wellness Visit | X | X | X |
| Hypertension Follow Up | X | X | X |
| Telehealth Attestation | X | X | X |
| USCIS Attestation | | | X |
| USCIS Exams | | | X |
| USCIS Vaccines | | | X |
### A multi-speciality clinic with divided responsibilities
This use case is ideal for practices that have various employees with distinct responsibilities. Spectrum Health is a 8 provider clinic that offers Primary Care, Acupuncture and Weight Loss services. Different providers and staff are responsible for different services while patients have access to all services during each visit.
Based on the above scenario, Spectrum Health will set up 3 [User Groups](/articles/user-groups) with the following members:
| Role | User Group #1- Primary Care | User Group #2- Acupuncture | User Group #3- Weight Loss |
| --------------------------- | --------------------------- | -------------------------- | -------------------------- |
| Primary Care Clinicians (4) | X | | |
| Acupuncturist (2) | | X | |
| Weight Loss Coaches (2) | | | X |
| Front Desk (2) | X | X | X |
| Medical Assistants (3) | X | | |
| Therapy Assistants (2) | | X | X |
Based on the above scenario, Spectrum Health will set up 3 Workspaces with the following resources. This will allow each Group to see only the resources that are relevant to their responsibilities.
| **Resources** | **Workspace #1- Primary Care** | **Workspace #2- Acupuncture** | **Workspace #3- Weight Loss** |
| ---------------------------------------- | ------------------------------ | ----------------------------- | ----------------------------- |
| **Time Zone** | | | |
| | (PDT -07:00) US - Pacific | (PDT -07:00) US - Pacific | (PDT -07:00) US - Pacific |
| **User Access** | | | |
| Acupuncture (User Group) | | X | |
| Primary Care (User Group) | X | | |
| Weight Loss (User Group) | | | X |
| **Provider Lists** | | | |
| Acupuncture (User Group) | | X | |
| Primary Care (User Group) | X | | |
| Weight Loss (User Group) | | | X |
| **Practice Locations** | | | |
| Spectrum Health | X | X | X |
| **Print Headers** | | | |
| Spectrum Health | X | X | X |
| **Lab Accounts** | | | |
| LabCorp | X | X | X |
| **Physical Exam Templates** | | | |
| General Annual | X | X | X |
| Medicare Annual Wellness Exam | X | X | X |
| Welcome to Medicare | X | X | X |
| Well Womens | X | X | X |
| **Review of Systems Templates** | | | |
| General Female | X | X | X |
| General Male | X | X | X |
| **Letter & Referral Templates** | | | |
| Acupuncture Follow Up Guidelines | | X | |
| Request for Medical Records | X | | |
| Sick Note for Work | X | | |
| Weight Loss Counseling Referral | X | | |
| Weight Loss Program - First 3 months | | | X |
| Weight Loss Program - First 6-12 months | | | X |
| Weight Loss Program - First 12-16 months | | | X |
| **Visit Note Templates** | | | |
| Acupuncture Attestation | | X | |
| Annual Wellness Visit | X | | |
| COVID-19 Follow Up | X | | |
| COVID-19 Screening | X | | |
| Hypertension Follow Up | X | | |
| Nutrition Review | | | X |
| Telehealth Attestation | X | | |
| Weight Loss- Initial Evaluation | | | X |
| Weight Loss- Follow Up | | | X |
| Weight Loss- Meal Plan (F) | | | X |
| Weight Loss- Meal Plan (M) | | | X |
## Related Articles
* [Workspaces Introduction](/articles/workspaces-guide)
* [User Groups Guide- Simplifying office messages & expanded calendar view](/articles/user-groups)
# Wyoming - WyIR - Immunization Registry Interface User Guide
Source: https://help.elationhealth.com/articles/Wyoming-WyIR-Immunization-Registry-Interface-User-Guide
This article describes how you can submit vaccination data to the Wyoming Immunization Registry [WyIR] directly within Elation as well as query for vaccination history and/or forecast.
To support the importance of promoting and prioritizing interoperability and exchange of patient immunization data across various healthcare platforms, Elation has established an electronic interface with the Wyoming State Immunization Registry known as WyIR.
## What is the WyIR Immunization Registry Interface?
The WyIR Immunization Registry Interface allows connected practices to send vaccination information from their Elation EHR directly to WyIR, the Wyoming Immunization Registry. Practices can also query WyIR for vaccination history or forecast.
## Why is the WyIR Immunization Registry Interface valuable?
With the WyIR Immunization Registry Interface, practices no longer need to separately log in to WyIR to enter vaccination records for their patients. Once the vaccination is recorded in Elation during the patient encounter, the information can be sent immediately from the patient's chart in Elation to WyIR. You can also pull vaccination history for specific patients WyIR NJIIS to allow you to populate your patient's clinical profile and make informed decisions for administering vaccines. This interface saves you time and allows you to streamline your vaccination workflows.
## How to establish interface between Elation & WyIR
The Elation Team will assist you with initiating an interface with WyIR. To notify us of your interest,
1. [Click here to fill out our contact form](https://app.elationemr.com/support/)
2. Select **I am a provider or staff member who uses Elation** for **What is your role?**
3. Select **Something else** for **Select an issue**
4. Enter the following information in the **Details** field:
* Which Immunization Registry do you want to connect to?
* Is your organization currently enrolled in WyIR?
* If yes, what is your IIS identifier?
* Are you currently reporting data to WyIR?
* Do you have an existing interface through another EHR?
* Who will be the WyIR point of contact?
* Are immunizations administered on site?
* If yes, how many sites/locations are you administering vaccines at?
* If yes, what types of vaccines are administered?
* If yes, what volume of vaccines are administered per week (excluding COVID and flu vaccines)?
* If yes, who is the vaccine inventory point of contact?
* If yes, are you currently managing inventory management in WyIR?
* What age range of patients are seen at your practice?
* Is your practice currently enrolled in a Public Vaccine Program (PVP)?
* If yes, which of these?: Wyoming Vaccinates Important People (WyVIP) Program, Vaccines For Children (VFC) Program, Adult Hepatitis Vaccine (AVH) Program
* If yes to VFC program, what is your VFC PIN number?
* Are you using any other EHRs to record, store, or send immunization information to WyIR?
* Are you looking to submit vaccinations and query records from WyIR or just query records from WyIR?
5. Click **Next**.
6. Click **No, I still need help** in the next window.
7. Click **Next**.
8. Confirm your contact information and then click **Submit** to submit your request to Elation.
## How to submit vaccination data to WyIR using Elation
You will use the Vaccine Form in the patient's chart to document the vaccination data and submit it the data to WyIR. Learn more about how to use the Vaccine Form using the
[Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
.
All submissions are one-time only. If you need to edit any vaccination data after it is sent to the Immunization Registry, you will need to update the data in both the patient's chart and the Immunization Registry directly.
## How to query for vaccination history/forecast using WyIR
You can query for vaccination history/forecast directly within a patient's chart by following the instructions listed in the
['Querying for vaccination history and/or forecast using an Immunization Registry Interface' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_IR)
.
## Frequently Asked Questions (FAQ)
### How can I tell if the vaccination record was successfully submitted to the immunization registry?
You can log into your State’s registry to review vaccination records submitted from Elation to the registry through the interface from time to time. If you have questions about a specific vaccination record,
[please send the patient ID and the name of the immunization to the Support Team](https://help.elationemr.com/s/contactsupport)
and we can look into the vaccination record.
### How can I edit or delete a vaccination record from the registry using Elation?
At this time, vaccination records submitted through Elation can only be edited or deleted within the registry. If you do make a change to or delete the vaccination record in the registry, we also recommend making the same change in Elation.
### I am running into errors when using the "Check Registry" or the "Check Forecast" buttons. What should I do?
Follow the instructions in the['Managing querying errors' section of the Vaccination Documentation Guide](/articles/Vaccination-Form-Guide#query_errors).
## Related Articles
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
# Letter & Referral Guide - Accessing patient information sent by an Elation EHR user
Source: https://help.elationhealth.com/articles/access-patient-information-securely-shared-by-an-Elation-EHR-user
This article describes how recipients of a secure online fax or email (from Elation) can access the interactive chart using the information provided in the fax or email.
## Overview
### What is Elation Connect?
Elation Connect is a secure portal that lets you view messages and health records shared by Providers using Elation Health's EHR. You can also download these records if you need to transfer them to another system, like your own EHR.
### Why were you asked to log in to Elation Connect?
You have been invited to log in to Elation Connect because:
* The Elation Provider wants to share Protected Health Information (PHI) with you securely. Since email is not HIPAA compliant, you’ll need to log in to view the information.
* The Elation Provider wants you to benefit from the features of an Elation Connect account, as outlined below.
### What are the benefits of setting up your Elation Connect account?
With an Elation Connect account, you can:
* View all correspondences from Elation Providers in one place.
* Download correspondences to transfer to your own EHR.
* Communicate back to Elation Providers directly through the portal - they’ll receive it in their EHR.
* Access correspondences anytime, even on the go.
## Workflow Instructions
### Setting up your Elation Connect account for the first time
#### You received an email
If you received an email with the subject line **Shared clinical information about our mutual patient…**, an Elation Provider is trying to share PHI with you. This is what the email may look like:
![Email from Repro2 Doctor2 with subject "Shared clinical information about our mutual patient, B.S." showing the "View Shared Clinical Information" button to click to access shared PHI.]()
To register for your Elation Connect account to access the PHI:
| **1** | Open the email and click **View Shared Clinical Information** . |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Create a password. |
| **3** | Call the sending Provider’s office to have them provide you with the 6 digit **Provider Security Code** as needed. The number to their practice is provided at the bottom of the box if needed. Then enter the 6 digit **Provider Security Code** . |
| **4** | Click **I agree, Create My Account** to create your account. |
| **5** | You can now log in to your Elation Connect account using your email and chosen password via [app.elationemr.com](http://app.elationemr.com) . |
#### You received a fax
If you received a fax that looks like one of the following images, an Elation Provider is trying to share PHI with you.
![Two-page clinical fax showing a cover sheet with Reference Code 89M-NJK-8XJ highlighted in a box, and a letter page addressed to Sunny Shine, MD at Cardiology, re: patient Kyley E. Smith.]()
To register for your Elation Connect account to access the PHI:
| **1** | Go to [app.elationemr.com/efax](http://app.elationemr.com/efax) . |
| ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Enter the **Reference Code** listed on the fax. The **Reference Code** is listed on the fax in the areas circled above. |
| **3** | Fill out the following: **My role in the practice is** - Select the option that best matches your role in your practice. • **My name is** - Select your name from the list or select **Other** if your name is not on the list. • **Create a password**- Enter a password of your choice. • **Enter password again** - Enter the password again. • **Choose a security question** - Select the security question you would like us to use when you need assistance retrieving your account. • **Answer to security question** - Enter the answer to your chosen security question. This will be used to retrieve your account. |
| **4** | Click **Agree and Go to Chart** . |
| **5** | Click **Go to my charts** in the welcome window. |
| **6** | Link your email to your Elation Connect account for easy access in the future by following these steps: Click on the email at the top right of the account. It likely ends in [elationemr.com](http://elationemr.com). • Click **Settings**. • Click **Edit profile**. • Update the **Email** address to one of your choice. • Fill in other required fields as needed such as **Credentials**, **NPI**, **State**, and **Medical License** #. • Click **Update**. • Check off the **I acknowledge that this is the same individual, and I am only updating their identifying information** box. • Click **Confirm and Update**. • You can now log in to your Elation Connect account using the email address and password you chose via [app.elationemr.com](http://app.elationemr.com). |
### Logging in to your Elation Connect account
#### You received an email
To log in to your Elation Connect account, use one of the methods below:
| **1** | Go to [app.elationemr.com](http://app.elationemr.com) and login with your Connect credentials. |
| ----- | --------------------------------------------------------------------------------------------------- |
| **2** | Open the email notification you received and click the **View Shared Clinical Information** button. |
#### You received a fax
To log in to your Elation Connect account, use one of the methods below:
| **1** | Use the **Reference Code** you received from the latest fax. Go to app.elationemr.com/efax and enter the **Reference Code** on the fax • Select your name from the list if you already have an account • Enter your password and click **Go to Chart** to access all old and new records. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Locate your account via [https://app.elationemr.com/efax/locate-account/](https://app.elationemr.com/efax/locate-account/). Go to [https://app.elationemr.com/efax/locate-account/](https://app.elationemr.com/efax/locate-account/). • Enter your last name and office fax number to locate your account. • Enter the password for your account. • Click **Go to Chart** to access all old and new records. |
#### Resetting your password
##### Resetting your password for an email account
| **1** | Go to [app.elationemr.com](http://app.elationemr.com) . |
| ------ | --------------------------------------------------------------------------------- |
| **2** | Enter in the email address for your account. |
| **3** | Click **Forgot password** . |
| **4** | Enter in the email address for your account. |
| **5** | Click **Submit Request** . |
| **6** | Look for an email from Elation with the Subject line **Elation Password Reset** . |
| **7** | Click on the link in the email to open the password reset page. |
| **8** | Enter a new password twice. |
| **9** | Click **Update Password** . |
| **10** | Click **Back to Login Page** . |
| **11** | Login with your email and new password. |
##### Resetting your password for a fax account
| **1** | Go to [app.elationemr.com/efax](http://app.elationemr.com/efax) and enter the **Reference Code** on the fax. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Select your name from the list if you already have an account. If you do not see your name in the list it means you do not have an account associated with this correspondence. Click **My name is not listed here** to enter your name and view only the contents of this particular fax. |
| **3** | Click **I forgot my password** . |
| **4** | Enter the answer to the security question you chose during registration. If you forgot your security question answer, click **I don't know the answer**. • Click **View Documents** to only view the most recent record sent to you. |
| **5** | Click **Submit** . |
| **6** | Enter a new password twice. |
| **7** | Click **Set new password and go to chart** . |
### Navigating Elation Connect
#### Viewing sent records
When you sign in, you’ll land on your Practice Home page. Check the **Provider Letter** inbox for new messages or replies from Elation Providers.
![Provider Letters inbox selected in the left queue, showing 1 new referral from Michaela Quinn, MD for patient Soloman Bergamel with Reply, Write Message, and Sign Off buttons highlighted.]()
Actions you can take:
* Click on the patient’s name to view the correspondence in the patient’s chart.
* **Reply**: Write a message back to the sender.
* **Sign Off**: Sign off on the correspondence and keep it in the patient’s chart.
* If the correspondence includes attachments, select which attachments (if any) to file as a Report in your version of the patient’s chart when prompted.
* Click **Actions** -> **Print** to print or save any records as a PDF as needed.
* (Conditional) **Acknowledge**:
* Appears once anyone starts a conversation.
* Dismiss the correspondence from your Practice Home inbox and keep it in the patient’s chart for records.
The patient’s chart contains the correspondence and its attachments. If the patient’s Clinical Profile was shared with you, you will see information pre-populated in the Clinical Profile (left hand side) of the patient’s chart.
From the chart,
* Click **Actions** -> **Print** to print or save any records as a PDF as needed.
* [Upload documents to the patient’s chart](/articles/filing-documents-to-a-patient-chart)and then attach them to a Provider Letter to share with the Elation Provider as needed. To send a letter:
1. Click **Letter** -> **to Provider**.
2. Enter the name of the Elation Provider in the **To** field.
3. Fill out the **Subject** and **Body** fields.
4. Add attachments as needed.
5. Options for attaching records:
6. **Select Chart Items to Attach**: Use this option to pick and choose individual patient records to attach to the letter or referral.
7. **Attach Everything in Chart**: Use this option to attach all attachable records.
8. Click **Sign & Send** to send the correspondence.
## Frequently Asked Questions
##### Am I able to access my Elation Connect account at any time?
Yes, you can access your Elation Connect account at any time via [app.elationemr.com](http://app.elationemr.com) using your login email and password.
However, if you are accessing records using only a Reference Code (without creating a full account), those records expire after 7 days of being sent. If you need to reference records for longer than 7 days, download the records to your computer before they expire.
##### I don’t want to create an account, can they just email or fax all the records to me?
Email is not a HIPAA compliant means of sharing Protected Health Information therefore it is not supported. Fax may not be possible if the correspondence is larger than a certain size, therefore you are receiving the information through Connect.
##### I am receiving an error when I click on the 'View Shared Clinical Information' button from my email. Why is this happening?
If you click on the **View Shared Clinical Information** button from your email and run into an error, it can be one of two reasons:
1. The invitation expired - Contact the sender and ask them to resend the information.
2. Your email is already associated with an Elation account (this can include Elation Patient Passport). - Contact the sender, provide them with a different email and ask them to resend the information.
##### I received a referral link but cannot access the chart. What should I do?
If you received a fax or email with a link to view patient information but are unable to access the chart, try the following steps:
**Check if the link has expired**
Records accessed via a Reference Code expire after 7 days of being sent. If more than 7 days have passed since the referral was sent, the link will no longer work.
**Verify you are using the correct access method**
* If you received a fax: Go to [app.elationemr.com/efax](http://app.elationemr.com/efax) and enter the Reference Code listed on the fax.
* If you received an email: Open the email and click **View Shared Clinical Information**.
**If you already have an Elation Connect account**
* Go to [app.elationemr.com](http://app.elationemr.com) and log in with your Connect credentials.
* If you forgot your password, use the password reset option or go to [app.elationemr.com/efax/locate-account/](https://app.elationemr.com/efax/locate-account/) to locate your account using your last name and office fax number.
**If your name is not listed when entering the Reference Code**
If you do not see your name in the list, it means you do not have an account associated with this correspondence. Click **My name is not listed here** to enter your name and view only the contents of this particular fax.
**If the link has expired or you still cannot access the records**
Contact the sending practice directly and ask them to resend the referral. The practice's contact information is typically included on the fax cover page or in the email notification you received.
##### I received an error that my email is already associated with an Elation account. What should I do?
If you see this error when trying to register for Elation Connect, your email address may already be linked to another Elation account (such as an Elation Patient Passport account or another provider account).
To resolve this:
| **1** | Contact the sending practice directly. |
| ----- | ---------------------------------------------------------- |
| **2** | Provide them with a different email address. |
| **3** | Ask them to resend the referral to your new email address. |
# Activate Online Payments
Source: https://help.elationhealth.com/articles/activate-online-payments
Learn how to activate online payments using Stripe in Elation Billing
This article provides step-by-step instructions on how to activate online payments in Elation Billing using Stripe integration.
## Overview
### What is Activate Online Payments?
Activating online payments enables your practice to accept credit card payments from patients through Stripe integration. This allows for convenient payment collection via the Collect Now button and through the online patient payment portal at ElationPay.com.
### Why is Activating Online Payments important?
Online payments streamline the collection process, reduce manual payment handling, and provide patients with convenient payment options. Payments can be collected in person, via email statements, or through the online portal.
## Workflow Instructions
### Elation EHR + Billing Practices
If your practice is an Elation EHR + Billing user, you will activate Stripe through the EHR instead. This process takes about 10 minutes and you can skip Step 2 below. See [EHR Stripe Instructions](/articles/using-elation-to-securely-collect-patient-payments) for details.
***
### Elation Billing Legacy Practices
#### Before You Start
Visit [Stripe.com](https://dashboard.stripe.com/register) and create and activate an account for your practice. We partner with Stripe to simplify payment processing.
1. **Navigate** - Click on the **Practice Settings** option under the **Settings** drop-down menu.
![Settings menu expanded showing "Practice Settings" highlighted with a red box, above "Account Users" and "Billing" options.]()
Click on the **ACTIVATE** button for online payments.
![Online Payments settings card showing "NOT ACTIVE" status banner in red and an ACTIVATE button to begin Stripe integration.]()
2. **Get Your API Keys** - Log into Stripe.com and click on **Developers** in the upper right, then on **API Keys**.
![Stripe dashboard top navigation with the Developers button highlighted, indicating where to click to access API keys]()
You will find 2 keys: a **publishable** and **secret** LIVE key. You will need both to activate the integration.
![Stripe Developer menu with "API Keys" option highlighted by a red arrow, under the Developers section sidebar.]()
3. **Enter Your API Keys** - Enter your API Keys into the billing software and click **ACTIVATE NOW**. The billing software will verify the keys and activate online payment processing for your account.
![Activate Online Payments dialog with empty Publishable Stripe Key and Secret Stripe Key fields, and an "Activate Now" button to submit.]()
4. **Use Online Payments** - Once activated:
* When you click the **COLLECT NOW** button on a patient profile, you will have the choice of charging a credit card
![Patient balance of $240.24 with the green "Collect Now" button and blue "Statements" button visible on the patient profile.]()
!["Choose a Payment Type" dialog with "Already Paid" and "Charge Credit Card" buttons, appearing after clicking Collect Now on a patient profile.]()
* Patient statements will reference the online payment portal at **ELATIONPAY.COM**
* You can view payments processed in the billing software when you log into your Stripe account
At this time, patient refunds are processed directly in Stripe. See [Stripe refund instructions](https://support.stripe.com/questions/refund-a-customer) for details.
## Frequently Asked Questions
### Does Elation support other payment processors?
At this time, Stripe is the only payment processor directly integrated with Elation. Other processors, such as Clover, are not supported as a direct integration. If you choose to use a different processor, payments would need to be collected and processed outside of Elation and then recorded manually in the EHR.
## Related Articles
* [Sending Statements](/articles/sending-statements)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
* [Using Elation to Securely Collect Patient Payments](/articles/using-elation-to-securely-collect-patient-payments)
# Activating Legacy Payment Workflow
Source: https://help.elationhealth.com/articles/activating-legacy-payment-workflow
Learn how to enable the legacy payment workflow for manual patient payment editing in Elation Billing
This article explains how to activate the Legacy Payment Workflow in Elation Billing for Elation EHR + Billing users.
## Overview
### What is the Legacy Payment Workflow?
The Legacy Payment Workflow is a setting that allows Elation EHR + Billing users to manually add and edit Patient Payments directly in Elation Billing. By default, this functionality is restricted when the Patient Payment Workflow Update is active.
### Why would I use the Legacy Payment Workflow?
For Elation EHR + Billing users with integrated patient payments, taking and editing Patient Payments in Elation Billing is restricted by default (you can only edit the Check Number and Posting Date). This is because payments collected or edited in Elation Billing will **not** update in the EHR. However, sometimes you may need to make manual edits—the Legacy Payment Workflow allows for this.
## Workflow Instructions
### Activating Legacy Payment Workflow
1. **Navigate to Practice Settings** - In Elation Billing, navigate to **Settings** → **Practice Settings**.
2. **Open Billing Rules** - Select the **Billing Rules** tab.
3. **Enable Legacy Payment Workflow** - Enable the **Legacy Payment Workflow** option.
***
### Posting a Patient Payment in Elation Billing
This payment will NOT appear in the EHR.
1. **Create New Payment** - In Elation Billing, select **Payments** → **+New Insurance Payment** (you'll swap to Patient in the next step).
2. **Change Payment Type** - In the New Payment pop-up, update the Payment Type from **Insurance** to **Patient**.
3. **Select the Patient** - Choose the patient for this payment.
4. **Enter Payment Information** - Supply the payment details.
5. **Save the Payment** - Click **Save** to complete.
***
### Editing a Patient Payment in Elation Billing
This edit will NOT appear in the EHR.
1. **Navigate to the Payment** - Find and open the payment you need to edit.
2. **Select Edit** - Click the **EDIT** button.
3. **Make Changes** - Update the necessary fields.
4. **Save** - Click **Save** to apply your changes.
## Related Articles
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
* [Using Elation to Securely Collect Patient Payments](/articles/using-elation-to-securely-collect-patient-payments)
# Add a New Patient
Source: https://help.elationhealth.com/articles/add-a-new-patient
Learn how to add new patients in Elation Billing
This article provides step-by-step instructions on how to add a new patient in Elation Billing, including integrated AiO patient creation and manual patient entry.
## Overview
### What is Adding a New Patient?
Adding a new patient is the process of creating a patient record in Elation Billing with demographic and insurance information. This enables you to create claims and manage billing for the patient.
### Why is Adding a New Patient important?
Accurate patient records are essential for proper claim filing, insurance verification, and maintaining billing records. Patient demographic information is required to submit claims to insurance payers.
## Workflow Instructions
### Integrated/AiO Patient Creation
Generally speaking, AiO Patients will be created in the EHR, which will then create a linked Patient file within the billing software. All changes to Patient Demographics will be made in the EHR, which will then update the demographics within the billing software.
### Adding a New Patient Manually
You can also add a new patient directly from the superbill screen when creating a new claim. The process is almost identical and you never have to leave the claim screen.
> 1. **Navigate** - Click on the **New Patient** option under the **Patients** drop-down menu.
>
> ![Patients menu expanded with "New Patient" option highlighted in a red box, indicating where to click to begin adding a patient.]()
>
> 2. **Enter the Patient Demographics** - Fill in the demographic fields and click **SAVE**. You will need to have some kind of address in the system to file a claim.
You can enter just the street address and zip code, then click **Validate Address** to auto-fill the rest.
![Patient Details form filled with name Oscar T Grouch, DOB 10/10/1969, Male, address validated at 13 W 64TH ST, New York, NY 10023. Arrows highlight the financial responsibility checkbox, Verify Address button, and Save New Patient button.]()
3. **Enter Insurance Info** - If there is no insurance, just click **SELF PAY**. Otherwise, you must choose insurance, Primary or Secondary, enter the member id, and then click **SAVE**.
![Insurance dialog showing the "+ Choose Insurance" button, Priority set to "PRIMARY", and required Member ID field empty. The "SELF PAY" button is highlighted for patients with no insurance.]()
4. **Add Additional Insurance Policies** - If the patient has additional insurance policies, you can add them after saving the initial patient record.
## Related Articles
* [Add or Edit Patient Insurance](/articles/add-or-edit-patient-insurance)
* [Filing a Claim](/articles/filing-a-claim)
* [Running Eligibility](/articles/running-eligibility)
# Add an Alert
Source: https://help.elationhealth.com/articles/add-an-alert
Learn how to add patient and claim alerts in Elation Billing
This article provides step-by-step instructions on how to add patient alerts and claim alerts in Elation Billing.
## Overview
### What is an Alert?
Alerts are visual notifications that display important information about a patient or claim. Patient Alerts appear across the patient's pages and superbills, while Claim Alerts appear only on the specific superbill.
### Why are Alerts important?
Alerts help ensure critical billing information is visible to all staff working with a patient or claim. They can highlight special billing requirements, payment arrangements, or other important notes.
## Workflow Instructions
### Adding a Patient Alert
1. **Navigate** - Click on the **Alerts** box at the bottom of a patient profile page.
**Patient Alerts will appear in Elation Billing:**
* On the patient's Elation Billing page
* On any of the patient's Superbills
* On any Payments that have the patient's Superbills added
**For Elation EHR + Billing users, alerts will also appear in the EHR:**
* When scheduling Patient Appointments
![Visit Note Billing Information section showing Additional Billing Notes field with arrow pointing to synced patient alert text from Elation Billing dated 11/26/2024.]()
* In a Visit Note's Billing Information → Additional Billing Notes
![Visit Note Billing Information section showing an orange arrow pointing to Additional Billing Notes displaying synced patient alerts from Elation Billing dated 11/26/2024.]()
![Visit Note dated 11/26/2024 showing Additional Billing Notes field with arrow highlighting synced Patient Alert message from Elation Billing appearing in the EHR.]()
* In the Billing Home → Billing Notes
![Billing Home showing the Billing Notes column with an arrow pointing to the synced alert message: "Patient Alerts created in Elation Billing will appear here!"]()
***
### Adding a Claim Alert
Claim Alerts will appear:
* On the Superbill
* On any Payments that have the Superbill added
1. **Navigate** - Click on the **Alerts** button on the top right of the Superbill.
![Status Tags section of a Superbill with an arrow pointing to the Alerts button in the top right corner, next to the Tags button.]()
***
### Creating the Alert
2. **Enter Alert** - Enter the text for the alert, choose a color, and click **SAVE**.
![Patient Alerts dialog showing alert text "This is my new ALERT" entered, with COLOR PICK dropdown expanded revealing Green, Yellow, Red, and Blue alert color options.]()
***
### Viewing Alerts
#### In Elation Billing
* Patient Alerts display on the patient page, claims, and payments posted
* Claim Alerts display on Superbills
#### In the EHR (Elation EHR + Billing only)
Patient Alerts will also appear in the EHR, while Claim Alerts remain only in Elation Billing. You can review Patient Alerts in the EHR:
* When scheduling Patient Appointments
![Visit Note Billing Information section showing Additional Billing Notes field with an arrow pointing to synced patient alert text from Elation Billing dated 11/26/2024.]()
* In a Visit Note's Billing Information → Additional Billing Notes
![Visit Note Billing Information section showing Additional Billing Notes field with an arrow pointing to synced patient alert text from Elation Billing dated 11/26/2024.]()
![Visit Note billing section showing Add'l Billing Notes field with arrow pointing to message: "Alerts synced from Elation Billing (11/26/2024 10:32 am PST) - Patient Alerts created in Elation Billing will appear here!"]()
* In the Billing Home → Billing Notes
![Billing Home showing the Billing Notes column with an arrow pointing to the message: "Alerts synced from Elation Billing — Patient Alerts created in Elation Billing will appear here!"]()
## Related Articles
* [Add Notes to Patient, Claim, or Statements](/articles/add-notes-to-patient-claim-or-statements)
* [Add a New Patient](/articles/add-a-new-patient)
# Add New Provider
Source: https://help.elationhealth.com/articles/add-new-provider
Learn how to add a new provider in Elation Billing
This article provides step-by-step instructions on how to add a new provider in Elation Billing.
## Overview
### What is Adding a New Provider?
Adding a new provider registers a healthcare provider in Elation Billing so they can be selected as the rendering provider on claims. Providers are added using their individual NPI (National Provider Identifier).
### Why is Adding a New Provider important?
Claims require a rendering provider to be specified. Adding providers to your practice settings ensures they appear in drop-down options when creating or editing claims on superbills.
## Workflow Instructions
### Adding a New Provider
1. **Navigate** - Select the **Practice Settings** option from the **Settings** drop-down menu, then select the **Providers** tab.
![Settings menu open with Practice Settings highlighted, as the first step to navigate to the Providers tab]()
![Providers tab selected in Practice Settings navigation, highlighted with a red border to indicate the active tab]()
2. **Add Provider** - Click on the **+Add Provider** button, then enter the provider's NPI (usually this is the individual NPI) and click **Add Provider** to confirm.
![Providers list with the +Add Provider button highlighted, showing two active providers with Edit and Deactivate action buttons.]()
!["Add Provider" dialog with empty Provider NPI field highlighted and arrow pointing to the green "Add Provider" button to confirm.]()
3. **Verify Completion** - You should now see your provider on the list as well as in the drop-down options when creating or editing claims on a superbill.
## Related Articles
* [Add or Edit a Service Location](/articles/add-or-edit-a-service-location)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
* [Filing a Claim](/articles/filing-a-claim)
# Add New User - Legacy Practices
Source: https://help.elationhealth.com/articles/add-new-user-legacy-practices
Learn how to add new users in Elation Billing for legacy practices
This article provides step-by-step instructions on how to add new Practice Users and Billing Company Users in Elation Billing.
## Overview
### What is Adding a New User?
Adding a new user creates login credentials for staff members to access Elation Billing. There are two types of users: Practice Users (access to one practice) and Billing Company Users (access to multiple practices).
### Why is Adding a New User important?
Proper user management ensures staff have appropriate access to billing functions while maintaining security. Different user roles provide different levels of access and permissions.
## Workflow Instructions
### Adding Practice Users
Practice Users only have access to one practice.
> 1. **Navigate** - Click on the **Practice Settings** option under the **Settings** drop-down menu.
>
> ![Settings menu expanded showing "Practice Settings" highlighted with a red box, under the Settings and Support navigation options.]()
>
> Click on the **Users** Tab.
>
> ![Users tab selected in Practice Settings navigation, showing Fee Schedule, Billing Rules, Users, and Tags tabs]()
>
> 2. **Add User** - Click on the **Add User** button, then enter the email and select the role. The user will receive an email to activate their account and create their password.
>
> ![Practice Users page with the Add User button highlighted, showing an empty user table with columns for Email, First, Last, Mobile, Role, Active, and Actions.]()
>
> ![Add User dialog with empty User Email field and User Role set to "Staff," showing where to enter details before sending the activation email.]()
>
> ***
>
> ## Adding Billing Company Users
Bill Co Users can have access to multiple practices.
1. **Navigate** - Start in a Practice you want the invitee to be able to access. By default, an added user will be provisioned access to the Practice from which the invite is sent. This access can be edited in Account Users.
Click on the **Practice Settings** option under the **Settings** drop-down menu.
![Settings menu open showing Practice Settings, Account Users (highlighted with red border), and Billing options under the Settings tab.]()
2. **Add User** - Click on the **Add User** button, then enter the email and select the role. The user will receive an email to activate their account and create their password.
![User list showing the highlighted "+ Add User" button, with two users listed: Brian Esser (Billco Staff, Active) and Heather Sams (Billco Admin, Active).]()
![Add User dialog with empty User Email field and User Role set to "BillCo Staff," used when inviting a new Billing Company User.]()
3. **Edit User Practice Permissions** - Click on the **Practices** button to add or remove access to practice(s) for a user. The changes will take effect after they log off and log in again.
![User list row for Brian Esser (BILLCO STAFF, ACTIVE) with the Practices button highlighted, used to manage practice access permissions.]()
## Related Articles
* [User Roles and Permissions](/articles/user-roles)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
# Add Notes to Patient, Claim, or Statements
Source: https://help.elationhealth.com/articles/add-notes-to-patient-claim-or-statements
Learn how to add patient notes, claim notes, and statement notes in Elation Billing
This article provides step-by-step instructions on how to add patient notes, claim notes, and statement notes in Elation Billing.
## Overview
### What are Notes?
Notes are text records attached to patients, claims, or statements. They help track important billing information and can optionally appear on patient statements.
### Why are Notes important?
Notes help billing staff communicate important information about patients and claims. Statement notes allow you to include custom messages on patient billing statements.
## Workflow Instructions
### Patient-Specific Notes
#### Adding a Patient Note
1. **Navigate** - Click on the **Notes** box at the bottom of a patient profile page.
![Patient profile navigation tabs with Notes highlighted in a red box, indicating where to click to add a patient note.]()
#### Adding a Claim Note
1. **Navigate** - Click on the **Notes** button on either the top left of the Superbill near the patient name, or in the middle of the Superbill page. You will only see the notes button after a claim is created. You can also access notes by clicking the comment bubble in the claims manager.
![Claim Notes button highlighted in the Superbill toolbar, showing 1 note exists, with matching Notes icon highlighted in the top-left toolbar.]()
***
### Entering a Note
2. **Enter Note** - Enter the text for the note and click **SAVE**.
![Patient Account Notes dialog showing an empty text field (2000 char max), a Save button, and a star icon used to toggle Statement Notes.]()
![Claim Notes dialog showing an empty text entry field (2000 char max), a Save button, and an existing note by Heather S. reading "code is 99214" dated 08-12-2020.]()
***
### Sending a Statement Note
Click on the ☆ when entering a note, or later after you've saved it, to toggle it as a **STATEMENT NOTE**.
* **Patient Statement Notes** will display on the top of EVERY statement for that patient
* **Claim Statement Notes** will display under the charge lines of statements and appear on ONLY statements where this balance is displayed. Once the claim is paid and not on the statement, the note will not be displayed either.
![Read Notes section showing a saved note dated 08-19-2020 by Heather S. marked as a Statement Note (star icon highlighted) with text "A Statement Note"]()
***
### Global Statement Notes (Every Patient's Statement)
To create a **Global Note** that appears on every statement:
1. **Navigate** - Go to **Billing** → **Send Statements**.
2. **Open Notes** - In the upper-right, select the green Note icon.
![Send Statements page with a red arrow pointing to the green Note icon in the upper-right corner, used to open Global Statement Notes.]()
3. **Write and Save** - Write and Save the note.
***
### How Notes Appear on the Statement
#### Patient Statement Notes
![Sample patient statement showing "Global Notes will appear here" and "Selected Patient Notes will appear Here" sections highlighted with an orange arrow, above the payment coupon.]()
#### Claim Statement Notes
![Sample patient statement showing two 2023-05-26 claim lines highlighted in orange, each displaying a claim note warning about no active insurance policy on file.]()
## Related Articles
* [Sending Statements](/articles/sending-statements)
* [Add an Alert](/articles/add-an-alert)
* [Add a New Patient](/articles/add-a-new-patient)
# Add or Edit a Service Location
Source: https://help.elationhealth.com/articles/add-or-edit-a-service-location
Learn how to add and edit service locations in Elation Billing
This article provides step-by-step instructions on how to add and edit service locations in Elation Billing.
## Overview
### What is a Service Location?
A service location is a physical address where healthcare services are provided. Service locations are used on claims to indicate where the patient was seen.
### Why is Adding or Editing a Service Location important?
Accurate service location information is required for proper claim submission. Claims must include the correct Place of Service (POS) code and address to avoid denials.
## Workflow Instructions
### Elation All-in-One Integration
If you are an Elation AiO (All-in-One) customer, updating your Service Locations in Elation Billing will also update your locations in the EHR.
***
### Adding a Service Location
1. **Navigate** - Select the **Practice Settings** option from the **Settings** drop-down menu, then select the **Locations** tab.
![Settings menu expanded showing "Practice Settings" highlighted with a red box, under the Settings and Support navigation tabs.]()
![Navigation tabs in Practice Settings with "Service Locations" tab highlighted in red, indicating where to click in step 1.]()
2. **Add Location** - Click the **Add Location** button.
![Locations list showing two existing locations, with the Add Location button highlighted and indicated by an arrow as the next step.]()
Complete all the location fields and click **SAVE**.
If you have the NPI, enter it first to auto-populate the location details.
Click the **VALIDATE** button to confirm the address with USPS.
![Add/Edit Service Location dialog showing Step 1 (Location NPI with Auto Populate button) and Step 2 (Location Name, Address fields, and required Location Type Code dropdown).]()
3. **Verify Completion** - Verify that you can see your location on the list as well as in the drop-down options when creating or editing claims on a superbill.
## Related Articles
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
* [Add New Provider](/articles/add-new-provider)
* [Filing a Claim](/articles/filing-a-claim)
# Add or Edit Authorizations/Referrals
Source: https://help.elationhealth.com/articles/add-or-edit-authorizations-referrals
Learn how to add, edit, and attach authorizations and referrals in Elation Billing
This article provides step-by-step instructions on how to add, edit, and attach authorizations and referrals to claims in Elation Billing.
## Overview
### What are Authorizations and Referrals?
Authorizations and referrals are approval numbers from insurance payers that are sometimes required before certain services can be billed. For the purpose of this article, we refer to both collectively as an **Authorization.**
### Why are Authorizations important?
Many insurance payers require prior authorization for certain procedures or referrals from primary care providers. Including the authorization number on claims helps ensure proper reimbursement and avoids denials.
When adding a CLIA, this is instead added within Practice Settings under the Practice Info tab.
## Workflow Instructions
### Adding an Authorization
1. **Navigate** - Click the **Auth** button in the insurance box. Click **Insurance** again to toggle back.
![Insurance Coverage section showing the "0 Auths" button highlighted, used to navigate to the Authorizations view within the insurance box.]()
2. **Add Authorization** - Click the **+ New** button in the Authorizations Box. Select a payer and enter all the Authorization or Referral information, then click **SAVE**.
![Authorization entry form with Payer set to AETNA, Auth Number H55446528, 1 unit, start date 08/01/2020, expiration 08/01/2021, and note field containing procedure code 99214.]()
***
### Editing or Inactivating an Authorization
3. **Edit or Inactivate** - To edit an authorization, click the yellow pencil next to the authorization. To deactivate an authorization, click on the red X button.
***
### Attaching an Authorization to a Claim
4. **Attach to Claim** - Click the **Add Authorization** button on the Superbill and then select the authorization to attach.
!["Add Authorization" button highlighted with a red border in the Copayment Collected section of the Superbill, ready to attach an authorization to a claim.]()
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Add or Edit Patient Insurance](/articles/add-or-edit-patient-insurance)
# Add or Edit Patient Insurance
Source: https://help.elationhealth.com/articles/add-or-edit-patient-insurance
Learn how to add and edit patient insurance policies in Elation Billing
This article provides step-by-step instructions on how to add and edit patient insurance policies in Elation Billing.
## Overview
### What is Adding or Editing Patient Insurance?
Adding or editing patient insurance is the process of entering and updating insurance policy information for patients in Elation Billing. This includes selecting the insurance payer, priority level, and member ID.
### Why is Adding or Editing Patient Insurance important?
Accurate insurance information is essential for proper claim routing and timely reimbursement. Having the correct payer, member ID, and policy priority ensures claims are submitted to the right insurance company.
## Workflow Instructions
### Elation EHR + Billing Practices
For Elation EHR + Billing practices, insurance should be added in the EHR. See [Managing Insurance](/articles/Managing-Insurance#store_patient_insurance) for more information on adding insurance to patients.
### Adding or Editing Insurance in Elation Billing
1. **Navigate** - You can add and edit patient insurance policies from a patient page, a superbill, or when posting a payment. Look for the insurance box shown below.
2. **Add or Edit Insurance Policy** - Click on the **+ New** button in the insurance box or click on the yellow pencil to edit.
**Required fields:**
* **Choose Insurance** - Select the insurance payer
* **Priority** - Select Primary, Secondary, or Tertiary
* **Member ID** - Enter the patient's member ID
* Click **SAVE**
If the patient has no insurance coverage, select the **Self Pay** Insurance.
> **Optional fields** (click **See More**):
>
> * Coverage Start/End dates
> * Relationship between the Patient and the Insured
> * Medicare Type Code/Medicare Secondary Code
>
> ![Insurance dialog with "+ Choose Insurance" button, Priority set to PRIMARY, and Member ID field highlighted as required. "SEE MORE" is annotated to reveal optional Coverage Start/End, Relationship, and Medicare fields.]()
>
> 3. **Choose Insurance and Search for Payers** - When you click **Choose Insurance**, you'll see an insurance list. The default view shows your favorites.
>
> * Click **All Payers** to view all available payers
> * Click **Add Payer** to add a new payer by linking to an existing payer ID or using payer ID **PAPER** for paper claims
Adding or removing favorites is as easy as clicking the ♡.
>
Search by Payer Name, AKA, or Payer ID.
![Search For Insurance Payers dialog showing Favorites Only, All Payers, and Add Payer buttons highlighted, with action icons and the Favorite heart column called out for the first payer row.]()
![Legend showing four insurance payer action icons: green checkmark (Select Insurance), blue AKA (Add Nicknames), yellow building (Edit Payer Address), red chat (Payer Notes).]()
## Related Articles
* [Add a New Patient](/articles/add-a-new-patient)
* [Filing a Claim](/articles/filing-a-claim)
* [Running Eligibility](/articles/running-eligibility)
# Add/Update a Fee Schedule
Source: https://help.elationhealth.com/articles/add-update-a-fee-schedule
Learn how to create and manage fee schedules in Elation Billing
This article provides step-by-step instructions on how to create and update fee schedules in both the EHR and Elation Billing.
## Overview
### What is a Fee Schedule?
A fee schedule is a list of CPT codes with associated charges that automatically populate when adding procedures to a claim. Fee schedules help ensure consistent pricing and save time during claim creation.
### Why is a Fee Schedule important?
Having an accurate fee schedule ensures your practice charges consistent rates for services and reduces manual data entry errors when creating claims.
## Workflow Instructions
### Elation EHR + Billing Users
For Elation EHR + Billing practices that add CPTs onto the Visit Note in the EHR, we strongly recommend establishing your Fee Schedule in the EHR. Fees present in the EHR will override any fee schedule in Elation Billing.
If you're adding CPTs to Superbills directly in Elation Billing, they will not pull fees from your EHR schedule. The Elation Billing fee schedule will only populate a fee on a claim-line that has no charge present.
### Creating a Fee Schedule in the EHR
Practices with the **Fee Schedules** section in EHR Billing Settings should follow [Fee Schedules Guide — Setting charges in the EHR](/articles/fee-schedules-in-the-ehr) instead. Fee Schedules replaces the **Popular CPT Codes** settings steps below and adds Medicare-based rates, plus separate rates by provider, payer, and service location. For those practices, Elation reads your Elation Billing Medicare configuration and custom fees into the EHR fee schedule.
1. **Navigate to Settings** - In the EHR (not Elation Billing), navigate to **Settings**.
2. **Open Billing Settings** - Under **Practice Settings**, select **Billing**.
3. **Add CPT Code** - At the bottom of **Popular CPT Codes**, select **+Add CPT Code**.
4. **Enter Code Details** - List the Code, a description, and a Charge. To add a Charge, Invoicing must be turned on. This option is located below the Automatic Coding settings section.
***
## Creating a Fee Schedule in Elation Billing
1. **Navigate** - You can update your fee schedule from any Superbill. Alternatively, you can create a new superbill by clicking **New Superbill** under the **Billing** drop-down menu.
2. **Add Claims** - Click the **Add Claims** button.
If you're on a new Superbill, you'll need to add a patient, then select Rendering, Location, and From Date.
![New Superbill with highlighted Add Patient button, provider/location/date fields, and Add Claims button — all required before clicking Add Claims to access fee schedule settings.]()
3. **Select Schedule** - Select the appropriate Fee Schedule using the dropdown in the upper-right. ![Superbill header with the fee schedule dropdown in the upper-right highlighted, showing "STANDARD" selected.]()
4. **Add Custom Codes and Fees** - Follow these steps to customize your fee schedule:
* Click **LIVE EDIT**, then change the name of the superbill to something new instead of **default**
* Click **ADD CATEGORY**, then name your category and choose a color
* Click the **PLUS** button next to your category and start searching for and adding CPT codes
* Click on your category box to expand and see the codes, then edit the fees
* Close the superbill or click **LIVE EDIT** again to complete the process
When clicking around adding fees, you might queue up codes to bill. Click the **X** on queued codes to remove them.
![Superbill header with the LIVE EDIT button highlighted in red, indicating where to click to begin editing a fee schedule named DEFAULT.]()
#### Live Edit
In this image, DEFAULT will be the name of the created schedule.
![Superbill in Live Edit mode showing the DEFAULT schedule name highlighted, with the ADD CATEGORY button outlined in red to indicate the next step.]()
#### Categories
!["NEW PATIENTS" category row in Live Edit mode, with the category name field, COLOR dropdown, and add/delete buttons highlighted.]()
#### Add Codes
![CPT code search results for "9920" showing 6 codes (99201–99205 and G9920). Select buttons for codes 99202–99205 are highlighted, indicating they can be clicked to add codes to the fee schedule.]()
#### Edit Fees
!["NEW PATIENTS" fee schedule category expanded showing CPT codes 99202–99205 with their fees highlighted: 153.76, 235.30, 350.34, and 463.12.]()
## Setting Fee Schedule as a Percentage of Medicare Rates
In Elation Billing, you also have the ability to set your default fee schedule as a percentage of Medicare rates in your region.
1. **Navigate to Settings** - In Elation Billing, navigate to **Settings** and select **Practice Settings**.
2. Navigate to the **Fee Schedule** tab.
3. Specify a **Base Rate** percentage of Medicare.
4. Select your **Medicare Region**.
5. Select **Update Base Fee Rate** to save changes.
This base rate percentage of Medicare will apply for CPT codes that meet the following criteria:
* CPT exists in Medicare's rate database
* Charge amount is \$0
* No custom fee exists for that CPT in Elation Billing
## Fee Schedule Precedence Order
For Elation EHR + Elation Billing customers, this is the precedence order of managing fee schedules:
1. Charges set in the **EHR Practice Settings > Billing > Popular CPT Codes**. These charges will auto-populate when the CPT code is added to the Visit Note or bill in the EHR.
2. Charges manually entered for the CPT code in the **EHR Bill Dialog**. These charges will carry over to the claim in Elation Billing.
3. Charges manually entered for the CPT code on the **Elation Billing Superbill** page.
4. Charges specified for the CPT code in **Elation Billing's Custom Fee Schedule**.
5. Charges calculated using the base rate percentage of Medicare, as specified in **Elation Billing Practice Settings > Fee Schedule**.
Practices using **Fee Schedules** in EHR Billing Settings follow a different order. Elation first matches one fee schedule to the bill using its provider, payer, and service location filters, then resolves the rate for each code within that schedule. See [How Elation picks a fee schedule](/articles/fee-schedules-in-the-ehr#how-elation-picks-a-fee-schedule) and [Which rate is used for a procedure code](/articles/fee-schedules-in-the-ehr#which-rate-is-used-for-a-procedure-code).
## Related Articles
* [Fee Schedules Guide — Setting charges in the EHR](/articles/fee-schedules-in-the-ehr)
* [Filing a Claim](/articles/filing-a-claim)
* [Set Claim Defaults on Superbill](/articles/set-claim-defaults-on-superbill)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
# Adding a Medicare Type Code
Source: https://help.elationhealth.com/articles/adding-a-medicare-type-code
Learn how to add a Medicare Type Code when Medicare is the secondary policy
This article explains how to add a Medicare Type Code when Medicare is the patient's secondary insurance policy.
## Overview
### What is a Medicare Type Code?
A Medicare Type Code is a designation required when Medicare is the patient's secondary insurance policy. This code indicates why Medicare is secondary to another payer.
### Why is a Medicare Type Code important?
When submitting claims where Medicare is the secondary payer, the Medicare Type Code must be included for proper claim processing. Without this code, claims may be rejected or denied.
## Workflow Instructions
### Adding a Medicare Type Code
For Elation EHR + Billing practices, while baseline insurance information is entered via the EHR, the Medicare Type Code currently needs to be entered via Elation Billing.
1. **Edit the Policy** - On the Medicare Policy, click the yellow **Pencil** (edit) button.
2. **Access Additional Options** - Select **See More** to expand the additional fields.
3. **Select Medicare Secondary Code** - Select the appropriate Medicare Secondary Code from the drop-down menu.
4. **Save** - Click **Save** to apply the changes.
For more detailed instructions and a visual guide, see [Add or Edit Patient Insurance](/articles/add-or-edit-patient-insurance).
## Related Articles
* [Add or Edit Patient Insurance](/articles/add-or-edit-patient-insurance)
* [Filing a Claim](/articles/filing-a-claim)
# Practice Locations Guide- Listing your service locations
Source: https://help.elationhealth.com/articles/adding-a-second-practice-location
You may serve your patients from multiple locations. You can add all your locations within your Practice Settings.
## What are Practice Locations?
You may serve your patients from multiple clinic locations or facilities. You can add all your service locations to your Elation Settings and associate all your service locations with a Place of Service (POS) code to comply with coding requirements.
Once you add a Practice Location, it will appear in your e-Presciption Summary window, in the **Service Location (POS)** box in the **Billing Information** section of your visit notes and in the appointment location section of your patient appointments for appointment reminders.
![Prescription Summary showing the Prescriber Location field highlighted, with "Elation North" selected and its address details displayed below the dropdown.]()
![Billing Information dialog showing "Service Location" set to "Elation Northeast" and "Place of Service" set to "11 - Office," both highlighted with red arrows.]()
![Create an Event dialog showing the Location dropdown expanded with options: No location specified, Elation East, Elation North, and Elation South.]()
The letterhead that appears when you print or send documents from Elation uses a different feature called Print Headers. [Learn more about Print Headers here.](/articles/print-headers)
**Practice Location name vs. Practice name.** The Practice Location name you edit here is separate from your overall **Practice name**. Updating a Practice Location does not change the practice name shown on your [Patient Booking Site](/articles/Patient-Booking-Site), in patient letters, or elsewhere in Elation. The practice name can only be updated by Elation Support — [contact Support](https://elationhealth.com/contact-support/) to request a practice name change.
## Default Practice Location
The default location is the **Primary Location** at the top of your locations list. The location was created using the business details you provided us when your practice signed up with Elation. If your default location is of a different address, adjust the **Primary Location** details with the correct information and then create a new Practice Location for other locations.
You can update the time zone for any additional Practice Location directly from its edit window. The time zone associated with your **Primary Location** cannot be edited directly — [contact Elation Support](https://elationhealth.com/contact-support/) to update it.
## How to add Practice Locations
This Setting can be set to **Admin Only** to limit edit privileges to Admin Level Users. [Click here to learn more about administrative privileges](/articles/administrative-privileges)
.
1. Go to **Settings** >> **Practice Locations**
2. Click **+ Add Practice Location** to add a new place of service or click **Edit** to edit an existing location
3. In the edit window, click on the **POS code** box to select the Place of Service code that corresponds to your practice location.
4. Click **Save**
![Add Practice Location dialog open with POS code dropdown expanded, showing options like 11 - Office and 10 - Telehealth. The "+ Add Practice Location" button is highlighted in the top right.]()
**Next Step**
**Review your Practice Location details for accuracy today!**
## Related Articles
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Billing Guide- Billing Report](/articles/lightning-reports)
* [Billing Guide- Setting up CPT Codes and Place of Service](/articles/billing-settings---service-locations--procedure-codes)
* [Print Headers Guide- Managing practice letterheads](/articles/print-headers)
* [Calendar Guide- Setting practice location for appointment reminders](/articles/using-multi-location-scheduling)
* [Automated Appointment Reminders](/articles/appointment-reminders)
# Adding an NDC
Source: https://help.elationhealth.com/articles/adding-an-ndc
Learn how to add National Drug Codes (NDC) to claims in Elation Billing
This article provides step-by-step instructions on how to add National Drug Codes (NDC) to claims in Elation Billing.
## Overview
### What is an NDC?
A National Drug Code (NDC) is a unique identifier for medications. NDCs are required on claims when billing for certain injectable drugs, vaccines, and other medications administered in the office.
### Why is Adding an NDC important?
Many payers require NDC information for drug-related claims. Including the correct NDC ensures proper reimbursement and helps avoid claim denials.
The NDC editor can be accessed on ANY Superbill that has at least one claim line.
## Workflow Instructions
### Adding an NDC to a Claim
1. **Click NDC** - On the Superbill's Claim lines, under the **Optional** column, select **NDC**.
![Claim lines grid showing two charge lines with NOTE and NDC buttons in the Optional column; a red arrow points to the NDC button on the first line (CPT 99213, $300.00).]()
Clicking NDC will open the Charge NDC panel, which allows you to add an NDC without adding it to your Saved NDCs.
***
### Managing Saved NDCs
2. **View and Create NDCs** - To create new NDCs to be saved and to view your Saved NDCs, select **Saved NDCs**.
![Charge NDC panel with an arrow pointing to the "Saved NDCs" button, used to view existing NDCs or create new saved NDC entries.]()
On clicking Saved NDCs, you will see the list of NDCs on file along with the option to **ADD NEW NDC**.
The Action buttons allow you to:
* Add the NDC to the Claim Line
* Edit the NDC
* Delete an NDC
![Saved NDCs modal showing one saved entry (FLU SHOT 2020, code 59676030401, 5 ML) with an arrow pointing to the ADD NEW NDC button at the bottom.]()
#### Adding a New NDC to Saved Codes
**ADD NEW NDC** unlocks the fields to add an NDC to your saved codes. The list of already-saved NDCs will still be visible. Once you've added the info for the NDC, make sure to **Save**.
![Saved NDCs form with Name "Test NDC", NDC Code "123456789", Dosage "30", Measure "Milliliter (ML)" filled in, and a red arrow pointing to the Save button.]()
***
### Applying an NDC to the Superbill
3. **Add the NDC** - Click the ✅ on the NDC you'd like to add.
![Saved NDCs modal showing FLU SHOT 2020 (code 59676030401, dosage 5 ML) with an arrow pointing to the green checkmark button used to apply the NDC to the claim.]()
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Add/Update a Fee Schedule](/articles/add-update-a-fee-schedule)
# Patient Chart Guide- Adding historical vitals
Source: https://help.elationhealth.com/articles/adding-historic-vitals
This article describes how you can easily add historical vitals information from old records using a Non-Visit Note in Elation.
## Why should I add historical vitals to the patient's chart?
Adding historical vitals allows you to trend vitals information over a period of time especially when you first start using Elation. If patients are keeping track of their blood pressure at home on their own, you can record those readings in the patient's chart using this feature to trend their results.
Once the vitals information is stored in the patient's chart, you can use the
[Chronological Record search](/articles/using-the-search-tool-in-your-patient-chart#Vitals)
to pull up a table of vitals information.
![Chronological Record showing vitals trend table for Minnie Jones with WT, HT, and BMI values across two dates: 05/10/2021 and 05/06/2021, filtered by TEXT: vitals search.]()
## Adding historical vitals
To add historical vitals:
1. Click **Notes** >> **Non-Visit Note**.
2. Click **Vitals** to prompt the **Document Vitals** box to appear
3. Enter vitals information as needed for the patient and make sure you update the date of the vitals records.
4. Click **Save** or **Save and Add Another** to keep adding more
5. Click **Sign Note** to save the Non-Visit Note containing the historical vitals
![Document Vitals dialog open with two BP readings entered (130/80 "morning before breakfast" and 145/88 "evening after dinner"), date set to 06/01/2022. The Vitals button in the Non-Visit Note is highlighted, showing how to open this dialog.]()
The vitals will then appear in a non-visit note within the patient chart and be available for trending immediately upon sign-off.
![Signed Non-Visit Note dated Jun 9, 2022 showing historical BP vitals for 06/01 and 06/02/2022 recorded in the patient's Chronological Record.]()
## Related Articles
* [Chronological Record Guide- Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
# Patient Tags Guide- Classifying patients for administrative efficiency
Source: https://help.elationhealth.com/articles/adding-patient-tags
Patient Tags allow you to see short notes and sort patients without having to open their patient demographics.
## What are Patient Tags?
Patient Tags is a feature that allows you to add classification labels (or tags) to a patient's chart. Patient Tags will allow you to see short notes about your patients without having to open their patient demographic section. You can also use the Patient List Report to easily search for patients by the Patient Tags in their chart.
Patient Tags are located underneath the patient's name & date of birth in the patient chart.
![Patient chart for Winston B. Addington showing the "Has a caretaker" Patient Tag highlighted with a red border beneath the patient's name and date of birth.]()
## Using Patient Tags
### Applying Patient Tags to a patient's chart
1. Open a patient's chart & find the patient's name
2. Click the **+** button underneath the patient's name and date of birth or click existing Patient Tags to apply additional Patient Tags.
3. Type in any phrase in the **Edit Patient Chart Tags** box to search for Patient Tags in your database.
4. Select the Patient Tag from the database to apply it to the patient's chart.
* If the tag you want to add is not in the database, follow the[add new tag](#add_from_search) instructions to add it to your database first.
5. Continue selecting Patient Tags until you are done.
6. Click **Update Tags** to save your changes.
### Editing or removing removing Patient Tags from a patient's chart
1. Open a patient's chart & find the patient's name.
2. Click existing Patient Tags to edit or remove Patient Tags.
3. Click the **x** button next to any Patient Tag(s) you want to remove to remove the Patient Tag(s).
4. Add new Patient Tags to replace any of the ones you removed if needed.
5. Click **Update Tags** to save your changes.
If you want to edit the name of a specific Patient Tag in your database, see the [Managing the Patient Tags Settings page section](#settings) below.
If you want to delete a Patient Tag from your database, see the [Managing the Patient Tags Settings page section](#settings) below.
**Creating Patient Tags from the patient's chart**
You can create the Patient Tags directly from the
**Edit Patient Chart Tags**
box:
1. Type out the exact name of the new tag in the **Edit Patient Chart Tags** box.
2. Click **Create tag...** to add the new tag to your database.
![Edit Patient Chart Tags dialog with "Sunshine Nursing Home" typed in the search field, showing "No results" and a highlighted "Create tag 'Sunshine Nursing Home'" option below.]()
1. Click **Update Tags** to save your new tag to the patient's chart.
## Managing the Patient Tags Settings page
The
**Patient Tags**
settings page will allow you to add, edit, merge and remove Patient Tags.
* Click **+ Add Patient Tag** to add a new Patient Tag to your database at any time.
* Click **edit** next to a Patient Tag to edit the name of Patient Tag.
* Editing a Patient Tag will trigger an update to all associated Patient Tags in the patient's chart.
* Click **merge** to merge the Patient Tag with another Patient Tag in your database.
* Merging a Patient Tag will trigger an update to all associated Patient Tags in the patient's chart.
* Click **remove** to delete the Patient Tag.
* Removing (deleting) a Patient Tag from the **Patient Tags** Settings page will not delete the Patient Tag from any charts where the Patient Tag is in use. If you want to remove the deleted Patient Tag from patient charts, use the [Patient List Report](/articles/find-patients-with-elations-patient-list) to find all patients that have the deleted Patient Tag and individually remove the Patient Tag from each chart.
* Deleted Patient Tags will no longer appear in the Patient Tag search.
### Premium EHR features
Premium EHR users can enable a Setting to only allow Admin Level Users to make edits to the
**Patient Tags**
Settings page. Once enabled, only Admin Level Users can add, edit or remove Patient Tags from the
**Patient Tags**
Settings page in their Elation Settings. Non-Admin Level Users will only be able to view the Settings page but will not be able to edit.
This feature is part of Elation's Premium EHR offering. Once this feature is activated it will take effect immediately. If you are already a Premium EHR user and you are interested in using this feature, click the **I need help** button to notify Elation and a member of the Elation Team will activate the feature for you.
If you are interested in upgrading to Premium EHR to use this features, click the **I need help** -> **Contract Elation Support** button and a member of the Elation team will assist you.
## Common Use Cases
### Common ways Elation customers use Patient Tags
* Noting the name of the care facility or hospital that the patient is residing in
* Noting care directives
* Noting special details about the patient such as
* time frames in which the patient is available for contact
* names of care takers
### Special Patient Tags
1. Elation has two special tags that are preloaded for two care directives to allow you to easily identify these instructions in the chart
* Physician Orders for Life-Sustaining Treatment (POLST)- The tag is called *POLST*\*\*and will display in pink.
* Do not resuscitate (DNR)- The tag is called **DNR** and will display in red.
2. If you use certain integrations with Elation, the integration can create Patient Tags on your behalf for certain functions. Depending on the integration, special tags created by the integration cannot be edited or removed.
### Running reports on applied Patient Tags
Patient Tags is a filter that can be used in the Patient List Report to help you search for patients based on the way you classify them using tags. See the [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list) article for more details on how to use Patient Tags as a filter.
## Frequently Asked Questions
### Can I add color to Patient Tags I created?
You cannot add color to tags you create. All tags will display in gray except for the [two special care directive tags](#special_tags) noted above.
### Is there a way for me to delete all the Patient Tags from my database and start fresh?
You can only remove Patient Tags from the database one at a time. We recommend using the **edit**, **merge**, and **remove** buttons on the
[Patient Tags settings page](https://app.elationemr.com/settings/patient-tags/)
to manage your Patient Tags database and keep each tag unique and distinct.
* Removing (deleting) a Patient Tag from the **Patient Tags** Settings page will not delete the Patient Tag from any charts where the Patient Tag is in use. If you want to remove the deleted Patient Tag from patient charts, use the [Patient List Report](/articles/find-patients-with-elations-patient-list) to find all patients that have the deleted Patient Tag and individually remove the Patient Tag from each chart.
* Deleted Patient Tags will no longer appear in the Patient Tag search.
### What happens to Patient Tags in the patient's chart when I merge charts?
When you use Elation's
[merge chart feature](/articles/merging-duplicate-charts)
to combine multiple charts into one, Patient Tags will also be combined so that tags from all charts will be in the merged chart.
### Can I see who added or removed a Patient Tag from a chart?
No, the patient chart does not show who added or removed a tag, or when — it shows only the tags currently applied. If your practice has Hosted Database access, query the patient tag data directly for that history.
**Next Step**
**Explore the Patient Tag feature and start classifying your patients for administrative reporting.**
## Related Articles
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Document Tags for Visit Notes & Reports Guide](/articles/tag-reports-and-notes-with-document-tags)
# User Accounts Guide - Administrative privileges
Source: https://help.elationhealth.com/articles/administrative-privileges
This article describes the Administrative ('Admin') level privileges available within Elation EHR.
## Overview
### What are Administrative ('Admin') level privileges?
Administrative (**Admin**) level privileges allow you to prevent certain members of your practice (with access to Elation EHR) from taking certain actions in your practice's Elation account. Administrative (**Admin**) users are allowed to take more actions in Elation compared to non-Administrative (**Admin**) users such as:
1. [manage Elation user accounts for providers and staff](/articles/managing-user-accounts)
2. enable certain features such as:
* [Multi-factor Authentication (MFA)](/articles/Multifactor-Authentication-MFA)
* [Patient Booking Site](/articles/Patient-Booking-Site)
* [Patient Forms](/articles/Getting-Started-with-Patient-Forms)
* [Patient Payments](/articles/using-elation-to-securely-collect-patient-payments)
* [Patient Invoicing](/articles/patient-invoicing)
* [Automated Appointment Reminders](/articles/appointment-reminders)
* [Integrated Video (Zoom)](/articles/Elation-Telehealth-powered-by-Zoom)©
3. configure different settings such as:
* [user groups](/articles/user-groups)
* [visit note categories](/articles/visit-note-categories)
* [report categories](/articles/report-types)
* [Patient Passport message routing](/articles/elation-patient-passport-an-introduction#Routing)
* [popular CPT Codes for billing](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?)
* [practice locations](/articles/adding-a-second-practice-location)
* [Insurance Carriers list](/articles/Managing-Insurance)
* [templates](/articles/templates-settings)
* [lab vendors list](/articles/labs-settings#managing_vendors)
* [appointment types](/articles/calendar-and-booking-settings#Appointment_Types)
* [virtual visit instructions](/articles/Elation-Telehealth-powered-by-Zoom#VirtualVisitInstructions)
### Why are Administrative ('Admin') level privileges useful?
Administrative (**Admin**) level privileges allow you to specify who can enable advanced features and who can configure important settings that impact your practice's workflows. Administrative (**Admin**) level privileges are generally assigned to the owner(s) or manager(s) of the practice because they are most knowledgeable about how they want to run the practice as well as what configurations are important in the Elation settings to maximize efficiency.
## Workflow Instructions
### Assigning Administrative ('Admin') level privileges
Only users within the practice with administrative (**Admin**) level privileges can assign administrative (**Admin**) level privileges to other users in the practice. To assign administrative (**Admin**) level privileges:
| **1** | Click on your email at the top of your Elation account and click **Settings**. |
| ----- | ------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Manage Accounts**. |
| **3** | Click the **Make Admin** button next to the user's name to assign them administrative (**Admin**) level privileges. |
### Revoking Administrative ('Admin') level privileges
Only users within the practice with administrative (**Admin**) level privileges can revoke administrative (**Admin**) level privileges for other users in the practice. To revoke administrative (**Admin**) level privileges:
| **1** | Click on your email at the top of your Elation account and click **Settings**. |
| ----- | ---------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Manage Accounts**. |
| **3** | Click the **Remove Admin** button next to the user's name to remove administrative (**Admin**) level privileges. |
### 'Admin' Settings
There are two types of **Admin** only settings in Elation. There are:
1. Settings that are always **Admin** only
2. Settings that you can assign to be **Admin** only
#### Settings that are always 'Admin' only
Settings that are always **Admin** only are under the **Admin User Only** section of the **Elation Settings** page. Only **Admin** users can view and edit the settings under this section. These are the settings that are always **Admin** only:
* [Manage Accounts](/articles/managing-user-accounts)
* [User Groups](/articles/user-groups)
* [Report](/articles/report-types) & [Visit Note Categories](/articles/visit-note-categories)
* [Patient Passport Messages](/articles/elation-patient-passport-an-introduction#Routing)
* [Security & Privacy](/articles/Multifactor-Authentication-MFA)
#### Settings that you can assign to be 'Admin' only
Settings that you can assign to be **Admin** only will have an **Admin only** toggle at the top of the page. Anyone can turn the toggle on but only **Admin** users can turn the toggle off after it is turned on.
* Gray = Off
* Green = On
![The Insurance Admin Only toggle shown in two states: gray/Off (top) and green/On (bottom), illustrating how enabling restricts edits to Admin users only.]()
All users can view these settings but only **Admin** users can edit the settings. These are the settings that can be set to **Admin** only:
* [Billing](/articles/billing-settings---service-locations--procedure-codes)
* [Patient Payments](/articles/using-elation-to-securely-collect-patient-payments)
* [Membership Management](/articles/Introduction-to-Membership-Management-with-Elation) (special feature)
* [Practice Locations](/articles/adding-a-second-practice-location)
* [Insurance](/articles/Managing-Insurance)
* [Templates](/articles/templates-settings)
* [Prescriptions](/articles/create-and-use-custom-rx-templates)
* [Sort Settings](/articles/chronological-record-sort-settings)
* [Labs](/articles/labs-settings#managing_vendors)
* [Lab Orders](/articles/ordering-lab-tests-enhanced#order_sets)
* [Calendar & Booking](/articles/Patient-Booking-Site)
* [Virtual Visits](/articles/Elation-Telehealth-powered-by-Zoom)
* [Patient Forms](/articles/Getting-Started-with-Patient-Forms)
* [Collaborative View Sharing](/articles/the-collaborative-view-hi-only#toggle) (special feature)
Certain features allow you to create data outside of the settings page (prescription templates, PE/ROS templates, letters and order sets). **Admin** and **non-Admin** users will be able to create templates and order sets from the patient's chart but only **Admin** users can edit or remove prescription templates, PE/ROS templates, letters and order sets from the settings pages if you make these settings pages **Admin only**.
## Frequently Asked Questions
### Can I make all settings in Elation 'Admin' only?
Only certain settings in Elation can be **Admin** only. Elation will notify you if we introduce more **Admin** only settings to Elation.
### I made the lab order feature 'Admin' only in Elation but my non-Admin staff was still able to create a new lab order set. Why?
Lab Order Sets can be created in the Lab Order Form in the patient's chart. For this reason, **Admin** and **non-Admin** users will be able to create lab order sets from the patient's chart but only **Admin** users can edit or remove lab order sets from the settings page.
### I made the prescriptions (rx) order set feature 'Admin' only in Elation but my non-Admin staff was still able to create a new prescription (rx) order set. Why?
Prescription Order Sets can be created in the Prescription (Rx) Form in the patient's chart. For this reason, **Admin** and **non-Admin** users will be able to create prescription order sets from the patient's chart but only **Admin** users can edit or remove prescription order sets from the settings page.
### How can I find who the Admins are in my practice?
Users who can see
**Settings**
→
**Manage Accounts**
are Admins in your practice.
If you do not see
**Manage Accounts**
in your Settings:
* You are not an Admin.
* Contact the primary provider or practice manager, who typically has Admin access. You can also ask a colleague who does see **Manage Accounts** to help identify the Admins in your practice.
If you do see
**Manage Accounts**
in your Settings:
* You are an Admin.
* Expand the list of active users under the **Provider** or **Staff** sections.
* If a **Make admin** button is present, that user is not an Admin.
* If a **Remove admin** button is present, that user is an Admin.
*Copyright ©2023 Zoom Video Communications, Inc. All rights reserved.*
## Related Articles
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
* [VIP Charts- Limiting access to certain patient charts](/articles/vip-chart-feature)
# Administrative Training Videos
Source: https://help.elationhealth.com/articles/administrative-training-series---individual-videos
This article houses instructional videos that provide an introduction of Elation geared towards administrative roles in your practice.
## Practice Operations Basics
1. 0:36- Administrative Reports
2. 0:36- Patient List Report
3. 2:49- Appointment Report
4. 3:37- Billing Report
5. 5:57- Calendar Settings (Patient Forms & Booking Site)
6. 5:57- Patient Forms
7. 9:05- Virtual Visits
8. 9:23- Appointment Types
9. 11:16- Calendar View
10. 11:37- Rooms
11. 11:47- Appointment Reminders
12. 12:48 Availability
13. 13:20- Booking Site
14. 14:58- Billing Related Settings
15. 14:58- Billing
16. 16:14- Practice Locations
17. 16:46- Insurance
18. 17:58- Other Practice Settings
19. 18:08- Patient Tags
20. 18:19- Document Tags
21. 18:28- Templates
22. 18:47- Print Headers
23. 19:08- Clinical Care Measure Settings
24. 19:36- Fax Usage & Settings
25. 19:49- Prescriptions
26. 19:57- Labs
27. 20:43- Lab Orders
28. 20:56- Provider Level User Settings
29. 20:56- Account Details
30. 21:21- Preferences
31. 21:52- Authorized Staff Delegates
32. 22:20- Patient Sharing Defaults
33. 22:42 Admin Level User Settings
34. 23:05- Manage Accounts
35. 24:03- User Groups
36. 24:36- Report & Visit Note Categories
37. 25:35- Patient Payments
38. 28:48- How to Contact Support
## Practice Home requiring actions
## Searching for patient charts
Read [this article](/articles/Patient-Chart-Guide-Searching-for-patient-charts) to learn more about searching for patient charts.
## Checking patients in for their appointment
Learn more about the check-in process in [this article](/articles/Calendar-Guide-Checking-patients-in-for-their-appointment).
## Patient Demographics
Read our [Patient Demographics Guide](/articles/Patient-Demographics-Guide) to learn more about this feature.
## Clinical Profile
Read our [Clinical Profile Guide](/articles/clinical-profile-record-patient-medical-history) to learn more about the feature.
## Fax Inbox
## Patient List Report
Read the
[Patient List Report Guide](/articles/find-patients-with-elations-patient-list)
for more information.
## Patient Forms
### Creating Forms
### Adding Forms to Appointment Types
## Patient Passport
## Related Articles
* [Clinical Training Videos](/articles/clinical-training-series---individual-videos)
* [Account Set Up Articles](/articles/EHR-account-setup-and-Provider-account-authentication)
# Applying Patient Payments with ⚡️Apply Patient Payments
Source: https://help.elationhealth.com/articles/applying-patient-payments-with-apply-patient-payments
Learn how to use the automated Apply Patient Payments tool in Elation Billing
This article explains how to use the automated ⚡️Apply Patient Payments tool to apply unapplied patient payments to outstanding balances.
## Overview
### What is ⚡️Apply Patient Payments?
The ⚡️Apply Patient Payments tool automatically applies unapplied patient payments to their outstanding balances. It intelligently matches payments to claims based on date of service and applies remainders to the oldest balances.
### Why use ⚡️Apply Patient Payments?
This automated tool saves time by eliminating the need to manually apply each patient payment. It ensures payments are correctly matched to claims and helps maintain accurate accounts receivable.
## Workflow Instructions
### Using ⚡️Apply Patient Payments
1. **Navigate** - Select the **Send Statements** page from the **Patient** drop-down menu.
You will NOT need to send statements to use the automated ⚡️Apply Patient Payments tool.
![Patients drop-down menu with "Send Statements" highlighted in an orange box, as the navigation destination for the Apply Patient Payments tool]()
2. **Run the Tool** - Click the ⚡️Apply Patient Payments button.
![Send Statements page showing Step 1 - Apply Payments, with the green "Apply Patient Payments" button and a "Skip" option visible on the right panel.]()
This will apply unapplied Patient Payments to their outstanding balances. If you have a large account with many patient payments and balances, this may take a couple of minutes.
### What ⚡️Apply Patient Payments Does
The tool performs the following actions in order:
1. **Find unapplied patient payments** - Identifies all payments that haven't been applied to claims
2. **Apply copays to matching DOS only** - Copays collected on a Superbill that has yet to be Settled will be reserved for use on that Superbill
3. **Match and apply other payments** - For all other unapplied payments, matches date of service and applies
4. **Apply remainder to oldest balances** - Any remaining payment amounts are applied to the oldest outstanding balances
## Related Articles
* [Sending Statements](/articles/sending-statements)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
# Calendar Guide - Using automated appointment reminders
Source: https://help.elationhealth.com/articles/appointment-reminders
Your practice can choose to send up to 3 appointment reminders to patients ahead of a scheduled patient visit.
## Overview
**Full name (a.k.a preferred name) used in patient-facing reminders.** When a patient has a Full Name (preferred/actual name) set in their demographics, that name—not their legal name—is used in appointment confirmation SMS, phone confirmations, and cancellation emails. This applies to all patient-facing reminder surfaces. See the [Patient Demographics Guide](/articles/Patient-Demographics-Guide) for more on the Legal Name vs. Full Name fields.
### What are automated appointment reminders?
In Elation, sending automated appointment reminders to patients is easy. You can send up to 3 reminders to patients ahead of a scheduled appointment. Each appointment reminder will contain the following details:
* Date and time of appointment
* Type of appointment (Appointment Type)
* Name of provider
* Address and phone number of practice (for ['In person' appointments](#location) only)
* A button to confirm the appointment
* (Optional) A button to [cancel](#cancel) the appointment
* (Optional) A button to [reschedule](#reschedule) the appointment (when the [Patient Booking Site](/articles/Patient-Booking-Site) is enabled)
* (Optional) [Instructions](#instructions) for their appointment; including a link to join the video visit for virtual appointments
### Why are appointment reminders valuable?
Elation's automated appointment reminders help ensure that your patients have the information they need to attend their visit and will decrease the number of no-shows on your schedule. All of the information and actions needed to follow up on a scheduled appointment will be immediately available in each appointment reminder.
* For text and email appointment reminders, patients will be able to confirm and, if enabled, cancel their appointments directly through the reminder to give your practice more insight into the accuracy of each provider's Calendar
* Details or instructions entered into the **Visit Instructions** field within an appointment, for both in-person and virtual visits, will be automatically sent to your patients
#### Reducing no-shows with reminders
Appointment reminders are one of the most effective tools for reducing patient no-shows. To maximize their impact:
* **Send multiple reminders.** Configure up to 3 reminders per appointment. A common approach is to send reminders 7 days prior, 1–2 days prior, and 1 hour in advance (delivered between 1 and 2 hours before the appointment).
* **Combine reminders with clear visit instructions.** Patients are more likely to attend when they know exactly what to expect—where to go, what to bring, and how to prepare. Use the **Visit instructions for patient** field to provide this information.
* **Enable appointment confirmation and cancellation.** When patients can confirm or cancel directly from the reminder, your practice gains real-time visibility into schedule accuracy and can fill open slots sooner.
### How will my patients receive reminders?
Patients will receive appointment reminders based on the patient's preferred contact method. You can set-up your patient's preferred method in the **Contact Information** section of the patient's demographic window in each patient's chart.
![Mickey Smith's Contact Information panel showing preferred contact method set to "SMS (Text Message)", with annotations linking the mobile number to SMS reminders, home number to phone call reminders, and email to email reminders. A warning indicates the mobile number is not opted in to receive text messages.]()
If the patient does not have a preferred contact method selected, then Elation will use the following hierarchy to determine how the reminder will be sent based on what information that is available within the **Contact Information** section of the patient's demographics:
1. Patient's Passport account contact preference (the default setting is email). If the patient does not have a Patient Passport account, then:
2. SMS (Text Message) to the **Mobile** phone number type stored in the patient's **Contact Information** (if the patient [opted in to receiving SMS (Text Messages)](/articles/SMS-Text-Message-Opt-In-Guide). If a **Mobile** phone type is not available or the patient did not opt in to receiving SMS, then:
3. Email notification to the email address stored in the patient's **Contact Information**. If no email address is available, then:
4. Phone call to a **Home** or **Main** phone number (or the **Mobile** phone number if patient opted out of SMS) **stored in the patient's \*\* Contact Information**\*.\*
5. If none of the above details are available in the patient's **Contact Information**\*,\* then the patient will not receive any automated appointment reminders from Elation.
The patient must have a **Mobile** phone listed as a one of the phone types in their demographics window and be [opted in to receiving SMS (Text Messages)](/articles/SMS-Text-Message-Opt-In-Guide) in order to receive text appointment reminders. If the patient did not opt in to receive SMS (Text Message), then the **Mobile** phone will receive a phone call reminder instead.
If the patient only has **Work**, **Night**, **Fax**, or **Other** phone number types available in their demographics window, then Elation will not send any reminders to the patient.
### What will appointment reminders look like to patients?
Below are examples of what the appointment reminders will look like to your patients.
#### SMS (Text Message) reminders
SMS (Text Message) reminders will go to the patient's SMS-enabled cellular phone (if they [opted in to receiving SMS (Text Messages)](/articles/SMS-Text-Message-Opt-In-Guide) and will come from the number *36331*. The text message will contain a URL for the patient to click on to:
* see additional details about their appointment, including:
* Date and time of appointment
* Type of appointment (Appointment Type)
* Name of provider
* Address and phone number of practice (for ['In person' appointments](#location) only)
* See the [**Appointment reminders for practices with multiple practice locations' section**](#multiple_practice_locations) below for additional details about practices with multiple practice locations.
* confirm their appointment
* (optional) [cancel](#cancel) their appointment
* (optional) view[instructions](#instructions) about their appointment; including a link to join the video visit for virtual appointments
Elation will continue to send reminders to patients even after a patient confirms their appointment until all reminders are sent.
![SMS appointment reminder text from 36331 linking to Elation patient-facing confirmation page showing Blood Test with Kary Jones, MD on March 14, 2022, with "I will be there" button highlighted.]()
#### Email reminders
Email reminders will come from the email address [*reminders@elationemr.com*](mailto:reminders@elationemr.com) and will contain the following details:
* Date and time of appointment
* Type of appointment (Appointment Type)
* Name of provider
* Address and phone number of practice (for ['In person' appointments](#location) only)
* See the [**Appointment reminders for practices with multiple practice locations' section**](#multiple_practice_locations) below for additional details about practices with multiple practice locations.
* A button to confirm the appointment
* (Optional) A button to [cancel](#cancel) the appointment
* (Optional) A button to [reschedule](#reschedule) the appointment (when the [Patient Booking Site](/articles/Patient-Booking-Site) is enabled)
* (Optional) [Instructions](#instructions) for their appointment; including a link to join the video visit for virtual appointments
Elation will continue to send reminders to patients even after a patient confirms their appointment until all reminders are sent.
![Email reminder from reminders@elationemr.com showing a Blood Test appointment with Kary Jones, MD on March 14, 2022 at 2:00 PM, with "I will be there" and "Cancel appointment" buttons. An arrow shows that clicking "I will be there" leads to a confirmation page displaying "Your appointment is confirmed."]()
#### Phone call reminders
Phone call reminders will be sent as an automated voice call to the **Home** or **Main** phone types (or the **Mobile** phone type if patient opted out of SMS) **stored in the patient's \*\* Contact Information**\*.\*The call with come from a California area code phone number and will have the following message:
*Hello. This is a courtesy reminder that you have an appointment with \[Provider's full name] at \[Date & Time of appointment]. If you have any questions or need to change your appointment, then please contact the office by calling \[Practice's phone number]. Once again, you have an appointment with \[Provider's full name] at \[Date & Time of appointment]. If you have any questions or need to change your appointment, then please contact the office by calling \[Practice's phone number].*
See the ***Appointment reminders for practices with multiple practice locations***\_ section\_ below for additional details about practices with multiple practice locations.
## Workflow Instructions
### Setting up appointment reminders for my practice
To turn on appointment reminders for your practice,
1. Go to **Settings** -> **Calendar & Booking** -> **Reminders**.
2. Choose the number of reminders you would like patients to receive and the time frame you want each reminder to be sent.
* You can insert any number between 1 and 365 into the text fields provided.
* The most recent option is **1 hour in advance**\*.\*
3. Data entered in the reminders will automatically be saved on the page.
In the example below, patients will receive the appointment reminders 7 days prior, 3 days prior and 1 hour prior to their scheduled appointment:
![Calendar & Booking Reminders tab showing three configured reminders: Reminder 1 set to 7 days in advance, Reminder 2 set to 3 days in advance, and Reminder 3 set to 1 hour in advance.]()
### Adding place and location details to appointment reminders
Appointment reminders will vary based on the appointment **Location** specified (if applicable) and the appointment **place** selected (**In person** vs. **Virtual**).
![Create an Appointment dialog showing the Location dropdown expanded with options: No location specified (highlighted), Billing Street, Elation Eastern Location, Elation Office 202, and New Location. The In person/Virtual toggle and Location field are outlined in red.]()
1. To add additional Practice Locations, view our [Practice Locations Guide](/articles/adding-a-second-practice-location)
* See the [**Appointment reminders for practices with multiple practice locations' section**](#multiple_practice_locations) below for additional details about practices with multiple practice locations.
2. To set a place, choose **In Person** or **Virtual** in the appointment details window
* If the **Visit instructions for patient** field is filled out, the appointment reminder will include those instructions. For **Virtual** visits, you can set [default Virtual Visit Instructions](https://app.elationemr.com/settings/telehealth/).
* If you select **Virtual**, the reminders will also include references to the appointment being conducted virtually.
### Adding visit instructions to appointment reminders
You can use the **Visit instructions for patient** field to send additional instructions to patients for their visit. Common use cases include directions to the office, parking information, what to bring, and how to prepare for the visit.
How instructions are configured depends on the appointment type:
* **Virtual visits** support default instructions. Set them once in **Settings** → **Virtual Visit** → **Virtual Visit Preferences** and they are automatically included in all virtual appointment reminders.
* **In-person visits** do not support default instructions. Instructions must be added to each appointment individually at the time of scheduling or by clicking **Edit** in the appointment window.
**VIRTUAL VISITS** When an appointment is set to **Virtual**, your default virtual visit instructions—including the video link—are automatically included in appointment reminders. Patients receive everything they need to join the video visit directly from the reminder. To set or update your default virtual visit instructions, go to **Settings** -> **Virtual Visit** -> **Virtual visit Preferences**. For more information on conducting virtual visits, see [Elation Integrated Video - Connecting with patients using video](/articles/Elation-Telehealth-powered-by-Zoom)
There is currently no way to set default visit instructions for **in-person** appointments. Visit instructions for in-person visits must be added on a per-appointment basis using the **Visit instructions for patient** field.
You can add visit instructions at the time of creating the appointment or after the appointment has been created by clicking **Edit** in the top right of the appointment window
If you edit the visit instructions after appointment reminders are sent, then you will need to click the **Send** button next to the visit instructions to manually send updated visit instructions to patients.
The Zoom link generated by Elation (when you first sign up for Virtual Visits) must be included in the visit instructions for virtual visits. If the Zoom link is not included, the patient will not have a link to join the virtual visit.
![Appointment detail popup for Katie Williams showing the Edit button highlighted and the Visit instructions for patient field outlined, with a Resend button to manually send updated instructions to the patient.]()
After adding visit instructions to the appointment, you can send the instructions to the patient right away by clicking **Send** / **Resend** . The instructions will automatically be included in the next reminder that will be sent to the patient.
Email Reminder:
![Email appointment reminder showing virtual visit details for Sara Smith, MD on Tuesday December 13, 2022 at 12:30pm PST, with a Zoom link and custom visit instructions included.]()
SMS (text message) Reminder:
![Patient's phone showing an SMS appointment reminder for a Telemedicine Virtual Visit with Sara Smith, MD on Tuesday, December 13, 2022 at 12:30PM PDT, with a Zoom link included in the visit instructions section.]()
### Allowing patients to cancel appointments via reminders
To allow patients to cancel their appointment from appointment reminders:
1. Go to **Settings** -> **Calendar & Booking**-> **Reminders**.
2. Click the button next to **Allow patients to cancel their appointments online** to turn it on (green).
![Calendar & Booking Reminders tab showing the "Allow patients to cancel their appointments online" toggle highlighted in red, with the toggle switched on (green).]()
This will cause appointment reminders to include the option for patients to cancel their appointment. If your practice also has the [Patient Booking Site](/articles/Patient-Booking-Site) enabled, reminders will also include a **Reschedule appointment** button — see [Allowing patients to reschedule via reminders](#reschedule) below.
![Patient-facing cancellation confirmation screen showing "Your appointment has been canceled" with appointment details and a "Book a new appointment" button.]()
![Cancellation confirmation email template showing subject line "Canceled: <service type> appointment with <provider, title>" and body with service details, date (May 20, 2019, 4:00pm), and a "Book a new appointment" button.]()
#### How patients can cancel from a reminder
Patients can cancel an appointment directly from their reminder in two ways:
* **From the reminder link:** If you enable the **Allow patients to cancel their appointments online** setting, patients can cancel directly from their SMS or email reminder.
* **By phone:** Patients can call your practice using the phone number included in the reminder.
#### After a patient cancels
When a patient cancels an appointment from a reminder, they receive a follow-up confirmation. If your practice uses the [Patient Booking Site](/articles/Patient-Booking-Site), a **Book a new appointment** button appears that opens the booking site pre-filtered to the original provider.
Patients with a [Patient Passport](/articles/what-patient-passport-messaging-looks-like-to-a-patient) account can also access your Booking Site link directly from their Passport to book a new appointment at any time.
### Allowing patients to reschedule via reminders
When **Allow patients to cancel their appointments online** is enabled **and** the [Patient Booking Site](/articles/Patient-Booking-Site) is active, appointment reminders include a **Reschedule appointment** button in addition to the Cancel button.
#### How the reschedule flow works for patients
1. The patient clicks **Reschedule appointment** in their reminder.
2. They are taken to an appointment management page with the prompt *"Pick a new time and we'll move your appointment."*
3. Clicking through opens the Booking Site pre-filtered to the original provider's availability.
4. When the patient selects a new time and completes the booking, the original appointment is **automatically canceled** at the same moment — the patient cannot end up holding two appointments.
5. If the patient abandons the flow at any point without completing the new booking, the original appointment **remains scheduled** and is not affected.
The Reschedule button only appears in email reminders when both **Allow patients to cancel their appointments online** is on and the Patient Booking Site is enabled for your practice. If only the cancel setting is on but the Booking Site is off, only the Cancel button appears.
### Checking if a patient received their appointment reminders
The appointment activity log will show you when and how appointment reminders were sent to your patients.
![Edit Patient Appointment dialog showing the Activity Log section highlighted, with two entries: an appointment reminder sent to johndoe@email.com on 10/11/24 and the appointment scheduled on 10/24/24.]()
To view the appointment activity log:
1. Click in the shaded area of the appointment in the Elation Calendar.
2. Select **Edit**.
3. Review the appointment reminder details in the Activity Log section at the bottom of the appointment box.
### Using appointment reminders when your practice has multiple practice locations
For practices with multiple [Practice Locations](/articles/adding-a-second-practice-location), remember to select the appropriate **Location** when adding patient appointments to the Calendar to ensure the correct practice address and phone number are shared with patients in their appointment reminders. If no **Location** is selected then the address and phone number of the **Primary Location** for your practice (as designated in your Practice Location Settings) will be shared with patients in their appointment reminders.
If preferred, you can ask Elation to turn on a feature for you so that practice phone numbers are never shared with patients in their appointment reminders when no **Location** is selected. Have an Admin Level User in the practice click the **I need help** -> **I need help from an Elation Team Member** button to submit a request and a member of the Support Team will assist you with turning this feature on.
## Frequently Asked Questions (FAQ)
### Can I customize the language for appointment reminders?
Appointment reminder language cannot be customized at this time. Due to the various capabilities and features tied to appointment reminders, Elation has standardized the details disclosed via the various appointment reminders to make sure patients have the most important information needed to show up correctly and on time for their appointment. Use the [instructions](#instructions) field to disclose additional instructions or details to the patient as needed.
### A patient said they never received their appointment reminder. What should I do?
1. The [appointment activity log](#reminder_audit) will show you when and how appointment reminders were sent to your patients. To view the appointment activity log:
2. Click in the shaded area of the appointment in the Elation Calendar.
3. Select **Edit**.
4. Review the appointment reminder details in the **Activity Log** section at the bottom of the appointment box.
5. If the activity log says the patient received a reminder via email
6. verify the patient's email address is spelled correctly.
7. ask the patient to search their email inbox for any emails from [*reminders@elationemr.com*](mailto:reminders@elationemr.com) (especially their Spam/Junk) folders.
8. If the activity log says the patient received a reminder via SMS (Text Message)
9. verify the patient's **Mobile** phone number is accurate.
10. verify the patient's **Mobile** phone number can receive SMS (Text Message).
11. have the patient check with their mobile service provider to see if the mobile service provider might have blocked the *36331* phone number used to send SMS reminders.
12. If the activity log says the patient received a phone call
13. verify the patient's **Home** or\*\* Main\*\* phone number is accurate.
14. ask the patient if they received any missed calls from a California area code phone number during the reminder timeframe you specified.
15. ask the patient if they received any voicemails from a California area code phone number during the reminder timeframe you specified.
If appointments are added to the Calendar after the timeframe specified for appointment reminder frequencies, then the patient will not receive that reminder. For example: Today is March 1, 2022. You have your appointment reminder preference set for **2 days in advance**. You add an appointment to the calendar dated March 2, 2022. The patient will not receive any appointment reminders because it falls out of the specified **2 days in advance** timeframe.
### My patient has a Mobile phone number on file but they received a phone call instead. Why did this happen?
Patients will only receive a SMS (Text Message) to the **Mobile** phone number type stored in the patient's **Contact Information** if the patient[opted in to receiving SMS (Text Messages)](/articles/SMS-Text-Message-Opt-In-Guide). If the patient did not opt in to receiving SMS then they will receive a phone call to **Mobile** phone number.
### A patient said they received an appointment reminder but the details of the reminder was incorrect. What should I do?
Ask the patient to show you the exact reminder they received if possible and compare it with the details of their appointment. If the reminder does not match the appointment, take a picture of the reminder the patient received. Afterwards, notify the Support Team via the **I need help** button or [fill out this form](https://help.elationemr.com/s/contactsupport) and our Support Team will investigate the cause behind the incorrect reminder details. The Support Team may also ask you to email them a copy of the picture of the reminder.
### Why is a reminder not sent if the patient only has Work, Night, Fax, or Other phone number types available in their demographics window?
Information within appointment reminders are considered Protected Health Information (PHI). In order to ensure only the patient has access to their own PHI, we can only send appointment reminders to **Contact Information** that is normally only tied to the patient themselves.
### My patient received another reminder even after they confirmed their appointment. Why?
Each customer can set up to 3 automated reminders for patient appointments. The timeframe of reminders vary and patients may forget about an appointment even after they confirmed their appointment. Elation will send out all scheduled appointment reminders, even to patients who have confirmed their appointment, to ensure patients show up for their appointment.
### Does confirming an appointment through a reminder update its status in the Elation calendar?
Yes. When a patient completes the confirmation step from an appointment reminder, the appointment's status in the Elation calendar updates from **Scheduled** to **Confirmed**. If the patient only opens the reminder without completing the confirmation step, the status will not update.
### When is the 1 day in advance appointment reminder sent?
The **1 day in advance** appointment reminder is sent more than 24 hours before the scheduled appointment. For example, if the appointment is on May 4th at 3pm Pacific then the appointment reminder is sent sometime before 3pm Pacific on May 3rd. The same rule applies to all **days in advance** options.
### When is the 1 hour in advance appointment reminder sent?
The **1 hour in advance** appointment reminder is sent between 1 and 2 hours before the scheduled appointment. For example, if the appointment is at 3pm then the appointment reminder is sent between 1pm and 2pm. Receiving this reminder up to 2 hours before the appointment is expected behavior, not a timing error.
### Can I turn off reminders for a specific Appointment Type?
Not currently. Reminder settings apply practice-wide across all Appointment Types — there isn't a way to suppress reminders for just one Appointment Type. Marking the appointment as **Confirmed** also doesn't prevent reminders from going out.
### Can I keep the office address from appearing on an appointment reminder (for example, for a phone-only visit)?
For appointments with the **place** set to **In person**, the reminder includes the practice address and phone number so patients know where to go. There is no setting to hide the address for an in-person appointment.
If your practice has multiple locations, leaving the **Location** blank does not remove the address; the reminder falls back to your Primary Location's details (see [Using appointment reminders when your practice has multiple practice locations](#multiple_practice_locations)).
### If a patient is booked on two calendars at the same time, will they receive two reminders?
Yes. Appointment reminders are generated per appointment, not per patient, and they are not combined or de-duplicated. If the same patient is booked at the same time on two calendars (for example, a provider's calendar and a resource or team calendar), each appointment sends its own reminder on your practice's configured schedule.
If you want to reserve time on a second calendar without sending the patient an additional reminder, add a calendar block (an event with no patient attached) to that calendar instead of booking a second patient appointment.
### We book patients on a resource or team calendar. How does that name appear in the reminder?
When an appointment is booked on a resource or team calendar (a non-provider scheduling calendar), the reminder shows that calendar's name in place of a provider's name, for example, "You have an appointment with \[Calendar Name]." Because these calendars are configured similarly to a provider name, the displayed name may include a comma. If you would like to adjust how a resource calendar's name appears to patients, have an Admin Level User use the **I need help** → **Contact Elation Support** button and our Support Team can help.
For more on what resource or team calendars are, their limitations, and how to request one, see [Resource or Team Calendars](/articles/Scheduling-capabilities#resource-or-team-calendars) in the Scheduling Capabilities Overview.
**Next StepSet up automated appointment reminders for your practice to ensure your patients never miss their appointment.**
## Related Articles
* [SMS (Text message) Opt-In Guide](/articles/SMS-Text-Message-Opt-In-Guide)
* [Practice Locations Guide- Listing your service locations](/articles/adding-a-second-practice-location)
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
# Billing Guide- Creating a superbill & coding for your visit
Source: https://help.elationhealth.com/articles/billing
This article provides a step-by-step guide to creating a bill in Elation.
## What is the Billing Form?
The Billing Form is the section at the bottom of the visit note used to store Procedure Codes, Diagnosis Codes and other billing information generally used for insurance claims submissions. All available fields are listed below. Fields with an asterisk (\*) can be made available to you in the [Billing Settings](/articles/billing-settings---service-locations--procedure-codes):
* Service Location
* Place of Service Code
* Referring Provider details
* State the Referring Provider is located in
* Name of the Referring Provider
* Patient Payment
* Ordering Provider details\*
* State the Ordering Provider is located in\*
* Name of the Ordering Provider\*
* Rendering Provider
* Supervising Provider Name\*
* Prior Authorization\*
* Billing Provider Name\*
* Procedure Codes (CPT or HCPCS)
* Diagnosis Codes (ICD-10)
* Modifier
* Amount, Quantity and Subtotal fields- generally for customers using the [Patient Invoicing](/articles/patient-invoicing) feature.
## Why is it important to store billing information for each patient encounter?
Billing information is generally used by insurance companies (also known as Payers) to understand the services rendered (based on procedure codes) during a patient encounter as well as understand the justification (based on diagnosis codes) behind the services rendered. This information is then used to calculate how much a provider is reimbursed for services rendered. Accurate and complete coding will result in timely payments from Payers and minimize the time and effort needed to receive reimbursement.
Elation strives to be the single place for all clinical information for your patients. You can use the Billing Form in the Visit Note to create a Super Bill for your patients. If you are using one of our integrated Practice Management System (PMS) partners, the claim will be automatically generated in the Practice Management System after you sign your visit note and you will not need to double document.
## Entering billing details in the Billing Form
### Locating the Billing Form in a Visit Note
At the bottom of each Visit Note format, there is a button to **+ Add Billing Information.** Click this button to open the Billing Form.
### Adding Service Location & other service details
Before adding your procedure and diagnosis codes to the Billing Form, review the following fields (as needed) to ensure all supporting details are sent along with your codes. Fields with an asterisk (\*) can be made available to you in the [Billing Settings](/articles/billing-settings---service-locations--procedure-codes).
* **Service Location**
* **Service Location** is a required field. The service locations listed is pulled from your Practice Locations Settings. If you need to add a new location, click **Edit Locations**. [Learn more about Practice Locations here.](/articles/adding-a-second-practice-location)
* If you recently added a new service location to your Practice Location Settings, you may need to click **refresh list** for it to appear in the list of service locations to select for the Billing Form.
* **Place of Service**
* If the Service Location you selected has a default Place of Service (POS) code, the default POS code is selected automatically. You can update the POS code for the claim as needed.
* Referring Provider details
* **State**
* Store the state the Referring Provider is located in.
* **Referring Provider**
* Store the name of the Referring Provider.
* **Patient Payment**
* Store any payments received from the patient for the encounter (i.e. Copay, Deductible, Coinsurance, etc).
* Ordering Provider details\*
* **State**\*
* Store the state the Ordering Provider is located in.
* **Ordering Provider**\*
* Store the name of the Ordering Provider.
* **Rendering Provider**
* Store the name of the Provider that rendered the services on the bill.
* If left blank, Elation Note populates this field using the following priority: the provider assigned to the visit note, then the note signer if no provider is assigned, then the patient's primary provider if neither is present. To control the Rendering Provider directly, assign the correct clinician to the visit note.
* This population only happens once, at the time the field is first set. If the assigned provider or note signer changes afterward, the Rendering Provider field does not automatically update to match. Manually update the Rendering Provider on the bill any time the intended provider changes.
* **Supervising Provider**\*
* Select the name of the Supervising Provider.
* **Prior Authorization**\*
* Store the Prior Authorization # for services rendered
* **Mark as incident-to billing**\*
* **Billing Provider**\*
* Select the name of the Provider that the services should be billed under.
* Add any additional billing notes needed in the **Additional billing notes** field at the bottom of the Billing Form.
* Customers using the [Patient Invoicing](/articles/patient-invoicing) feature may need to use the following fields when generating a patient invoice:
* **Amt (\$)**
* Store the amount you want to charge a patient for the procedure rendered.
* You can use the minus (-) sign to enter a negative amount (such as a discount) if needed.
* **Qty**
* Store the quantity of the procedure you are charging for.
* **Subtotal (\$)**
* The subtotal is automatically calculated by multiplying the **Amt (\$)** and **Qty** fields.
![Billing Form Details section showing Service Location "Elation South," Place of Service "11 - Office," Patient Payment "$20," Prior Authorization "PA561691618," Supervising and Billing Provider "Stuart Price, MD," and "Mark as incident-to encounter" checkbox checked.]()
All fields with an asterisk (\*) above can be made available to you in the [Billing Settings](/articles/billing-settings---service-locations--procedure-codes) . For [Elation Billing](/articles/Elation-Billing-All-in-One) customers, data stored in enabled fields will also push to Elation Billing when you push the bill over.
For customers using the [Puredi integration](/articles/Elation-Puredi-Integration-Guide), data stored in enabled fields will also push to Puredi when you push the bill over, with the exception of the **Ordering Provider** fields.
\*\*These fields do not sync with other integrated PMS at this time.
### Adding Procedure and Diagnosis codes
Certain automated coding features will automatically add CPT codes or ICD-10 codes to the Billing Form:
* Selecting from your [personal CPT/HCPCS Code database](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) in the [Visit Note Procedures field](/articles/documenting-procedures)
* Selecting from the ICD-10 database from the [Visit Note Assessments field](/articles/visit-note-assessments)
📖 **Elation Billing Users**
[Click here to learn more about automating bill creation with AI Billing](/articles/AI-Billing-Introduction) .
You can also manually enter codes by following these instructions:
Click in the **Procedure** field to type any CPT or HCPCS code you want to document.
If you have any CPT/HCPCS codes you commonly use, store it in your [Popular CPT Codes Settings](/articles/billing-settings---service-locations--procedure-codes#Where%20do%20I%20find%20the%20Popular%20Procedure%20Codes%20list?) to create a personalized database. CPT/HCPCS codes in your personal database can be found by:
* Typing in the CPT/HCPCS code
* Typing in the description text of the procedure code you are looking for
* Scrolling through the list Elation automatically shows you, which includes your practice’s popular CPT/HCPCS codes
Placing your cursor over the code will show you the code description if one is available.
![Billing Form procedure field dropdown showing popular CPT codes including 99395, 99214, 90471, 99215, 99396, 99397, and Q0091 for selection.]()
For non-insurance bills, instead of typing in CPT/HCPCS codes you can also free-text any service you want to bill for (ex. **Records Copy**) in the **Procedure** field. The **Procedure** field can hold up to 20 characters.
Click in the **Modifiers** field to type in any modifier code, as needed.
Click the **+ Add Dx** button or type in a blank **Dx** field to search for the diagnosis code you want to document and select the appropriate code from Elation’s Diagnosis Code database. You can search by:
* Typing in the description of the diagnosis
* Typing in the ICD-10 code
The diagnosis codes from the patient’s Problem List will also appear automatically for selection. You can also search by ICD-9 code but only the ICD-10 code will appear in the Billing Form.
Click the **+ Add Billing Item** button to add additional billing lines.
Click one of the **Save** options to save your edits.
#### Exporting diagnosis codes to a Visit Note
You can also add ICD-10 codes to your Billing Form by exporting the problems from the patient’s Problem List in the Clinical Profile. You can either export all of the problems to a visit note, or select individual problems to export, by clicking **Actions** and selecting one of the **Export to Note** options that exports to Billing.
![Problem List Actions menu expanded, showing export options including "Export All Crosswalked (HPI, A, Billing)" highlighted, with an arrow pointing to it. Patient has Hypertension and Diabetes in Problem List.]()
If your Problem List contains deprecated, non-billable diagnosis codes, you will be unable to export those codes to the Billing section of a visit note. Please follow the instructions in [this Guide](/articles/Managing-deprecated-ICD10-codes) to update the deprecated codes to active codes to optimize usage of the export feature from the Problem List.
### Saving the Billing Form
Use one of the **Save** options at the bottom of the Billing Form to save any data entered in the Billing Form.
* If you click **Discard**, any edits made will be discarded.
A Billing Guidance feature is also available to help your practice ensure you are not missing billing information when signing visit notes. When turned on, this feature is designed to trigger a reminder at visit note sign-off to review your bill for missing procedure or diagnosis codes. [Learn more about the Billing Guidance feature here.](/articles/billing-settings---service-locations--procedure-codes#coding_guidance)
## Using an integrated PMS with Elation
Only certain fields in the Billing Form sync with each integrated Practice Management System (PMS). Consult the User Guide for your integration PMS for detailed information on which fields sync to your integrated PMS.
## Coding Tips
### Copying billing items
To expedite your code entry workflow, use the ![Duplicate billing line button icon used to copy all procedure and diagnosis codes from one billing line to a new line]()
(duplicate button) to the right of a billing line to create a copy of all the procedure and diagnosis codes from that billing line to a new billing line. This makes it easy for you to code for multiple procedures that have similar supporting diagnosis codes.
### Deleting billing items
Click the ![Red trash/delete icon used to delete an entire billing line including all procedure codes, diagnosis codes, and modifiers]()
(delete button) to the right of the billing line to delete an entire line of billing entry (including all the procedure codes, diagnosis codes and modifiers you have entered).
### Automated Coding
Learn more about automatic coding options in the following [Automatic Coding Guide](/articles/elation-coding-automation).
## Frequently Asked Questions (FAQ)
### Can I edit my billing information at any time?
Yes! To edit the billing information before a visit note is signed off, simply click **Edit Billing** where the billing information you've entered is displayed at the bottom of the visit note.
Once a visit note is signed by a Provider Level User, only the Provider Level User that signed the visit note or their [billing delegate](/articles/staff-permissions--staff-delegates#bills_view) can edit the billing information tied to the visit note. To edit billing information for a visit note after that visit note is signed, find the visit note in the chronological record in the patient's chart and click **Actions** --> **Edit Bill**.
For customers using a Practice Management System (PMS) integration with Elation, edits to the billing information will not be pushed to the PMS. You must edit the bill/claim directly in your PMS if changes are needed.
### Can the bill show both ICD-9 and ICD-10 codes for Dx?
Elation will automatically show both the ICD-9 and ICD-10 in the diagnosis database every time you search for a diagnosis code. You can also search by both ICD-9 and ICD-10 codes. Only the ICD-10 code will display in the Billing Form and only the ICD-10 code is sent to an integrated PMS.
### Can I add charges to the Billing Form?
Turn on Patient Invoicing to print patient invoices after entering charges in the **Amt (**$)**, **Qty** and **Subtotal ($**)** fields of the Billing Form. [Learn more about Patient Invoicing here](/articles/patient-invoicing).
For customers using a Practice Management System (PMS) integration with Elation, the **Amt (**$)**, **Qty** and **Subtotal ($**)** fields do not sync with any PMS.
## Next Step
**Start coding for your visits today!**
## Related Articles
* [Billing Home Guide- A dashboard for managing your bills](/articles/Billing-Home)
* [Billing Guide- Navigating Billing Settings](/articles/billing-settings---service-locations--procedure-codes)
* [Billing Guide- Patient Invoicing- Generating invoices to patients for services rendered](/articles/patient-invoicing)
* [Billing Guide- Frequently Asked Questions](/articles/Billing-Guide-Frequently-Asked-Questions)
* [AI Billing Introduction](/articles/AI-Billing-Introduction)
* [Visit Note Documentation Guide- Procedures](/articles/documenting-procedures)
* [Visit Note Documentation Guide- Assessments](/articles/visit-note-assessments)
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Insurance Card Image Upload Guide](/articles/Insurance-Card-Image-Upload-Guide)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
* [Elation Billing- Using Elation's all-in-one billing solution to manage your claims](/articles/Elation-Billing-All-in-One)
# Billing Guide- Navigating Billing Settings
Source: https://help.elationhealth.com/articles/billing-settings---service-locations--procedure-codes
In Billing Settings, you can enable automatic coding and billing guidance, enable or disable patient invoicing, set up delayed billing, and create fee schedules to ease the entry of billing information on your visit notes.
## Billing Settings Overview
If your practice uses **Elation Billing** , charges set in the EHR take precedence over the Elation Billing fee schedule. An Elation Billing fee schedule only fills a charge on a claim line that is still empty. See [Add/Update a Fee Schedule](/articles/add-update-a-fee-schedule#fee-schedule-precedence-order) for the full precedence order.
To view your Billing Settings, go to **Settings** > **Billing**. The Billing Settings allows you to do the following for your practice:
1. set automatic coding preferences
2. turn on Elation's [Patient Invoicing](/articles/patient-invoicing) feature
3. turn on reminders to code your visits
4. manage your practice's fee schedules
5. enable additional billing fields
6. turn on special settings for Practice Management System (PMS) Integration users
### How to use Automatic Coding
Elation's coding automation is designed to help you get credit in quality programs for the documentation already present in your visit note by automatically adding CPT and/or ICD-10 codes to the billing information section of your visit notes based on certain information you enter or certain actions you take. Currently this feature applies to body mass index assessments (BMI), blood pressure (BP), and negative PHQ-9 depression screening results. For more information on this feature, please reference [Elation Coding Automation for BMI, Blood Pressure, and negative PHQ-9 screen results](/articles/elation-coding-automation) .
### How to turn on Patient Invoicing
Patient Invoicing is a practice-wide setting that can be turned on or off inside Billing settings. Patient Invoicing can allow you to assign charges to procedures and generate invoices for patients from your bills. For more information on updating these settings and understanding this functionality please [click here](/articles/patient-invoicing).
You can create your own custom code to use as a Popular CPT Code to charge patients for services that do not have standard CPT Codes when using [Patient Invoicing](/articles/patient-invoicing) . Here are some common use cases: You can create a code called **FORMS** and associate a charge of \$10 for completing medical paperwork.
You can create a code called **RCOPY** and associate a charge of \$25 for a copy of their medical records.
You can create a code called **VMB12** and associate a charge of \$35 for Vitamin B12 injections.
### How to enable Billing Guidance
Billing Guidance is available to help your practice ensure you have entered all appropriate Procedure Codes and Diagnosis Codes in the [Billing Form](/articles/billing) when signing visit notes. This feature is designed to trigger a reminder at visit note sign-off if any Procedure Codes, Diagnosis Codes, or a service location are missing. Billing Guidance works for both legacy visit notes and [Elation Note](/articles/Elation-Note). To enable this feature
1. Go **Billing Settings** --> **Billing Guidance**
2. Click the button on the right hand side to toggle the feature on (green)
3. Select which type of reminder you wish to use from the dropdown for each rule
![Billing Guidance settings with the feature toggled on, and the "One or more lines have no procedure code" rule dropdown expanded showing None, Warning, and Prevent sign-off options.]()
The three options for Billing Guidance reminders are as follows:
* *None* = You would not see any reminders for that rule
* *Warning* = You will see a reminder that suggests adding additional billing information prior to signing your visit note. You can then continue by clicking
1. **Add Billing Information** to add additional codes
2. **Sign Anyway** to sign the visit note without adding additional codes
* *Prevent sign-off* = You will see a reminder that blocks you from signing your visit note until you add additional billing information. You can then continue by clicking
1. **Add Billing Information** to add additional codes
2. **Cancel** to return to your visit note draft
**Reminder as a suggestion (warning) at sign-off:** ![Warning dialog titled "Sign without billing information?" showing missing procedure codes error, with "Add Billing Information" and "Sign Anyway" buttons.]()
**Reminder as a blocker, prevents sign-off:** !["Billing information needed before sign-off" dialog blocking visit note sign with message that no procedure or diagnosis codes exist, showing "Add Billing Information" and "Cancel" buttons.]()
### How to add Place of Service for billing
When billing for a visit, you can specify a practice/service location and corresponding Place of Service (POS) code in your Practice Locations Settings page.
1. Go to **Settings** > **Practice Locations**
2. Click **+ Add Practice Location** to add a new place of service or click **Edit** to edit an existing location
3. In the edit window, click on the **POS code** box to select the Place of Service code that corresponds to your practice location.
4. Click **Save**
For more details see: [Practice Locations Guide- Listing your service locations](/articles/adding-a-second-practice-location)
### How to manage Popular CPT (Procedure) Codes
If your Billing Settings has a **Fee Schedules** section, **Fee Schedules** has replaced **Popular CPT Codes** settings. Your practice's existing Popular CPT codes and their charges appear in the **Custom Rates** table of your Default fee schedule, where you manage them from now on. See [Fee Schedules Guide — Setting charges in the EHR](/articles/fee-schedules-in-the-ehr).
The list of CPT (procedure) codes that appears in the billing window is stored under Billing settings. Each practice can freely add, edit, or remove codes from the list or change the order in which they appear.
The steps in this section apply to practices whose Billing Settings does not yet have a **Fee Schedules** section. If you have **Fee Schedules**, add and edit these codes and their charges as custom rates on your Default fee schedule instead — see [Managing custom rates](/articles/fee-schedules-in-the-ehr#managing-custom-rates).
Under Billing Settings, scroll down to the section called Popular CPT® codes. Click **+Add CPT codes** to add additional codes, **edit** to make changes to existing CPT codes, **Delete** to delete codes, or drag and drop codes to re-order them.
Reordering is only available in the Popular CPT Codes list. **Fee Schedules** has no equivalent control, so practices using Fee Schedules cannot change the order codes appear in.
The list is paginated. Use the search field above the list to find a code by code, modifier, or description.
Because the list is paginated, browser search (Ctrl+F or Cmd+F) only finds codes on the page you are currently viewing. Use the search field to search your whole list.
![Popular CPT Codes settings as they appear before the Fee Schedules update, showing Edit/Delete buttons per code and a drag handle to reorder codes, with the "+ Add CPT Code" button highlighted at the bottom.]()
You can store codes with up to 8 characters.
Cater the description to one that you can easily remember. This will make it easier for your to find CPT Codes when entering billing information in our visit notes.
If you already have a patient chart open in another tab while you make changes to your Procedure list in Settings you will need to refresh that patient chart in order to view the changes.
#### 'Charge' field
If you have patient invoicing turned on, you can add default charges to each Procedure code in your list in Billing settings. Simply click **edit** and enter the charge amount. When you add a Procedure code with a default charge to your bill, the **Charge** field will automatically fill with the default charge value. Charges will then print on invoices when you generate an invoice for a patient.
![Popular CPT Codes list with CPT 99214 "moderate complexity office visit" being edited, with the Charge (dollars) field active and empty, ready for input.]()
### How to enable additional billing fields
You can enable additional billing fields and synchronize these fields; some of which will come in handy for customers who bill incident-to encounters. The fields include Supervising Provider, Billing Provider, Ordering Provider and Prior Authorization. To enable any of these fields:
1. Scroll down to the Billing Fields section
2. Click on the toggle to configure the fields you want to include on your bills - green is ON (enabled) and gray is OFF (disabled)
* **Supervising Provider**
* This field is for the Rendering Provider to store the name of their Supervising Provider if required by their State regulations.
*
Each Provider Level User can select a default Supervising Provider under [User Settings](/articles/User-Accounts-Guide-Provider-User#provider-level-account-details) .
* **Billing Provider**
* This field is used to store the name of the Provider that the claim is to be billed under and is commonly used for incident-to billing.
* **Ordering Provider**
* This field is used when services provided require a referral or order from another healthcare provider such as diagnostic imaging, laboratory tests, specialist consultations, and certain medical procedures. This is not a common field for Primary Care.
* **Prior Authorization**
* This field is used to store the Prior Authorization number, if required, for any services rendered on the bill.
3. Once a field is enabled, it will appear at the top of the bill in your EHR visit notes
![Billing Fields settings panel with all four toggles—Supervising Provider, Billing Provider, Ordering Provider, and Prior Authorization—enabled (gray/off position).]()
For [Elation Billing](/articles/Elation-Billing-All-in-One) customers, data stored in enabled fields will also push to Elation Billing when you push the bill over.
For customers using the [Puredi integration](/articles/Elation-Puredi-Integration-Guide), data stored in enabled fields will also push to Puredi when you push the bill over.
\*\*These fields do not sync with other integrated PMS at this time.
### Practice Management System (PMS) Integration Users Only
The following Settings will only be available (and visible) for certain Practice Management System (PMS) Integration Users.
Always consult your Practice Management System (PMS) user manual for the full details around how bills are synchronized between Elation and your integrated PMS.
#### How to turn on Delayed Billing
Delayed Billing is a special setting for customers who are utilizing certain Practice Management System (PMS) integrations with Elation. [Learn more about the Delayed Billing feature here](/articles/How-to-set-up-Delayed-Billing) .
#### How to send bills to your PMS in bulk
There are three ways to send bills from Billing Home to your integrated PMS:
1. **Send individual bills** — In the **Actions Menu** next to each bill, click **Send to PMS** or **Resend to PMS** to send or resend a single bill.
2. **Bulk Send Bills to PMS button** — The **Billing Home - Bulk Send to PMS** setting controls the **Bulk Send Bills to PMS** button in [Billing Home](/articles/Billing-Home). When toggled on, this button allows you to bulk send all bills of a specific status or all selected bills to your integrated PMS. When toggled off, the button will not be available. Note that bulk send actions impact ALL bills in the respective status you select.
* You have 3 options that you can configure for the **Bulk Send Bills to PMS** button:
* Enable option to bulk send **Signed** bills
* This Setting requires the **Delayed Bills** setting to also be enabled in your Billing Settings. A **Send all Signed** action will be available under **Bulk Send Bills to PMS** to allow you to send all bills in the **Signed** status to your integrated PMS.
* Enable option to bulk resend **Failed to Send** bills
* A **Resend all Failed to send** action will be available under **Bulk Send Bills to PMS** to allow you to send all bills in the **Failed to Send** status to your integrated PMS.
* Enable option to bulk resend **Sent to PMS** bills
* A **Resend all Sent to PMS** action will be available under **Bulk Send Bills to PMS** to allow you to send all bills in the **Sent to PMS** status to your integrated PMS.
Use the multi-select option when you want to send specific bills to the PMS regardless of their status. Use the other send buttons when you want to send all bills of a particular status at once.
![Billing Home – Bulk Send to PMS settings panel with the main toggle enabled (green) and all three sub-options—Signed, Failed to Send, and Sent to PMS bills—toggled off (gray).]()
### How to enable the "Send to PMS" button in the Visit Note draft
Certain PMS Integrations will allow you to send your bill to the PMS prior to signing the visit note. This feature is controlled by the **Sent to PMS from Visit Note** Setting. When toggled on, a **Send to PMS** button will appear in your visit note drafts and clicking on the button will immediately send the billing information entered over to your integrated PMS. When toggled off, the **Send to PMS** button will not be visit note in your visit note draft and the action of signing the Visit Note will push the billing information entered over to your integrated PMS (unless you have [Delayed Billing](#DelayedBilling) turned on).
## Related Articles
* [Fee Schedules Guide- Setting charges in the EHR](/articles/fee-schedules-in-the-ehr)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Billing Home Guide- A dashboard for managing your bills](/articles/Billing-Home)
* [Billing Guide- Patient Invoicing- Generating invoices to patients for services rendered](/articles/patient-invoicing)
* [Billing Guide- Frequently Asked Questions](/articles/Billing-Guide-Frequently-Asked-Questions)
* [Billing Guide- Delayed Billing](/articles/How-to-set-up-Delayed-Billing)
* [Visit Note Documentation Guide- Procedures](/articles/documenting-procedures)
* [Visit Note Documentation Guide- Assessments](/articles/visit-note-assessments)
* [Patient Demographics Guide- Managing patient insurance](/articles/Managing-Insurance)
* [Elation Coding Automation for BMI, Blood Pressure, and negative PHQ-9 screen results](/articles/elation-coding-automation)
* [Add/Update a Fee Schedule (Elation Billing)](/articles/add-update-a-fee-schedule)
*\*CPT copyright 1995 - 2022 American Medical Association. All rights reserved.*
# Calendar Guide - How to set up the provider calendar
Source: https://help.elationhealth.com/articles/calendar-and-booking-settings
This article provides a quick guide on how providers can set up their calendar to manage patient appointments in their Elation EHR.
📖
**RECOMMENDED READING**
This article provides a quick guide on how providers can set up their calendar to manage patient appointments in their Elation EHR. If you plan to use the Booking Site feature with Elation, we recommend reading the
[Patient Booking Site Guide](/articles/Patient-Booking-Site)
first.
## Overview
### Understanding Scheduling Privileges for Providers and Staff
Before setting up your calendar, it's helpful to understand how scheduling-related privileges differ between Provider Level Users and Staff Level Users.
#### Calendar ownership and default views
* Only Provider Level Users have their own Calendar in Elation. The exception is a resource or team calendar, a non-provider scheduling calendar that Elation Support can set up for a practice to book patients on a role or resource rather than a specific provider.
* If you are a Provider Level User, the Calendar will always default to showing your own Calendar.
* If you are a Staff Level User in a multi-provider practice, the Calendar will default to showing the Calendar for the provider you set as your **Default physician** under **Settings** >> **User Settings**. If you have not set a Default physician, the Calendar will default to the first provider alphabetically by first name.
* If the practice has only one Provider Level User, the Calendar will always default to showing that provider's Calendar for all users.
* If your practice uses Workspaces, you may not see certain provider calendars depending on your Workspace configuration. See the [Workspaces and scheduling visibility](#Workspaces_Scheduling) section below for details.
#### Telehealth visit privileges
* Regular Providers, Non-Prescribing Providers, and Limited Use Providers can activate and use the telehealth [Zoom](/articles/Elation-Telehealth-powered-by-Zoom) feature.
* On Call Providers cannot activate the telehealth [Zoom](/articles/Elation-Telehealth-powered-by-Zoom) feature themselves, but they can start virtual visits from a Regular or Non-Prescribing Provider's calendar.
* Staff Level Users can start virtual visits from a Regular or Non-Prescribing Provider's calendar but cannot activate the telehealth feature independently.
### Premium EHR considerations
[Premium EHR Users](/articles/Premium-EHR-Features-Guide) should review the sections below for more details about our specific features interact with appointments and their Calendars.
#### How chart access controls affect appointment access
Your practice may use chart access controls that affect what users can do when viewing appointments.
* **Viewing appointments vs. opening charts:** Staff members can view appointment times and details on the Calendar. However, if chart access restrictions are in place (such as VIP Charts or Patient Cohorts), they may not be able to open certain patient charts even if they can see the scheduled appointment. If your practice uses Workspaces, users may also be unable to see certain provider calendars. See the [Workspaces and scheduling visibility](#Workspaces_Scheduling) section below for more information.
* **VIP Charts:** When a chart is marked as VIP, only the Provider assigned in practice can access it without restriction. Other users may see a warning or be blocked entirely, even if you can see their appointment on the Calendar.
* **Patient Cohorts:** Patient Cohorts allow practices to automatically restrict chart access based on patient criteria. If a patient is assigned to a cohort and you are not a member of that cohort, you may be unable to open the patient's chart even if you can see their appointment on the Calendar.
* **Block All Chart Access:** Admin Level Users can revoke a user's access to all patient charts. Users without chart access will see an **Unauthorized access** page when attempting to open any patient chart, but they will still be able to see the appointment on the Calendar.
For more information, see the [User Accounts Guide- Chart access permission control options](/articles/User-Accounts-Guide-Chart-access-permission-options) article.
#### Workspaces and scheduling visibility
If your practice uses the Workspaces feature, scheduling visibility may vary based on your Workspace configuration.
##### People List and Calendar visibility
* The **People List** resource in Workspaces controls which Provider Level Users appear for selection when viewing Provider Calendars and scheduling appointments.
* By default, all Provider Level Users appear in the Calendar and appointments unless a specific User Group is selected in the People List settings.
* Providers will always have access to their own Calendars, regardless of Workspace settings.
##### Time zone display
* If you are using Workspaces, the availability displayed on your Calendar will reflect the time zone configured for your Workspace.
##### Switching between Workspaces to see related Calendars
* If you belong to multiple Workspaces, you can switch between them to see the related Calendars by clicking the Workspace dropdown next to your email in the blue navigation bar at the top of Elation.
* Admin Level Users can use the **Return to practice view** option to see all resources within the EHR regardless of Workspace membership.
Non-Admin User View
![]()
Admin User View
![]()
For more details, see the [Workspaces Introduction](/articles/workspaces-guide) article.
## Workflow Instructions
### Accessing the Calendar Settings
The Elation Calendar settings is in **Settings** >> **Calendar & Booking**. The main calendar related sections here are **Appointments**, **Calendar view**, **Reminders**, and **Rooms**.
### Managing Appointment Types
Appointment types are the different appointment options you can utilize in the Elation Calendar. By default, Elation will load the following Appointment Types to new Elation accounts to start you off:
* Follow-Up
* Office Visit
* Physical Exam
* Walk-in
* New Patient
* Procedure
#### Creating a new appointment type
| **1** | Navigate to **Settings**. |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Click **Calendar and Booking** in the Settings options. |
| **3** | Click **Add Appointment Type**. |
| **4** | Fill out all of the sections as described in the images below. ![Edit appointment type panel for "Annual Wellness Exam" showing three highlighted sections: Name (45 min, Annual tag), Place (In person selected), and Auto-created visit note (Complete H&P Note format, Annual Physical Exam Visit Note category, Physical Exam template).]()
![Edit appointment type panel showing Forms section with Follow-Up Medical History Form and PHQ-2 and PHQ-9 linked, set to send 2 days before appointment, and Booking site section with "Show this appointment type on the booking site" checked and three providers selected.]()
|
| **5** | Click **Save**. |
| **6** | Reload your Practice Home to allow your updates to display. |
Learn more about the [auto-created visit note feature here](/articles/visit-note-automation).
You can add multiple visit note templates to a single appointment type. This means that, for telehealth visits, you only need to have one "Telehealth" visit note template that can be layered on top of any other visit note template relevant to the appointment type (e.g. Annual Wellness for Women).
#### Editing an existing appointment type
| **1** | Click **Edit** on the appointment type that you wish to edit. |
| ----- | ------------------------------------------------------------- |
| **2** | Enter the changes to the appointment type. |
| **3** | Click **Save**. |
| **4** | Reload your Practice Home to allow your updates to display. |
#### Removing an existing appointment type
| **1** | Click **Delete** on the appointment type you wish to remove. |
| ----- | ------------------------------------------------------------ |
| **2** | Reload your Practice Home to allow your updates to display. |
If there are any past or currently scheduled appointments that are assigned the type that you remove, those appointments will continue to keep that appointment type. Removing an appointment type means that you will no longer be able to create new appointments with that type.
#### Sorting appointment types
Click and drag the handle ![Drag handle icon used to reorder appointment types in the Calendar & Booking settings]()
on the left hand side of the appointment type to re-order it. The order of your appointment types in Settings will be reflected in the **Appointment type** drop-down menu in the **Create an Event** window in the Elation calendar.
![Create an Event dialog showing the Appointment type dropdown expanded, with options including Office Visit (highlighted), Follow-Up, Telemedicine, Annual Wellness Exam, New Patient, High Priority, Procedure, Walk-in, Wellness Visit, Friday Block, and Long Block.]()
### Managing the Calendar View
To edit the way your calendar displays information, go to the **Calendar view** tab under the **Calendar & Booking** settings page.
* **Time block intervals for calendar:** Set the duration of the time block intervals shown on the internal Elation Calendar for everyone in your practice. For example, if you set the block interval at 15 minutes, the scheduler will display times throughout the day in 15-minute increments. Options are 5, 10, 15, 20, 25, 30, 45, and 60 minutes.
* **Time block intervals for booking site:** Set the interval between the appointment start times patients can pick on your Booking Site. Options are 5, 10, 15, 20, 25, 30, 45, and 60 minutes. This setting is independent of **Time block intervals for calendar**, so your internal calendar and your Booking Site can use different intervals. If this dropdown is left unset, the Booking Site falls back to the calendar interval.
* **Hide the durations under the patients name on appointments and on events:** If you wish to hide durations that show up on appointment and events, move the toggle to appear green.
* **Show Canceled Appointments:** If you wish to see canceled appointments in the calendar, move the toggle to appear green.
The start times patients see on the Booking Site are counted forward from the start of each provider's availability block, not from the top of the hour. For a 20-minute Booking Site interval, an availability block that begins at 9:00 AM produces 9:00 / 9:20 / 9:40 start times, while a block that begins at 8:45 AM produces 8:45 / 9:05 / 9:25. If you want start times to land on specific minute marks (for example :00 / :20 / :40), set each provider's availability block to begin on the hour under **Settings** → **Calendar & Booking** → **Availability**.
![Calendar view showing three annotated settings: appointments displayed in 15-minute intervals, a Lunch block with hidden duration toggle option, and a canceled appointment for A.T. Patient highlighted in red.]()
If there is only one provider in the practice, the Calendar will always default to showing that provider's Calendar.
If you are provider viewing the Calendar in a multi-provider practice, the Calendar will always default to showing your Calendar.
If you are a staff viewing the Calendar in a multi-provider practice, the Calendar will default to showing the Calendar for the provider you set as your **Default physician** under **Settings** -> **User Settings**.
### Managing Exam Rooms
To add, edit, and delete exam room names that you can use from the Elation Calendar, go to the **Rooms** section in the **Calendar & Booking** settings page. You will be able to select from your list of exam rooms after you select one of the **In Room** options for the appointment's status.
#### Creating a new exam room
| **1** | Click **+ Add room**. |
| ----- | ----------------------- |
| **2** | Fill out the room name. |
| **3** | Click **Save**. |
#### Editing an existing exam room
| **1** | Click **Edit** on the room that you wish to edit. |
| ----- | ------------------------------------------------- |
| **2** | Change the room name. |
| **3** | Click **Save**. |
#### Removing an existing exam room
Click **Delete** on the room that you wish to remove.
### Using automated Appointment Reminders
Your practice can choose to send up to 3 appointment reminders to patients ahead of a scheduled patient visit. Elation's automated appointment reminders help ensure that your patients have the information they need to attend their visit and will decrease the number of no shows on your schedule.
Our system uses the following logic to determine which notification to send:
1. Preferred contact method. If not, then:
2. SMS Text to the mobile phone number. If not, then:
3. Email notification to the email address. If not, then:
4. Phone call to a home or main phone number.
Appointment reminder notifications cannot be sent to work, night, fax or other phone numbers.
To turn on appointment reminders, go to the **Reminders** tab and follow the instructions in the [Automated Appointment Reminders](/articles/appointment-reminders) article.
## Frequently Asked Questions
### Can I add additional time block intervals to the settings?
The available options for both time block interval dropdowns are 5, 10, 15, 20, 25, 30, 45, and 60 minutes. You cannot add other values. If you need a specific interval such as 20 minutes on your Booking Site while keeping a different interval on your internal calendar, use the two separate dropdowns under **Settings** → **Calendar & Booking** → **Calendar view**: **Time block intervals for calendar** controls the internal calendar grid, and **Time block intervals for booking site** controls the start times patients see on the Booking Site.
### Can I add additional colors for appointment types?
The appointment type color options cannot be adjusted at this time. Elation will notify you if this changes in the future.
### Can a non-clinical staff role that doesn't have an NPI get its own bookable calendar?
A Staff Level account can't have its own Calendar, since Provider Level accounts are the only account type with a dedicated Calendar. If you need a bookable calendar for a role that doesn't have an NPI, such as an aesthetician, ask Elation Support to set up a resource or team calendar. This is a non-provider scheduling calendar that patients can book appointments on, separate from any individual provider's Calendar.
### My schedule dropdown shows a custom group (like a care team or specialty group) in addition to "All Providers." How do I add or remove a provider from it?
Those are [User Groups](/articles/user-groups), which Practice Admins can manage themselves. Go to **Settings** → **User Groups**, click **Edit** next to the relevant group to add or remove providers. The updated group is reflected in the schedule dropdown on save.
**Next Step**
Review the [Elation Integrated Video feature](/articles/Elation-Telehealth-powered-by-Zoom) to see if you want to utilize it for your patients.
## Related Articles
* [How to use Elation Calendar](/articles/how-to-use-elation-calendar)
* [Patient Booking Site Guide](/articles/Patient-Booking-Site)
* [Automated Appointment Reminders](/articles/appointment-reminders)
* [Introduction to Google Calendar Sync](/articles/introduction-to-google-calendar-sync)
* [Elation Integrated Video- Connecting with patients using video](/articles/Elation-Telehealth-powered-by-Zoom)
* [User Accounts Guide- Chart access permission control options (Premium)](/articles/User-Accounts-Guide-Chart-access-permission-options)
* [Workspaces Introduction (Premium)](/articles/workspaces-guide)
# Change Healthcare Outage - Information and Resources
Source: https://help.elationhealth.com/articles/change-healthcare-outage-information-and-resources
Information about the February 2024 Change Healthcare outage and its impact on Elation Billing
This article provides information about the Change Healthcare outage that began on February 22, 2024, and its impact on Elation Billing users.
## Overview
On February 22, 2024, we learned that Change Healthcare, a vendor used widely in the healthcare industry for processing claims, retrieving insurance eligibility details, and sending ERA, experienced an outage due to a cybersecurity incident.
## Affected Services
### List of Payers Affected
Electronic transmission to-and-from 626 payers available within Elation Billing were disrupted by this outage. See the [List of Affected Payers](#list-of-affected-payers) section at the bottom of this article for the full list.
### Services Interrupted
For payers associated with Change Healthcare, the following services were interrupted:
* **Claims Transmission** - Claims can still be sent from Elation Billing. ClaimMD holds claims for affected payers and transmits them once Change gives the all-clear
* **ERA Transmission and Retrieval** - Electronic Remittance Advice was disrupted
* **Real Time Eligibility (RTE)** - Eligibility checks were unavailable
### Non-Change Payers
Services offered by payers NOT associated with Change Healthcare remained intact. If you experience problems with a payer's service in Elation Billing, please contact Support.
## Other Resources
### Elation EHR Status
For real-time updates on the Elation EHR, please refer to [Elation.Status.io](https://Elation.Status.io)
### Change Healthcare Status
For real-time updates from Change Healthcare, please refer to [Change Healthcare Status](https://status.changehealthcare.com/incidents/hqpjz25fn3n7)
## Message Log
Below is a log of all messaging sent out in Elation Billing regarding this outage. The most recent messaging is at the top.
***
### February 28, 2024 - 9:15 AM PST
Update regarding new resources and ClaimMD status on alternative payer connections.
#### ClaimMD Update
ClaimMD actively engaged with affected payers to identify alternative methods for processing data. Several payers made additional connectivity options available, and claims that were previously on hold began processing again.
For those wishing to submit paper claims to payers that do not offer an alternative electronic submission method, use ClaimMD's paper claim printing service. Change your payer ID to **PAPER** and include the payer's mailing address. ClaimMD will print and mail the claims for a small fee.
***
### February 22, 2024 - 1:29 PM PST
Initial notification of service disruption affecting:
* Real-Time Eligibility (RTE) lookups
* Submission of claims to certain payers
* Electronic prescription (eRx) transmissions
Our Security Team confirmed that Elation Health's systems remain secure with no risk of impact from this external incident.
***
### February 22, 2024 - 7:34 AM PST
Initial alert that Claims Submission and Real Time Eligibility lookup service for certain payers was temporarily unavailable due to a vendor service outage.
***
## List of Affected Payers
These payers' Claims Submission, ERA, and Real Time Eligibility were disrupted by this outage.
Claims can still be sent from Elation Billing to all payers. ClaimMD holds claims for affected payers and transmits them once Change gives the all-clear.
For the complete list of 626 affected payers, please contact Elation Billing Support or refer to [ClaimMD's external payer list](https://www.claim.md/payer_list.html).
## Related Articles
* [Enrolling for Claims Submission, ERA, and Real-Time Eligibility](/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
# User Accounts Guide- Changing your password
Source: https://help.elationhealth.com/articles/changing-your-password
This article with guide you on the various ways you can update your Elation account password.
## Changing your password from the Login Page
1. Go to [https://app.elationemr.com/login/](https://app.elationemr.com/login/) (Elation Login Page)
2. Click the **Forgot Password?** button below the **Log In** button
![Elation login page with the "Forgot password?" button highlighted, located below the Log In button in the Provider & Staff Login form.]()
1. Enter your Elation login email address & click **Submit Request**
*
You must have access to the email address you use for your Elation account in order to reset your password. If you do not have access to this email address, [click here to contact the Support Team](https://help.elationemr.com/s/contactsupport) for further assistance.
2. You will receive an email in your email inbox from [support@elationemr.com](mailto:support@elationemr.com) with the subject line **Elation Password Reset.** Click on the link in the email to reset your password.
![Elation Password Reset email from ElationEMR Support with the password reset link highlighted in a red box, prompting the user to click it to reset their password.]()
1. Enter your new password twice & then click **Update Password**
2. Click **Back to Login Page** ([https://app.elationemr.com/login/](https://app.elationemr.com/login/)) to login with your email and new password.
## Changing your password from your Elation account settings
1. Login to your Elation account and click on the **Settings** button that appears beneath your email address.
2. Click on **Account Details** under User Settings
3. Click **Change Password**
![Side-by-side comparison of Account Details pages for a Staff User (Angela Brand) and Provider User (Karly Smith, MD), each with the "Change password" link highlighted in red next to the masked password field.]()
1. First enter your current (old) password, then enter your desired new password twice in the next 2 fields and click on **Update Password**.
![Elation Health Change Your Password page at app.elationemr.com/password/change/ showing fields for Old Password, New Password, Retype Password, and the Update Password button.]()
1. Done! Your password has been updated. You can now log into Elation with your new password moving forward.
## Tips for creating a stronger password
Choosing a password is important to ensure only you have access to your Elation account and the Protected Health Information (PHI) within the account. We have put together a few tips to help you choose a strong password:
1. Pick a password that is not used with your email address on other websites. The most frequent password security lapse results when other websites (especially ones that are not very sensitive to security) are hacked and your password is made public. You do not want this password to be the same as the one you use on Elation.
2. Pick a password that is difficult to guess. This means it should not be something like your practice’s address or phone number or contain your first or last name.
3. Take advantage of numbers, symbols and pass-phrases. Pass-phrases are phrases made of groups of nonsense words and numbers, which you can use as options for creating passwords that may be memorable without being guessable. For example: apple9carpet2zebra!
## Adding extra security to my account
If you would like to add extra security to your Elation account, we recommend exploring Elation's [Single-Sign On feature](/articles/single-sign-on) or [Multi-factor Authentication (MFA) feature.](/articles/Multifactor-Authentication-MFA)
## Frequently Asked Questions (FAQ)
### I did not receive a password reset email. What should I do?
1. Search your email account for an email from [support@elationemr.com](mailto:support@elationemr.com) with the subject line Elation Password Reset; especially the Trash, Spam or Junk folders.
2. Try to reset your password again from this link: [https://app.elationemr.com/password/reset/](https://app.elationemr.com/password/reset/) and see if you receive the password reset email via the second attempt. Make sure you enter the email address associated with your Elation account.
3. If #1 and #2 are unsuccessful, click here to contact the Support Team for further assistance.
### I am unable to access my email inbox to reset my password. What should I do?
You must have access to the email address you use for your Elation account in order to reset your password. If you do not have access to this email address, [click here to contact the Support Team](https://help.elationemr.com/s/contactsupport) for further assistance.
### I received a password reset email but I did not request one. What should I do?
In most cases, this is not a security concern and no action is needed. The Elation password reset form at [https://app.elationemr.com/password/reset/](https://app.elationemr.com/password/reset/) is public so users who cannot log in can request a reset — anyone can enter any email address on that form, which triggers the reset email to the address that was entered. Receiving one of these emails does not mean someone has access to your account or knows your password. If you did not request the reset, you can safely ignore and delete the email; the reset link expires and cannot be used unless it is opened and a new password is set.
Your password only changes if you click the link in the email and complete the reset. As long as you did not do that, your existing password still works and your account remains secure.
Take action only if one of the following is true:
* You are also seeing signs your account was actually accessed — for example, changes to your account, patient charts, or settings that you did not make. In that case, reset your password immediately from [Changing your password from your Elation account settings](#changing-your-password-from-your-elation-account-settings) and [contact the Support Team](https://help.elationhealth.com/s/contactsupport).
* You are receiving a high volume of unrequested reset emails. [Contact the Support Team](https://help.elationhealth.com/s/contactsupport) so they can help investigate.
## Related Articles
* [User Accounts Guide- Using Single-Sign On to access your Elation EHR account](/articles/single-sign-on)
* [User Accounts Guide- Using multi-factor authentication (MFA) to access your Elation EHR account](/articles/Multifactor-Authentication-MFA)
* [User Accounts Guide- Managing Elation accounts for providers and staff](/articles/managing-user-accounts)
# Requiring Action Guide - Reviewing & signing requiring action items from the Practice Home or patient's chart
Source: https://help.elationhealth.com/articles/check-for-your-offices-daily-to-do-list
Requiring Action collects many different types of items—reports, messages, letters, tasks, and more.
## Overview
### What is Requiring Action?
The Requiring Action queue appears at the top of every patient chart and in the Practice Home. It collects all open items assigned to you that require your review or sign-off before they can be moved to the Chronological Record, including failed faxes, failed ePrescriptions, CancelRx items, unread patient letters, provider letters awaiting sign-off, and unfinished notes. Items remain in Requiring Action until the appropriate user takes the required action to clear them.
#### Requiring Action queues in the Practice Home
The Requiring Action queues in your Practice Home centralizes all of the items that require your attention in a single view, and continue to show your pending items even when you switch between linked practices or [workspaces](/articles/workspaces-guide). Queues with items will have a yellow number label and will display the number of items that require your attention within that queue. You can use the queues to:
* Be the **To Do** lists for yourself or another office team member.
* [Send reminders](/articles/post-date-a-message-to-yourself-or-a-colleague) to yourself or another office team member.
* Manage your team and check for productivity by [viewing their queues](#View).
To change who can sign off on items in these queues (for example, granting or revoking staff delegate privileges), an Admin Level User must make those changes in **Settings** → **Admin Managed Delegates** . If you do not see **Admin Managed Delegates** under **Settings** , you are either not an Admin or your practice does not have access to the [Premium EHR](/articles/Premium-EHR-Features-Guide) features. Contact a practice manager with Admin privileges to request changes.
![Office Messages inbox selected in Practice Home, showing 7 messages for Sample D. Patient. First message is signed off; second has a "Sign Off" button visible and a Reply field, indicating it requires action.]()
### What items typically appear in the Requiring Action queue and who can clear them?
Who can clear an item depends on both the item type and the user's account level:
* Provider Level Users can sign off on most clinical items by default.
* Staff Level Users can clear certain items (such as letters and some office messages) and can sign off on others only when a provider has granted them delegate permissions.
* Authorized Delegates are Staff Level Users explicitly configured by a provider to sign on their behalf for specific item types.
If you do not see a Sign Off button on an item, your user type or delegate permissions may not include sign-off access for that item type. See the [Requiring Action & Open Items Queues](/articles/the-requiring-actions-queue-follow-up-on-action-items) article for troubleshooting steps.
#### Quick Reference Table
This table summarizes common requiring action items, where to find them, who can clear them, and how they are resolved.
Requiring Action Item Type
Practice Home Queue
Patient Chart Section
Who Can Clear
Required Action(s)
Optional Action(s)
Lab Result
Reports
Requiring Action
* **Provider Level Users** - Can sign off on electronic lab results, even if they are assigned to a different provider.
* **Staff Level Users** - Can sign off if they have been delegated sign-off permissions by a provider.
* **Provider Level Users** - **Sign Off**.
* **Staff Level Users (with delegation)** - Sign off on behalf of provider.
Click Sign Off & Send to patient or Sign Off & Send to provider to attach the report to a Patient Letter or Provider Letter.
Imaging Report
Reports
Requiring Action
* **Provider Level Users** - Can sign off on imaging reports, even if they are assigned to a different provider.
* **Staff Level Users** - Can sign off if they have been delegated sign-off permissions by a provider.
* **Provider Level Users** - **Sign Off**.
* **Staff Level Users (with delegation)** - Sign off on behalf of provider.
Click Sign Off & Send to patient or Sign Off & Send to provider to attach the report to a Patient Letter or Provider Letter.
Faxed Document
Reports
Requiring Action
If the document was filed with File on behalf of Provider checked, no sign-off is required and the document goes directly to the Chronological Record
* **Provider Level Users** - Can sign off on faxed documents only if they are the assigned provider.
* **Staff Level Users** - Can sign off if they have been delegated sign-off permissions.
* **Provider Level Users** - **Sign Off**.
* **Staff Level Users (with delegation)** - Sign off on behalf of provider.
Office Message
Office Messages
Requiring Action / Outstanding Items
* **Provider Level Users** - Can sign any Office Message thread, even if they are not a recipient.
* Staff Level Users - Can click Mark Complete only if the thread contains no Provider Level Users.
* **Premium EHR users** - May configure Staff Level Users as Office Message Delegates to sign on behalf of providers.
* **Provider Level Users** - **Sign Off**.
* **Staff Level Users (with delegation)** - Sign off.
* **Staff Level Users (when no providers are on the thread)** - **Mark Complete**.
* **Users part of an office message thread that was signed** **by a Provider**- **Acknowledge**.
Refill Request
Rx Requests
Requiring Action
Only providers with active EPCS credentials can address controlled substance refill requests. Rx Delegates cannot approve or renew controlled substance prescriptions.
* **Provider Level Users** - Can address non-controlled substance and controlled substance refill requests.
* **Rx Delegates** - Can only address non-controlled substance refill requests.
**Approve** , **Deny** , or **Renew**
Unsigned Note
Draft Notes
Requiring Action
* **Provider** **Level Users -** Can sign visit notes and other notes (phone/non-visit email).
* **Staff Level Users**- Can sign other notes (phone/non-visit email).
**Sign** or **Sign & Close**
Unsigned Order or Referrals
Draft Orders
Requiring Action
* **Provider** **Level Users -** Can sign orders and referrals.
* **Rx/Orders/Referrals Delegates** - Can sign orders or referrals on behalf of providers.
**Sign** or **Sign & Close**
Unsigned Letter
Draft Letters
Requiring Action
Any user can sign Patient Letters and Provider Letters.
**Sign & Send**
Patient/Provider Letter messages
Patient Letters, Provider Letters
Requiring Action
Provider; Staff Delegate (for Referrals)
**Reply** , **Sign** , or **Acknowledge**
Click **End Conversation** to close the thread.
If you need to configure delegate permissions for staff, an Admin Level User can set up Staff Delegates in the practice settings. See the [Staff Permissions & Staff Delegates Guide](/articles/staff-permissions--staff-delegates) for details.
For more details about what other items can be found in specific inboxes, see the [Checking for items that require your attention in the inboxes section](#inboxes) below.
## Workflow Instructions
### Using quick actions at the top of your Practice Home
![Practice Home toolbar with "Launch first 5 patients" and "Launch first 10 patients" links and "Showing: Newest First" dropdown highlighted, plus a Refresh button.]()
#### Checking for new items in the Practice Home
Click the **Refresh** button to update your queue/inboxes to see if there are any new items you need to address without leaving the Practice Home page.
#### Launching multiple patient charts at once from Practice Home
Open up to 10 patient charts from each inbox at once by clicking **Launch first ... patients**. A new browser tab will open for each patient chart so you can review items that need your attention.
If new tabs do not open, it's most likely due to a **pop-up blocker**. In **Chrome**, click the pop-up blocked icon in the address bar and select **Always allow pop-ups and redirects from app.elationemr.com**. In **Firefox**, click the pop-up blocked notification in the address bar and select **Allow pop-ups for app.elationemr.com**.
#### Setting your Practice Home display order preference
Set your preference on whether you want to see the newest or oldest items first in each inbox by selecting from the **Showing** dropdown. Your preference will be saved as you navigate across the inboxes, and it will be saved each time you open the Practice Home page on the same web browser.
### Specifying inbox/queue options
![Practice Home queue panel with "View Queue For: Self" selected. Draft Notes is highlighted as the active queue. Office Messages and Reports each show 1 pending item; Draft Orders shows 1.]()
#### Changing your inbox/queue view
Check for requiring action items in other office members' queues by clicking the **View Queue For:** dropdown men, finding the member you would like to view queue for and clicking on their name.
You also have the option to view the queue for:
* Everyone
* All Physicians
* All Staff
#### Checking for items that require your attention in the inboxes
This table describes the items that may appear in the various Practice Home inboxes. Certain item types can be addressed from the Practice Home directly while others will require you to click on the patient's name to open the patient's chart to view the requiring action item.
| **Inbox** | **What items will appear here?** | **Additional details** |
| -------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Urgent** | Office messages or patient reports addressed to you AND marked as **Urgent** by a member of your practice. • **Stat** reports addressed to you from interfaced lab or radiology vendors. • Failed electronic prescriptions that you attempted to send. • Failed electronic lab orders that you attempted to send. • Failed faxed Letters/Referrals that you attempted to send, including faxes that have exhausted all automatic retries. | |
| **Office Messages** | Any office messages addressed to you directly or addressed to a [user group](/articles/user-groups) that you are in (for example the **Staff (Group)** which has all the staff members in the practice in it) | Click the **Filter by** dropdown in the **Office Message** inbox to further narrow the inbox by: All messages to Self • Messages addressed to you directly • Messages addressed to any [groups](/articles/user-groups) you are part of [Click here to learn more about the office message feature](/articles/How-to-use-Office-Messages). |
| **Rx Requests** | Electronic prescription refill requests addressed to you. | [Click here for more details about electronic refill requests](/articles/managing-electronic-prescriptions#refill_requests). |
| **Reports** | Patient reports from the **Fax Inbox** or interface that are assigned to you. | Click the **Filter by** dropdown in the **Reports** inbox to further narrow the inbox by the report category. • Click **Re-assign** to reassign the report to another provider or delegate. |
| **Reminders** | Notifications from unopened letters or referral orders you created. | |
| **Patient Letters** | Messages sent to you by patients through Patient Passport. | [Click here for more information about responding to Patient Letters](/articles/Passport--Communicating-with-patients#responding-to-messages-from-patients) . |
| **Provider Letters** | Messages sent to you by other providers through their Elation account or the Provider Portal. | |
| **Draft Notes** | Any unsigned visit notes or other notes (phone, non-visit, email) assigned to you. | |
| **Draft Letters** | Any incomplete letters that were assigned to you or that you created. | |
| **Draft Orders** | Any incomplete prescription, test orders or referrals that were assigned to you or that you created. | |
### Finding unsigned or draft notes
Unsigned visit notes and other draft notes (phone, non-visit, and email notes) assigned to you appear in the **Draft Notes** inbox in your Practice Home. They also appear as an **Unsigned Note** in the **Requiring Action** queue at the top of the patient's chart.
To clear them, open the note and click **Sign** or **Sign & Close**. Provider Level Users can sign visit notes and other notes; Staff Level Users can sign other notes (phone, non-visit, email).
### Clearing requiring action items
To clear requiring action items, review the item and take the appropriate action needed to complete or address the item. Certain item types can be addressed from the Practice Home directly while others will require you to click on the patient's name to open the patient's chart to view the requiring action item. [See the Quick Reference Chart at the top of this article](#quick_reference_table) for details about how to clear certain requiring action items.
**Next Step**
**Check your Practice Home for outstanding Requiring Action items!**
## Related Articles
* [Lab Reports- Viewing results from lab interfaces](/articles/Viewing-results-from-lab-interfaces)
* [Importing Documents via the Fax Inbox](/articles/Fax-Inbox-Introduction)
* [Office Message Feature Guide](/articles/How-to-use-Office-Messages)
* [User Groups for Office Messages Guide](/articles/user-groups)
* [Post Date a Message Guide- Reminders & Task Follow Up](/articles/post-date-a-message-to-yourself-or-a-colleague)
* [Requiring Action & Open Items Queues- Managing open action items for your patients](/articles/the-requiring-actions-queue-follow-up-on-action-items)
# Chronological Record Guide- Sort Settings
Source: https://help.elationhealth.com/articles/chronological-record-sort-settings
This article reviews sorting the chronological record by patient event date versus provider activity date.
## What is the Chronological Record Sort Setting?
It often takes a whole team of care professionals to keep a patient healthy. As the patient's provider you often find yourself storing copies of consultations and test results administered by other providers caring for your patient. Elation allows you to store these records in the patient's chart and sort patient records by:
* Patient Event Dates= shows what the patient has been up to, and sorts reports by document date
* Provider Activity Dates= shows what your practice has been up to, and sorts reports by filed date
You can see below how an allergist report dated 08/01/2014 that was filed into the chart on 08/25/2016 displays based on the different sort views:
### Ordering by Patient Event Dates
![Chronological Record ordered by Patient Event Dates, showing Allergist Report listed under Aug 1 2014, with abnormal lab values highlighted in red for the Aug 11 Comp. metabolic panel.]()
### Ordering by Provider Activity Dates
![Chronological Record sorted by Provider Activity Dates, showing Allergist Report at top dated Aug 25 2016, reflecting when it was filed rather than its 08/01/2014 document date.]()
## How to adjust the Chronological Record Sort Setting
### Practice Setting
Go to **Settings** >> **Sort Settings** to find the practice wide setting for sorting records in the Chronological Record. Once this Setting is changed it will be applied to all patient charts.
![Sort Settings page with "Sort Reports in the Patient Chronological Record by" dropdown set to "Provider Activity Dates"]()
### Patient's Chart
Inside each patient chart, you will also have the ability to change the sort preference on-the-go if you want to toggle between the two different sort views by clicking on **Ordering By:**
!["Ordering By" dropdown in a patient chart showing two options: Provider Activity Dates and Patient Event Dates, with Patient Event Dates currently selected.]()
**Next Step**
**Review your Chronological Record sort preference and make changes as needed.**
## Related Articles
* [Chronological Record Introduction- A timeline of your patient's records](/articles/store-everything-in-chronological-record)
* [Chronological Record Guide- Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
# Generating & submitting claim appeals
Source: https://help.elationhealth.com/articles/claim-appeals
Learn how to create and submit claim appeals in Elation Billing
## Overview
### What is a claim appeal?
A claim appeal is a formal request to an insurance payer to reconsider a denied or underpaid claim. Appeals include documentation supporting why the claim should be paid or paid at a higher rate.
### Why are claim appeals important?
Appeals give you the opportunity to recover revenue from claims that were incorrectly denied or underpaid. Including supporting documentation and claim history increases the chances of a successful appeal.
## Before you begin
* **Check the payer's filing deadline.** Most payers require appeals to be submitted within a set window after the original denial (commonly 90, 180, or 365 days). Confirm the deadline on the payer's EOB or contract before starting.
* **Gather supporting documentation.** This may include the original claim, EOB/ERA, medical records, chart notes, proof of timely filing, or a letter of medical necessity. This information can be included on the appeal when generating an appeal.
* **Review Claim History.** Use [Claim History](/articles/claim-history) to view the full clearinghouse trail for the claim you're appealing. This information can be included on the appeal when generating an appeal.
## Workflow Instructions
### Creating a claim appeal
Locate the claim using one of the following workflows:
* The **Superbill** itself
* Patient record → **Claims** → **Charges**
* **Billing** → **Claims Manager**
Click the **Print** button on the claim you would like to appeal.
In the window that appears, select whether or not you want the original claim form and then click **Appeal** → **Start**. This will open a new window for you to complete the appeal.
![Paper Billing dialog with "Primary" print type selected, "With Claim Form" radio button chosen, and the Appeal button highlighted with a red border.]()
Review the Appear Options:
1. Select the type of Appeal Form you want to use
2. Specify whether you want any of the following included with the appeal:
* CMS-1500 Claim Form
* Remittance (ERA)
* Claim History
3. Add attachments to the appeal (e.g. visit note, letter of medical necessity, etc.)
![Appeal Options dialog with "Anthem Claim Re-process / Inquiry Request" selected, CMS-1500 Claim Form and Remittance (ERA) checked, Claim History unchecked, and a Generate Appeal button.]()
Click **Generate Appeal**.
Review the details of the prefilled form for accuracy.
Make sure the attached documents appear as expected.
Click **Continue**.
Choose your submission method:
* **Electronic submission** - Only available for some payers.
* **Mailed by clearinghouse** - Mailed on your behalf for an additional fee.
* Specify the mail to address and then click **Send Mail**.
* **Faxed by clearinghouse** - Faxed on your behalf for an additional fee.
* Specify a fax to number and then click **Send Fax**.
* **Download and mail** - Download the appeal packet at no additional cost and mail it yourself.
* Click **Manual Appeal** and then download the the appeal packet.
![Submit Appeal dialog showing three submission options: Send Mail (with prefilled practice address), Send Fax (with empty fax number field), and Manual Appeal to download and send yourself.]()
For information on additional fees, see [Fees Associated with Elation Billing](/articles/fees-associated-with-elation-billing).
### Tracking the status of an appeal
Once an appeal has been generated, you can update the Tags on the claim to add the claim to an appeals Worklist for easier followup. See [Using the Worklist](/articles/using-the-worklist#appealed) for more information.
For updates on the status of the appeal, contact the payer directly. You can use **Claim Notes** to track each follow-up.
### Acting on a claim after a decision is made on the appeal
* **If the appeal is approved**, the payer issues payment and a new ERA. You can post the payment to the claim like any other payment. The claim status updates accordingly in the Worklist.
* **If the appeal is denied**, review the payer's response for the denial reason. Depending on the payer, you may be able to file a second-level appeal or escalate through the payer's grievance process.
## FAQ
Once an appeal is generated, you can start a new appeal on the same claim by repeating the steps above. Contact the payer directly if you need assistance with an appeal that was already submitted.
The **Appeal** button appears in the print confirmation window for claims that have been submitted through Elation Billing. If you don't see it, confirm the claim was submitted via Elation Billing and that you have the appropriate billing permissions.
* If the claim was submitted via Elation Billing and you have the appropriate billing permissions, reach out to Contact Elation Support.
## Related Articles
* [Common Code Denials](/articles/common-code-denials)
* [Claim History](/articles/claim-history)
* [Denials Reporting](/articles/denials-reporting)
* [Using the Worklist](/articles/using-the-worklist)
* [Fees Associated with Elation Billing](/articles/fees-associated-with-elation-billing)
# Claim History
Source: https://help.elationhealth.com/articles/claim-history
Learn how to find and view claim history in Elation Billing
This article explains how to find and view claim history in Elation Billing.
## Overview
### What is Claim History?
Claim History provides a complete record of all actions and status changes for a claim, including submission dates, payer responses, rejections, payments, and adjustments.
### Why is Claim History important?
Reviewing claim history helps you understand why a claim was denied, track the progression of a claim through the billing cycle, and gather documentation for appeals.
## Workflow Instructions
### Finding Claim History
The Claim History can be found in multiple places:
1. The Claims Manager
2. Superbill's Page
3. Patient's Page
4. Payment's Page
![Claim History button icon shown in two states: inactive (grey on white) and active (white on purple), both depicting a counterclockwise arrow around a clock face.]()
***
### From the Claims Manager
In the Claims Manager, the Claim History button is the first (far-left) button under the **More** column.
![Claims Manager showing patient Samwise Gamgee's charges, with a red arrow pointing to the three More column icons; the leftmost clock/history icon is the Claim History button.]()
***
### From the Superbill
On a Superbill, the Claim History button is towards the top-center of the page, on the upper-right corner of the Superbill Info panel, preceded by Files.
![Superbill 1103 for Samwise Gamgee, with a red arrow pointing to the Claim History button (counterclockwise clock icon) in the top toolbar, to the right of the Files icon.]()
***
### From the Patient Page
1. **Navigate** - From the Patient's page, select the **Claims** button, followed by the **Charges** tab.
2. **Access History** - The Claim History button is the first (far-left) button under the **More** column.
![Patient Claims modal with Charges tab selected (highlighted), showing claim rows for Samwise Gamgee. A red arrow points to the More column's first icon (Claim History button) on the top row.]()
***
### From the Payment Page
On a Payment, the Claim History button is found in the Superbill information line, preceded by Notes and followed by Delete.
![Payment #718 from Aetna showing two superbill claim lines. A red arrow points to the Claim History button in the Superbill 1075 row, located between the Notes and Delete icons.]()
## Related Articles
* [Claim Appeals](/articles/claim-appeals)
* [Common Code Denials](/articles/common-code-denials)
* [Using the Worklist](/articles/using-the-worklist)
# Claim Line Can't Be Deleted
Source: https://help.elationhealth.com/articles/claim-line-cant-be-deleted
Learn how to delete a claim line that is blocked by associated payments
This article explains why a claim line may be blocked from deletion and how to resolve the issue.
## Overview
### Why Can't I Delete a Claim Line?
Generally speaking, a claim line will be blocked from deletion if there are any payments associated with the Superbill. This protection prevents accidental deletion of claim lines that have financial transactions recorded against them.
## Workflow Instructions
### How to Delete a Blocked Claim Line
1. **Remove Superbill from Payments** - Delete the Superbill from all Payments currently associated with it.
If you believe you will need to re-post the Superbill to these payments after deleting the claim line, make a record of all payments for later reference (Check Numbers, screenshots, Superbill Alert/Note, etc.).
> 2. **Hard Refresh the Billing Software** - Once the Superbill has been dissociated from all Payments, perform a hard refresh of the Billing Software on the Superbill's page.
See [How to Hard Refresh the Billing Software](/articles/refresh-the-billing-software) for instructions.
3. **Delete the Claim Line** - Once you've dissociated all Payments and refreshed the billing software on the Superbill's page, you will be able to delete the claim line.
## Related Articles
* [Clearing Out a Payment](/articles/clearing-out-a-payment)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
* [Elation Billing FAQs](/articles/elation-billing-faqs)
# Claims Queue
Source: https://help.elationhealth.com/articles/claims-queue
Learn how to use the Claims Queue to review and submit claims in Elation Billing
This article explains how to navigate, use, and bill claims from the Claims Queue in Elation Billing.
## Overview
### What is the Claims Queue?
The Claims Queue is where your claims land after designating where they'll be billed. It serves as the last stop for claims before they're sent out to their payer(s).
### Why is the Claims Queue important?
The Claims Queue allows you to review claims before submission, make last-minute edits, remove claims that aren't ready, and batch-submit claims to payers efficiently.
## Workflow Instructions
### Navigating to the Claims Queue
There are two ways to reach the Claims Queue:
1. **From the Billing dropdown menu** - Select **Claims Queue** from the **Billing** menu.
![Billing menu with "Claims Queue" highlighted, showing options: New Superbill, Superbills, Claims Manager, and Claims Queue]()
2. **From the Bill Now button** - Click **Bill Now**, then select **See Queue**.
![Top navigation bar showing the green "Bill Now" button, which is clicked to access the Claims Queue via "See Queue"]()
!["Lighting Bill" confirmation popup showing 0 claims in the Queue, with Cancel, See Queue, and Bill Now buttons.]()
### Using the Claims Queue
Once you are in the Queue, you can see the claims that have been designated for sending to their respective payer(s).
![Claim Queue table showing three claims with columns for Claim #, Name, Date, Payer, Priority, and Paper (Print/Tags buttons). The "Remove Selected From Queue" button appears above the list.]()
1. **View a Claim** - Click the blue **Claim #** to open the claim in a new tab.
2. **Remove Claims from Queue** - Click anywhere within the claim's row (that isn't a button) to select it, then select **Remove Selected From Queue**.
To select multiple claims for removal, hold **Ctrl** (Windows) or **Command** (Mac) when clicking rows.
3. **Print for Paper Billing** - Click **PRINT** to generate a claim form, mark the claim as Billed, and remove it from the Queue.
If the 1500 form is not appearing, it's most likely due to a **pop-up blocker**. In **Chrome**, click the pop-up blocked icon in the address bar and select **Always allow pop-ups and redirects from app.elationemr.com**. In **Firefox**, click the pop-up blocked notification in the address bar and select **Allow pop-ups for app.elationemr.com**.
![Paper Billing dialog with "With Claim Form" selected, which generates a Red CMS 1500. Options include "Without Claim Form" for printing on blank CMS 1500.]()
4. **Manage Tags** - Click **TAGS** to update the tags on a claim. By default, any claim in the Queue will be tagged "Queued".
If a claim's Worklist Status is changed to **Yes**, it will be automatically removed from the Queue once this status is saved.
![Add Worklist / Tags dialog showing Worklist Status set to "No" and the QUEUED tag checkbox selected among available System Claim Tags.]()
### Billing the Queue
1. **Submit Claims** - When you are ready to send your Queue off to the payer(s), click the **Bill Now** button, then click **Bill Now** in the popup that appears.
2. **Automatic Tag Update** - Billing claims will automatically change their Tag from **Queued** to **Billed**.
3. **Claim Transmission** - At this stage, the claims will be sent to the clearinghouse, where they'll be routed to the payer.
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Using the Worklist](/articles/using-the-worklist)
* [Print a Claim](/articles/print-a-claim)
# Clearing Out a Payment
Source: https://help.elationhealth.com/articles/clearing-out-a-payment
Learn how to clear out an erroneous or duplicate payment in Elation Billing.
## Overview
### Removing an erroneous or duplicate payment
Deleting a payment is not supported in Elation Billing. To remove an erroneous or duplicate payment from your active books, you can clear it out using the workflow below. The payment record is retained for audit purposes but no longer affects claim balances or financial totals.
### When to use this workflow
Use this workflow when a payment was posted in error or is a true duplicate that should not affect any claim. If the payment was voided, reversed, or updated by the payer (for example, a recoupment or corrected ERA), use [Posting Voided, Reversed, or Updated Payments](/articles/posting-voided-reversed-or-updated-payments) instead.
### Prerequisites
* A [user role ](https://help.elationhealth.com/articles/user-roles)with permission to edit payments and remove Superbills from a Payment.
* The **Payment ID**, **Check #**, or **Payer** name so you can locate the payment.
* Confirmation that the payment is safe to clear (not partially reconciled to claims you intend to keep).
## Workflow instructions
### Locating the payment
1. Navigate to **Payments** → **Payments**.
2. Search by check number, payer, payment date, or Payment ID.
3. Open the payment you want to remove by clicking on the Payment ID.
### Clearing out a payment
If there are any Superbills on the Payment, delete them by clicking the **trashcan** icon.
![Superbill 1141 for Samwise Gamgee showing a SETTLED status with $0.00 balance; the trashcan icon is highlighted with an arrow, indicating where to click to remove the Superbill from the Payment.]()
* Removing a Superbill from the Payment unlinks it; the claim itself is not deleted and returns to its prior balance status. Re-attach the Superbill to the correct Payment if the original posting was simply applied to the wrong check.
1. Click **Edit** button at the top of the payment.
![Payment #757 header showing payer Aetna, Pay Date 2023-05-15, Post Date 2023-05-26, with an arrow pointing to the Edit button in the top-right action bar.]()
2. Set the **Payment Amount** to \$0.
3. Change the Check/Reference # to the word 'Duplicate'\*\* \*\*(if 'Duplicate' has already been used for this payer, append a unique suffix such as **Duplicate-2** or the original check number, for example **Duplicate-12345**).
4. Leave the **Payment Date**, **Payer**, and **Payment Method** as originally entered so the historical record is preserved.
5. Click **Save**.
1. Click on the **Payment Notes** icon.
2. Document why the payment was cleared (e.g., "Duplicate of check #12345 posted on 01/02/2026").
3. If Superbills were removed, add a **Claim Note** on each affected claim as well. This is the only audit trail for the change.
Reopen the Payment and confirm:
* The **Payment Amount** displays as \$0.00.
* The **Check/Reference #** reads 'Duplicate' (or your unique variant).
* No Superbills are attached.
* Your **Payment Note** is saved.
#### Can't edit the Payment?
If your Elation EHR + Billing practice has the Patient Payment Workflow Update active, you may find you cannot edit the Payment Amount. In that case, refer to the guide on [Activating Legacy Payment Workflow](/articles/activating-legacy-payment-workflow) to temporarily deactivate the feature for the purpose of removing a erroneous or duplicate payment.
## Special cases
### ERA-linked or auto-posted payments
If the payment was created from an ERA, clearing it does not remove the ERA file from your system. Remove the Superbills from the payment first, then edit the **Payment Amount** to \$0 as described above. The ERA remains available for reference and re-posting if needed.
### Partially applied or reconciled payments
If any portion of the payment has already been correctly applied to a claim you want to keep, do not clear the entire payment. Instead:
* Remove only the Superbills that should not have been on the Payment, or
* Use the [Posting Voided, Reversed, or Updated Payments](/articles/posting-voided-reversed-or-updated-payments) workflow to adjust specific line items using the **Ignored** field.
### Identifying cleared payments later
To find previously cleared payments, search the Payments list for the **Check #** 'Duplicate' (or your unique variant). Cleared payments appear with a \$0.00 amount and no attached Superbills.
## Impact on reports and patient statements
* **Financial reports** - Cleared payments display as \$0.00 entries and do not contribute to deposit or revenue totals. The original **Payment ID** is retained.
* **Patient statements** - Because no Superbills are attached, a cleared payment does not appear on patient-facing statements or balances.
## Related articles
* [Posting Voided, Reversed, or Updated Payments](/articles/posting-voided-reversed-or-updated-payments)
* [Activating Legacy Payment Workflow](/articles/activating-legacy-payment-workflow)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
* [Negative Balances](/articles/negative-balances)
* [Elation Billing FAQs](/articles/elation-billing-faqs)
# Clinical Profile Guide- A snapshot of the patient's health status
Source: https://help.elationhealth.com/articles/clinical-profile-record-patient-medical-history
This article shows you how to set up the patient clinical profile, which is the left-hand panel that appears in every patient's chart.
You can hover your move over the video bar to jump ahead to chapters within the video.
## What is the Clinical Profile?
The Clinical Profile is the left-hand panel that appears in every patient's chart. It is home to important patient details including their allergies, problems, history and medications. The Clinical Profile is also used for documenting vaccines, growth charts and storing legal and confidential notes.
The Clinical Profile is always accessible when navigating the patient’s chart and can be edited by any user. It is designed to support seamless collaboration and documentation as you move through your patient workflows. Keeping the Clinical Profile accurate and up to date will allow you to make informed healthcare recommendations. You can even reference data from the Clinical Profile into notes and visit notes to facilitate documentation.
You can easily share the clinical profile by clicking on the **Print/Fax** button at the top to print the clinical profile or fax it to a collaborating provider.
If you use Elation's
[Passport for Patients feature](/articles/elation-patient-passport-an-introduction)
, you can even share the patient's clinical profile with them by choosing the related sharing preference.
## Using the Clinical Profile for charting
Any record in the clinical profile can be referenced into a note or visit note to facilitate documentation of a clinical encounter. You can click the **Actions** button next to any header to export the entire section to a note or visit note. You can also click **Actions** next to a specific record to only export that record to a note or visit note.
Certain visit note formats also allow you to reference different sections of the Clinical Profile into your visit note with buttons directly within the visit note format itself. Review the various visit note formats in the
[Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
article to choose the best format for your charting preferences.
Learn more about
[using Clinical Profile documentation to facilitate charting here](/articles/no-double-documentation-with-the-clinical-profile)
.
## Demographics Overview
The Clinical Profile is designed to be efficient and supports the display of the SOGI (sexual orientation and gender identity) Patient Demographics fields. Preferred name (ex. full name if different from legal) and pronouns will display in the Clinical Profile if documented, while other important data, like the patient's insurance and contact details, remains easy to see and reference. Additionally, the Passport icon and hover tooltip now displays the patient’s current Passport activation or invitation status.
![Patient chart for Rachel Gramms showing the demographics panel highlighted with a red border, displaying name, DOB, pronouns, NKDA status, provider Karly Smith MD, insurance, and cell phone number.]()
**Beta feature:** A patient notes icon may also appear next to the allergy and risk score badges in the Clinical Profile. Hover it to preview the patient's demographics notes, or click it to jump straight to the **Notes** field. This icon is part of a beta release and is only available to a select number of practices. See [Patient Demographics Guide — Patient Notes icon](/articles/Patient-Demographics-Guide#patient-notes-icon).
## Appointments Overview
Underneath the demographics overview, you will see the next appointment date and time for the patient if one is scheduled and you will also see the date of the last documented visit (visit note) if there is one on file.
![Clinical Profile appointment section highlighted, showing "Next Appt: Fri, Mar 25, 2022 at 11:00 am" and "No documented visits" below patient demographics.]()
## Allergies
Utilize the **Allergies** section to document structured information about your patient's allergies. If no allergies are listed, default text of *NKDA*\*\*will be displayed in the Clinical Profile.
To document an allergy:
1. Click the **+ Add Allergy** button in the **Allergies** section
2. Fill in the following field as needed:
3. **Allergy**= Use the drop-down menu to select the most accurate allergy information from Elation's database of allergens, ingredients and drugs. If you cannot find the substance in the database then type in your own text.
*
When you select from Elation's database, Elation will be able to use that information to detect potential allergic reactions when you prescribe medications and notify you of interactions.
![Add Patient Allergy dialog with "barley" typed in the Allergy field, showing a dropdown with "Barley Grass" listed under Most Popular and Best Matches, each tagged as Drug Name.]()
1. **Reaction**= optional field that allows providers to enter structured data about the type of allergic reaction that occurs for the allergen, ingredient or drug listed.
2. **Reaction Code**= optional field that allows you to enter a reaction code. The code is in the SNOMED-CT (Systematized Nomenclature of Medicine — Clinical Terms) format.
* SNOMED is a standardized, multilingual vocabulary of clinical terminology that is used by physicians and other health care providers for the electronic exchange of clinical health information. There is only a subset of SNOMED codes that apply to allergic reactions.
3. **Severity**= optional field that gives everyone three options to select when documenting an allergy for a patient: mild, moderate and severe.
4. **Status**= field that allows you to specify if the allergy is still active. The default is **Active**
5. **Onset Date**= option field that allows you to note when an allergy began
6. Click **Save** or **Save & Add Another** to save the allergy
You can edit any allergy documentation by clicking on the **Actions** button next to the documentation.
## Drug Intolerances
Use the **Drug Intolerances** section to document any drug intolerances that your patient has. If the patient does no have any, click **None** and the text **No known drug intolerances** will be appended to the Clinical Profile.
To document drug intolerances:
1. Click **+ Add Drug Intolerance** in the \*\*Drug Intolerances \*\* section
2. Fill in the following fields as needed
3. **Substance**= Use the drop-down menu to select the most accurate drug intolerance information from Elation's database of drugs. If you cannot find the substance in the database then type in your own text.
*
When you select from Elation's database, Elation will be able to use that information to detect potential drug reactions when you prescribe medications and notify you of interactions.
![Add Drug Intolerance dialog with "code" typed in the Substance field, showing a dropdown of matching results including Codeine as an ingredient and codeine-combination drug names.]()
1. **Reaction**= optional field that allows providers to enter structured data about the type of reaction that occurs for the drug listed.
2. **Reaction Code**= optional field that allows you to enter a reaction code. The code is in the SNOMED-CT (Systematized Nomenclature of Medicine — Clinical Terms) format.
* SNOMED is a standardized, multilingual vocabulary of clinical terminology that is used by physicians and other health care providers for the electronic exchange of clinical health information. There is only a subset of SNOMED codes that apply to allergic reactions.
3. **Severity**= optional field that gives everyone three options to select when documenting a drug intolerance for a patient: mild, moderate and severe.
4. **Status**= field that allows you to specify if the drug intolerance is still active. The default is **Active**
5. **Onset Date**= option field that allows you to note when a drug intolerance began
6. Click **Save** or **Save & Add Another** to save the drug intolerance
## Problem List
Quickly see the problems, diagnoses and risk scores of the patient from the Problem List. This information is referred to as your diagnosis (Dx) when writing prescriptions, ordering labs and imaging for your patient. It also includes helpful risk score information that provides a snapshot into the severity of a patient's health risk.
To add a problem to the Problem List:
1. Click **+ Add Problem** under the **Problem List** section
2. Fill in the following fields:
3. **Search for a diagnosis**= Use this field to search the diagnosis database for a diagnosis. You can search by ICD-9 Code, ICD-10 Code or description.
*
You can add multiple diagnoses to a problem by clicking **+ Add Another Dx**
![Add Patient Problem dialog with "hypertension associated with diabe" typed in the search field, showing 4 matching diagnoses with ICD-10, ICD-9, and RISK score columns.]()
1. *Title*= The **Title** will default to the description of the diagnosis you selected from the database but you can always adjust it to your preference.
2. **Dx Date**= use this field to specify when the problem began. The date will default to **today** if you do not change the date.
3. **Status**= field that allows you to specify if the problem is active, controlled or resolved. The default is **Active**
4. **Synopsis**= field that allows you to add notes about the diagnosis
5. Click **Save** or **Save & Add Another** to save the Problem
Once saved, the problem can be edited or exported to your visit notes under several different sections by hovering your mouse over the problem, clicking on **Actions**, then selecting the destination to export to.
Learn more about using the Problem List for other clinical workflows in the [Problem List Guide](/articles/managing-your-problem-list).
## History
The History section of the Clinical Profile is organized into distinct subsections to help you easily populate and reference details about your patient. Details within each section can be recorded in free-text or a structured manner.
* PMH (Past medical history)
* PSH (Past surgical history)
* FH (Family health history)
* SH (Social history)
* (Cognitive status)
* Func (Functional status)
* Psych (Psychological status)
* Habits
* Diet
* Exc (Exercise)
### Free-text Fields
Free-text fields are fully customizable and allow you to personalize how you document details for the patient.
1. Click on the text-field in which you’d like to add information. The field will turn yellow.
2. Type the details for your patient and press the **Enter** key on your keyboard to save.
*
If you want to document in a long-form format within free-text, you can hold down the **Shift** key on your keyboard and press the **Enter** key to create a line break within the text field.
3. If you’d like to revise text that has already been saved, click directly on the text and the field will turn yellow again to allow for edits.
4. If you’d like to rearrange the order of your free-text fields, click on the 3 horizontal lines to the left of the text, hold down the cursor and drag the text and drop it in the appropriate order.
###
### Structured text fields
Structured text fields include a short pick-list of possible responses to a question. Examples include Social History (SH), Psychological Status (Psych), Habits and Exercise (Exc).
1. To add a structured question, click on the **add...** button to the right of the section heading and select an option
2. A new field or form will appear as a new line-item in the section. Click on the new field or the **Fill out form** button to proceed. See the Questionnaires section of this article for more information about structured screening forms.
3. To change the response, click on the dropdown arrow again and select a different option.
### Questionnaires
Elation’s built-in questionnaires allow you to easily document responses and calculate the score for common screenings. Please reference the [Clinical Profile Guide- Structured Questionnaires](/articles/structured-questionnaires) for more information on how to best use this feature.
## Medications
Your patient's current medications and medication history is an essential part of their clinical care. You can document medications to ensure your patient’s medications are up to date. Any permanent medications [you prescribe or order](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) will immediately be recorded in the **Permanent Rx Meds** or **Permanent OTC Meds** sections and a copy of any script that was prescribed during the last 6 clinical encounters will be available in *Scripts Since Last 6 Visits*.
New patients joining your practice may already be taking medications prescribed by other providers. To document an existing medication that a patient is actively taking (not order new medications):
!["Document Med Patient Is On" dialog box open, with arrows highlighting the "+ Document Med Pt Is On" buttons in both the Permanent Rx Meds and Permanent OTC Meds sections of the Clinical Profile.]()
1. Click **+Document Med Pt Is On** to open the dialogue box.
2. Select **New**, **Change** or **Refill** from the **Type** menu and enter in the date the patient started the medication.
3. In the **Date:** field, document the date the medication was started
*
If the patient does not remember the exact month and date the medication was started, type in the year and then press the **Tab** key on your keyboard. Elation will automatically set the date as January 1st of that year.
4. Enter the medication name in the **Med:** field by typing in the drug name and selecting it from the medication database
5. Fill in the \*\*Sig \*\* field to note directions for use of the medication
6. In the **By:** field, note the name of the provider that prescribed the medication for the patient
7. Check off the **Add to Permanent Med List as** box to specify if you want to add the medication to the permanent **Rx** or *OTC***medications list. By default, Elation will automatically select to add the medication to the \*\* Permanent Rx Meds** List
8. In the *Note*field you can note any additional details about this medication as needed.
9. Click the **more…** button at the bottom of the box to log the quantity of the medication, units and refills.
*
Entering this information when you document new medications for patients is useful to make medication refills easy.
10. Click **Save & Add Another** to continue documenting additional medications, or **Save & Close** when you are finished.
To view a full Medication History for the patient that includes temporary and discontinued medications, click the **Meds Hx** icon at the top of the patient's chart and click **Medication History**. To learn more about managing the patient's medication list, review our [Medication List Management Guide](/articles/medication-history).
## Patient's Provider List
The
*Patient's Provider List*
section allows you to see other providers who are collaborating with you to care for this patient or providers whom you have noted as caring for the patient. If you
[sent letters or referral](/articles/how-to-send-a-fax)
to any provider, they will appear in this list. You can also click **+ Add Provider** to add more providers to this list.
*
Selecting from the provider database when adding a provider will allow you to easily use the data from this section when writing new letters or referrals.
## Other Info
This section of the clinical profile is used to document vaccinations, file legal paperwork, and also where you will view growth charts for pediatric patients.
### Growth Charts
To view growth charts, click on the **Actions** dropdown to the right of the **Other Info** section, and click **See Growth Charts**. Learn more about Growth Chart in the [Growth Charts for Pediatric Patients](/articles/growth-charts-for-pediatric-patients) article.
### Vaccinations
The **Vacc:** section allows you to record free-text or structure vaccination information. You can also click **Immunization Table** to view the Immunization Table for the patient or click **Actions** >> **Print Immunization History** under the **Other Info** header to print the patient's immunization history. Learn more about this section using the [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide).
Printed immunization records show the patient's preferred name as the primary name, with their legal name in smaller text beneath it. If the preferred name matches the legal name (or none is on file), only the legal name is shown. The legal name is always retained so the record remains valid for schools, employers, travel, and insurance.
![Immunization Table opened from the Clinical Profile, showing the Adult Set selected with vaccines listed (COVID-19, HPV, HepA, HepB, Influenza, MMR, Meningococcal, PCV13, PPSV23, Td) and dose columns. Arrow points from the Immunization Table button in the Vacc section to the table.]()
![Document Vaccination dialog opened from "+ Add Vaccination, detailed" button in the Vacc section, showing fields for vaccine name, ordered by, administered status selected, date 03/01/2022, and given by Karly Smith, MD.]()
### Legal Notes & Documents
The
*Legal*
section will allow you to document legal notes for the patient as well as reference legal documents in their chart. For legal documents, you can use the
[drag & drop feature](/articles/filing-documents-to-a-patient-chart)
to file legal documents into the patient's chart under the
\*Legal Reports \*
category and those documents will appear in this section of the Clinical Profile. This is useful for documents such as Release Forms, Patient ID Cards (Drivers License, Passports), Intake Forms or any other legal documents. You are also able to add a Document Tag to these forms to make it easy to identify who has or does not have specific legal forms on file.
![The Legal tab selected in the documents viewer showing a filed DNR order, with an arrow pointing to the corresponding "DNR reviewed on 03/01/2022" entry in the Legal section of the Clinical Profile.]()
## Health Maintenance
The Health Maintenance serves as a central location for tracking and documenting current and outstanding health measures, such as exams and screenings. You can document the progress of health measures as free text or use Elation's structured Health Maintenance features. Learn more about this section in the
[Health Maintenance Documentation & Reminders Guide](/articles/health-maintenance)
.
## Confidential
The C
*onfidential*
section of the Clinical Profile will allow you to document confidential and private notes for the patient that can only be seen by members of your office. Notes in the
*Confidential*
section will never be printed or shared outside of your practice. Learn more about confidential records in the
[Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
article.
![Confidential section in the Clinical Profile, highlighted with a red border, showing the privacy notice "The information in this section will never be shared outside this practice" and an "add confidential item" field.]()
## Frequently Asked Questions (FAQ)
### Can I re-order the different sections of the Clinical Profile?
You cannot re-order the different sections of the Clinical Profile. They are outlined to match the layout of the different
[Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
we have available for users.
### Can the problem list be ordered by relevancy not chronologically?
You can order your problems any way you like. The most recently added item is usually added to the bottom of the list. Use the 3 horizontal line button next to the problem to drag and reorder the list.
### Can I re-order the different records in each section?
Yes, any
[free-text field](#free_text_fields)
can be re-ordered. Use the 3 horizontal line button next to the record to drag and reorder the list.
### How do I document a hospitalization, including admit and discharge dates?
Elation does not have a dedicated hospitalization field with structured admit and discharge date fields. Admit and discharge information for a hospitalization typically comes directly from the hospital as a fax or electronic notification (for example, an ER report, discharge summary, or CCD/C-CDA document) if your practice is listed as the patient's PCP. File and sign that notification so it's stored as a report in the patient's
[Chronological Record](/articles/store-everything-in-chronological-record)
— this is the primary place the admit and discharge dates and details are documented.
If you'd also like to keep a running summary of a patient's major hospitalizations for quick reference in the Clinical Profile, you can additionally add free text to the **PMH (Past Medical History)** section (or **PSH** if the hospitalization was for a surgical procedure). This is a supplementary summary and not a replacement for the filed hospital report or notification in the Chronological Record.
### Can I remove or hide specific sections of the Clinical Profile that I do not use?
You cannot hide or remove specific sections of the Clinical Profile but you can collapse all the sections by clicking the **Collapse** button above the **Allergies** section and then expand the sections you want to see to make the Clinical Profile more consolidated. Once you click **Expand** or reload the chart, all sections will be expanded again.
### Can I make the entire Clinical Profile confidential?
You cannot specifically make the Clinical Profile confidential but you can make the entire chart into a
*VIP Chart*
.
[Learn about the VIP patient charts feature here.](/articles/vip-chart-feature)
### Which parts of the Clinical Profile can patients see in Passport?
If you choose the
**Entire Clinical Profile except the Confidential section**
option for your
[Passport Sharing preference](https://app.elationemr.com/settings/patientpassport/)
, patients can see every section of the Clinical Profile except the
*Confidential*
section. The default Passport Sharing preferences are a Provider User Setting. You can change this on a per patient level by clicking on the **Passport** button at the top of the patient's chart.
**Next StepStart documenting clinical information in your patient's clinical profile too streamline charting!**
## Related Articles
* [Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Problem List Guide](/articles/managing-your-problem-list)
* [Clinical Profile Guide- Structured Questionnaires](/articles/structured-questionnaires)
* [Prescription Form Guide- ePrescribing & Ordering Medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Medication List Management Guide](/articles/medication-history)
* [Growth Charts for Pediatric Patients](/articles/growth-charts-for-pediatric-patients)
* [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide)
* [Filing Documents to a Patient Chart](/articles/filing-documents-to-a-patient-chart)
* [Health Maintenance Documentation & Reminders Guide](/articles/health-maintenance)
* [Patient Chart Guide- Managing confidential records](/articles/confidential-items-in-your-patient-chart)
* [VIP Charts- Limiting access to certain patient charts](/articles/vip-chart-feature)
# Clinical Reminders for Clinical Quality Measures
Source: https://help.elationhealth.com/articles/clinical-reminders-for-clinical-quality-measures
This article describes the Clinical Reminders feature and provides instructions on how to adjust Clinical Reminder Settings for Clinical Quality Measures.
## Overview
### What are Clinical Reminders?
Elation's Clinical Reminders feature surfaces notifications at the top of in-draft visit notes to remind providers of certain actions to take to address gaps in patient care based on the patient's demographics and recorded problems. Certain Clinical Reminders are tied to specific [Clinical Quality Measures](/admin-compliance) for [MIPS](/articles/MIPS-2026-Overview).
### What are benefits of Clinical Reminders?
Certain patients will require certain preventive care follow up or services based on their age and health conditions. As the patient's chart accumulates information over time, it may not be easy to readily identify when certain preventive care services are missing from the patient's care plan. Clinical Reminders will remind you when certain preventive care services are necessary.
### Who sees Clinical Reminders?
Clinical Reminders appear at the top of in-draft visit notes for both providers and staff when enabled. The table below summarizes how visibility and configuration work for each role.
| **Role** | **Can view Clinical Reminders in visit notes?** | **Can configure their own reminder preferences?** | **How reminders are controlled** |
| ------------------------------------------------------------------------------- | ----------------------------------------------- | ------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------- |
| Provider Level Users | Yes, if enabled | Yes | Each provider configures their own reminders under **Settings** > **Preferences** > **Clinical Reminders (MIPS)** |
| Staff Level Users (including nurses, medical assistants, and care coordinators) | Yes, if enabled | No | Users can configure reminders for all staff under **Settings** > **Clinical Care Measure Settings** |
Staff Level Users—including nurses—will see the same Clinical Reminders as providers when those reminders are enabled in **Clinical Care Measure Settings**. However, staff cannot customize which reminders they see individually; the settings apply to all Staff Level Users in the practice.
## Workflow Instructions
### Adjusting Clinical Reminders Settings
#### Adjusting Clinical Reminders Settings as a Provider Level User
##### Enabling Clinical Reminders
Each individual Provider Level User must adjust their own Clinical Reminders Settings. To enable Clinical Reminders as a Provider Level User:
1. Click on your email at the top of your Elation account and then click **Settings**.
2. Click **Preferences** to view your account preferences settings.
3. Go to the **Clinical Reminders (MIPS)** section and toggle the **Enable Clinical Reminder Service (CRS)** to **Yes** to enable Clinical Reminders for your own account.
4. Next, toggle any reminder's setting to **On** to enable that reminder. Enabled reminders will appear at the top of your visit note drafts whenever patients meet the conditions for those reminders.
These changes will only apply to your Provider Level account. Other Provider Level Users must adjust their own Clinical Reminders Settings. To change Clinical Reminders settings for all Staff Level Users in your practice, [see below](#adjust_settings_for_staff) .
##### Disabling Clinical Reminders
Each individual Provider Level User must adjust their own Clinical Reminders Settings. To disable Clinical Reminders as a Provider Level User:
1. Click on your email at the top of your Elation account and then click **Settings**.
2. Click **Preferences** to view your account preferences settings.
3. Go to the **Clinical Reminders (MIPS)** section and toggle the **Enable Clinical Reminder Service (CRS)** to **No** to disable all Clinical Reminders for your own account.
4. If you want to disable specific reminders, toggle any reminder's setting to **Off** to disable that reminder. Disabled reminders will no longer appear at the top of your visit note drafts.
These changes will only apply to your provider account. Other Provider Level Users must adjust their own Clinical Reminders Settings. To change Clinical Reminders settings for all Staff Level Users in your practice, [see below](#adjust_settings_for_staff) .
#### Adjusting Clinical Reminders Settings for all Staff Level Users in the practice
The **Clinical Care Measure Settings** page controls which Clinical Reminders appear for all Staff Level Users in your practice. This includes nurses, medical assistants, care coordinators, and other clinical or administrative staff. Changes made here apply to every staff member—individual Staff Level Users cannot override these settings.
##### Enabling Clinical Reminders
To enable Clinical Reminders Settings for all Staff Level Users in the practice:
1. Click on your email at the top of your Elation account and then click **Settings**.
2. Click **Clinical Care Measure Settings** under **Practice Settings**\*.\*
3. Toggle the **Enable Clinical Reminder Service (CRS)** to **Yes** to enable Clinical Reminders for all Staff Level Users in the practice.
4. Next, toggle any reminder's setting to **On** to enable that reminder for all Staff Level Users in the practice. Enabled reminders will appear at the top of visit note drafts for all Staff Level Users whenever patients meet the conditions for those reminders.
##### Disabling Clinical Reminders
To disable Clinical Reminders for all Staff Level Users in the practice:
1. Click on your email at the top of your Elation account and then click **Settings**.
2. Click **Clinical Care Measure Settings** under **Practice Settings**\*.\*
3. Toggle the **Enable Clinical Reminder Service (CRS)** to **No** to disable Clinical Reminders for all Staff Level Users in the practice.
4. If you want to disable specific reminders, toggle any reminder's setting to **Off** to disable that reminder. Disabled reminders will no longer appear at the top of any visit note drafts for Staff Level Users.
##### Premium EHR features
Premium EHR Users can enable a feature that only allows Admin Level Users to access and edit the **Clinical Care Measure Settings** page. Once enabled, only Admin Level Users will see the **Clinical Care Measure Settings** page; non-Admin Level Users will not see this page in their Elation Settings.
This feature is part of Elation's Premium EHR offering. Once this feature is activated it will take effect immediately. If you are already a Premium EHR user and you are interested in using this feature, click **I need** **help** -> **Contact Elation Support** to notify Elation and a member of the Elation Team will activate the feature for you.
If you are interested in upgrading to Premium EHR to use this features, click **I need help** -> **Contract Elation Support** to notify Elation and a member of the Elation Team will assist you.
### Taking action on a Clinical Reminder
Enabled Clinical Reminders will always appear at the top of in-draft visit notes if the patient meets the conditions for that reminder.
* To address a Clinical Reminder during an encounter, click **Address** and then select the next appropriate action you will take to complete the requirements for the reminder.
* To dismiss a Clinical Reminder that will not be addressed during that encounter, click **Dismiss**. The same Clinical Reminder will reappear the next time a new visit note draft is open for that patient unless the conditions for meeting the Clinical Reminder have been met.
## Frequently Asked Questions (FAQ)
### Can I add my own Clinical Reminder to this list?
You cannot add your own Clinical Reminders to Elation at this time. We will notify you if this changes.
### How do I bring a Clinical Reminder back if I accidentally clicked "Dismiss"?
If you clicked **Dismiss** for a Clinical Reminder, the reminder will only reappear the next time a new in-draft visit note is open unless the conditions for meeting the measure have been met. Best practice is to open a second in-draft visit note, copy the contents from the first in-draft visit note to the second in-draft visit note and then discard the first in-draft visit note. Afterwards you can address the Clinical Reminder again in the remaining in-draft visit note.
## Related Articles
* [Clinical Quality Measure Help Center Articles](/admin-compliance)
# Clinical Training Videos
Source: https://help.elationhealth.com/articles/clinical-training-series---individual-videos
We've created a number of videos on the clinical workflow to ensure you are set-up for success on our EMR. Please review the following clinical training series.
## "Before the Visit" & "After the Visit" Basics
This training video will cover the various features you will need to prepare for a patient visit and follow up on after the visit responsibilities. This video is ideal for front office staff, anyone who manages appointments, faxes and patient communication. You can also skip to the following timeframes to view specific topics:
1. 1:07- Creating a New Patient Chart
2. 2:44- Finding Patient Charts
3. 4:13- Requiring Actions Queue
4. 6:55- Elation Schedule
5. 13:22- Appointment Reminders
6. 16:21- Fax Inbox Documents Management
* 20:17- Manually Add Lab Values to Lab Reports
7. 23:12- Drag & Drop Documents into the Patient Chart
* 25:20- Restore Deleted Reports or Visit Notes
8. 26:00- Patient Tags
9. 27:44- Document Tags
10. 29:57- Office Messages
11. 33:09- Patient Passport
* 36:01- Patient Passport Messages
12. 39:48- How to Contact Support
## Office Message Feature
Read the
[Office Message Feature Guide](/articles/How-to-use-Office-Messages)
to learn more about this feature.
## "During the Visit" Basics
This training video will walk you through the various features needed to document and complete a patient visit. This video is ideal for providers or anyone that manages clinical documentation and follow up for patients. You can also skip to the following timeframes to view specific topics:
1. 0:46- Finding the Patient Chart
2. 2:30- Navigating the Patient Chart
3. 5:18- Clinical Profile
4. 14:19- Visit Note Documentation
* 22:14- Managing Patient Medications
* 26:04- Medication History Download
* 30:25- Ordering Tests
* 35:51- Completing the Visit Note
5. 35:44- Provider Letters & Referrals
6. 40:36- Reviewing Lab Results
* 42:13- Manually Add Lab Values to Lab Reports
7. 42:33- Elation Integrated Video
8. 45:14- How to Contact Support
## Clinical Profile
Read the
[Clinical Profile Guide](/articles/clinical-profile-record-patient-medical-history)
to learn more about this feature.
## Visit Note Templates
Read the
[Visit Note Templates Guide](/articles/elation-visit-note-templates)
to learn more about this feature.
## Prescription Form
Read the
[Prescription Form Guide- ePrescribing & Ordering Medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
to learn more about this feature.
## Prescription (Rx) Templates
Read the
[Prescription (Rx) Templates Guide](/articles/create-and-use-custom-rx-templates)
to learn more about this feature.
## Letters & Referrals Form
Read
[Letters & Referrals Guide- Sending messages to patients & corresponding with third party professionals](/articles/how-to-send-a-fax)
to learn more about this feature.
## Related Articles
* [Administrative Training Video](/articles/administrative-training-series---individual-videos)
# Collaborative Billing Fields
Source: https://help.elationhealth.com/articles/collaborative-billing-fields
Learn how to enable and use additional billing fields in Elation EHR and Elation Billing
This article explains how to enable and use additional billing fields in both Elation EHR and Elation Billing.
## Overview
### What are Collaborative Billing Fields?
Additional Billing Fields introduces new Provider Fields into both the EHR and Elation Billing:
* **Supervising Provider** - Available in Elation Billing by default, new to EHR
* **Billing Provider / Incident To** - For designating incident-to encounters
* **Ordering Provider** - For specifying who ordered a service
* **Prior Authorization** - Available in Elation Billing by default, new to EHR
### Why are Collaborative Billing Fields important?
These fields ensure that claims include all required provider information, which is necessary for proper reimbursement, especially for incident-to billing and supervised services.
## Workflow Instructions
### Enabling Additional Billing Fields in the EHR
1. **Navigate to EHR Settings** - Navigate to your practice's EHR **Practice Settings** → **Practice Settings** → **Billing**.
2. **Toggle Additional Fields** - Navigate down the page to **Additional Billing Fields** and enable the field(s) you'd like to be available on the Visit Note.
![Additional Billing Fields settings panel showing four toggles — Supervising Provider, Billing Provider, Ordering Provider, and Prior Authorization — all currently disabled.]()
3. **Establish Default Providers (Optional, Admin Only)** - To establish a default Supervising and/or Billing Provider:
* Within the EHR Settings, navigate to **Manage Accounts**
* Under **Providers**, select **Edit** on the Provider you'd like to update
* Select the **Billing** tab
* Establish the default Provider(s)
* Click **Save**
![Edit Profile page showing the Billing tab selected, with Supervising Provider (empty) and Billing Provider set to "Test Doctor, MD" under Default Providers.]()
***
### Enabling Additional Billing Fields in Elation Billing
1. **Navigate to Elation Billing Settings** - Navigate to Elation Billing **Settings** → **Practice Settings** → **Billing Rules**.
2. **Toggle Fields** - Select the fields you'd like to be available on the Superbill.
![Bill Settings panel in Elation Billing showing Referring Provider and Supervising Provider toggles enabled, while Billing Provider and Ordering Provider remain disabled.]()
***
### Using Additional Billing Fields in the EHR
Any combination of these four fields can be enabled. The information in these fields will also populate on the Superbill when pushed from EHR into Elation Billing.
#### Supervising Provider
Enabling Supervising Provider will display this field in the Billing Information of the Visit Note:
![Bill dialog for Snow White dated 12/26/2023, showing the Supervising Provider field populated with "Lead Doctor, M.D." under the Details section.]()
#### Billing Provider / Incident To
Enabling Billing Provider will allow a Visit Note's bill to be marked as an Incident-To encounter, allowing the Billing Provider to be listed:
![Bill dialog for patient Snow White dated 12/26/2023 showing "Mark as incident-to encounter" checkbox checked and Billing Provider set to "Lead Provider, MD"]()
#### Ordering Provider
Enabling Ordering Provider will display this field in the Billing Information of the Visit Note:
![Bill dialog for Snow White dated 12/26/2023 showing Ordering Provider field populated with "Test Doctor, M.D. (888-888-8888)" in the Details section alongside procedure 12345.]()
#### Prior Authorization
Enabling Prior Authorization will display this field in the Billing Information of the Visit Note:
![Bill dialog for Snow White (12/26/2023) showing the Prior Authorization field in the Details section, currently empty (–), alongside State CA and Referring Provider fields.]()
## Frequently Asked Questions
### Why can’t I turn off the Billing Provider or Supervising Provider field?
If you are using AI Billing, the **Billing Provider** and **Supervising Provider** fields stay visible while any active AI billing rule changes them, so that the effect of those rules is always visible on the bill. When you turn one of these fields off, Elation lists the rules that depend on it and offers **Review rules** or **Keep field on**. Remove the listed rules first, then turn the field off. Elation does not turn rules off on your behalf. For more about these rules, see [AI Billing Guide - Scrubbing claims](/articles/AI-Billing-Guide-Scrubbing-claims).
## Related Articles
* [AI Billing Guide - Scrubbing claims](/articles/AI-Billing-Guide-Scrubbing-claims)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
* [Add New Provider](/articles/add-new-provider)
* [Add or Edit Authorizations/Referrals](/articles/add-or-edit-authorizations-referrals)
# Common claim rejections and denials
Source: https://help.elationhealth.com/articles/common-code-denials
Reference guide for common claim rejections and denials and their solutions
This article provides a reference guide for common claim rejections and denials, along with possible solutions.
## Overview
### Rejection vs. denial
Rejections happen before the payer adjudicates the claim — usually a front-end edit at the clearinghouse or payer that prevents the claim from being accepted. Fix the issues and resubmit the claim from the Claims Queue. See [Claims Queue](https://help.elationhealth.com/articles/claims-queue#claims-queue) for the rejection-handling workflow.
Denials happen after the payer adjudicates the claim and decides not to pay. Review the Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC), correct or appeal as appropriate, and resubmit a corrected claim or appeal. See [Managing Denials](https://help.elationhealth.com/articles/managing-denials) for the denial-handling workflow.
### How to use this guide
Entries are grouped into **Front-end rejections** and **Payer denials**, then by category. Scan the section that matches the type of message you're working, or use your browser's Find function to search for a specific alert message or CARC:
* **Windows:** Ctrl + F
* **Mac:** Command + F
Billing and coding decisions are best made by you and your team — you know your practice best. This article is simply here to show you what Elation's billing features can do and how to make the most of them.
## Front-end rejections
These messages come back from the clearinghouse or payer's front-end edits before the claim is adjudicated. Correct the issue in the claim and resubmit through the [Claims Queue](/articles/claims-queue).
### Coding / data
| Rejection / denial message | Explanation | Possible solutions |
| -------------------------------------- | -------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Diagnosis pointer required | No DX codes present | Add diagnosis codes to the claim and rebill |
| Diagnosis code pointer missing/invalid | Error with DX fields | Confirm diagnosis codes are correct on the claim. Elation Billing automatically selects a maximum of 12 diagnosis codes for submission — manual trimming isn't required. If you still see this error, reach out to Elation Support using **Help** → **Contact Elation Support**. |
### Demographics
| Rejection / denial message | Explanation | Possible solutions |
| -------------------------- | --------------------------------------- | ----------------------------------------------------------------------------------- |
| Invalid address/city/zip | Information mismatch with payer records | Verify address with USPS tool, ensure patient address matches payer records, rebill |
### Enrollment
| Rejection / denial message | Explanation | Possible solutions |
| ----------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Submitter not approved | Not enrolled for electronic claims | Enroll for Claims for the Payer via **Settings → Practice Settings → Insurance** |
| Billing NPI not on file | NPI not valid with payer | Enroll for Claims for the Payer via **Settings → Practice Settings → Insurance** |
| CLIA certification number invalid/missing | Claim is for a CLIA-waived in-house test (e.g. CPT with a **QW** modifier) but the practice's CLIA certificate number is missing or incorrect | Add or correct the CLIA number under **Settings → Practice Settings → Practice Info**, then resubmit as a [corrected claim](https://help.elationhealth.com/articles/filing-a-corrected-claim) |
### Workers Comp / Auto
| Rejection / denial message | Explanation | Possible solutions |
| ----------------------------------- | --------------- | ------------------------------------------------------------------------------------------------------------------------------------------------- |
| Workers Comp/Auto claim ID required | Claim ID needed | Add the patient's claim ID to the **Auth/Referral Number** field in Authorizations; sometimes the Member ID needs to be the patient's SSN, rebill |
## Payer denials
These messages come back from the payer after the claim has been adjudicated, usually through an ERA/EOB. For an end-to-end workflow, see [Managing Denials in Elation Billing](/articles/managing-denials).
### Authorization / referral
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ----------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO15 | Authorization number missing, invalid, or does not apply | Authorization exists but was not transmitted correctly on the claim, or does not match the billed service/provider. | Add the correct authorization number to the claim and resubmit as a [corrected claim](https://help.elationhealth.com/articles/filing-a-corrected-claim). |
| CO197 | Pre-certification/authorization/notification/pre-treatment absent | No authorization was obtained before the service was rendered (different from CO15, where auth exists but is missing from claim). | Request retro-authorization if payer allows (often a 24–72 hr window). Otherwise [generate an appeal](https://help.elationhealth.com/articles/claim-appeals#what-is-a-claim-appeal) based on medical necessity or emergent circumstances. |
### Benefit limits
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO119 | Benefit maximum for this time period or occurrence has been reached | Patient has hit a benefit cap (visit limit, annual max, lifetime max, or per-occurrence limit) for this service category. | Verify benefit limits with payer. Confirm CPT is correct. If limit shouldn't apply, [file an appeal ](https://help.elationhealth.com/articles/claim-appeals)with documentation. Otherwise transfer balance to patient if plan allows. |
### Bundled / inclusive
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ----------------------------------- | ------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO97, CO234 | Benefit included in another service | Claim bundled or previously processed | Check payer portal, confirm appropriate modifiers used, [submit a correct claim](https://help.elationhealth.com/articles/filing-a-corrected-claim) if needed. |
### Capitation
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | --------------------------------------- | ------------------------------------------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO24 | Payment adjusted - capitation agreement | Claim is covered by a capitation agreement | If fully capitated, [settle the capitated claim](https://help.elationhealth.com/articles/posting-a-capitation-payment#settling-a-patient-claim-to-capitation). If part of the claim is capitated, create a Payment with amount in Allowed field and settle the remainder to capitation. If wrong payer, transfer to correct payer. |
### Coordination of Benefits / coding
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ---------------------------------------------------------- | --------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| CO16 | Lacks information for adjudication | Generalized alert, check Remittance Advice Remark Codes | Look at the ERA/EOB for the claim and review the denial codes, fix issues, [submit a corrected claim](https://help.elationhealth.com/articles/filing-a-corrected-claim). |
| CO16 | Missing primary payer adjustment information (CAS segment) | On a secondary claim, the primary payer's adjustment codes/amounts (CAS segment data) were not populated. | Post the primary payment, populate the Claim Adjustment Segment fields from the primary EOB, and resubmit the secondary claim. |
### Provider identifiers
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ---------------------------------------------------------------- | --------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO16 | Missing/incomplete/invalid rendering provider primary identifier | The rendering provider's NPI is missing, incorrect, or wasn't properly selected on the claim. | Confirm the rendering provider is added under **Settings → Practice Settings → Providers** with an active individual NPI (see [Add New Provider](/articles/add-new-provider)), confirm the correct rendering provider is selected on the claim, and [submit a corrected claim](https://help.elationhealth.com/articles/filing-a-corrected-claim). |
### COB / other insurance primary
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ---------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO22 | This care may be covered by another payer per coordination of benefits | Another payer is expected to be primary; secondary claim is missing primary payer EOB/adjudication data. | Verify payer order. If billed wrong primary, resubmit to correct payer. If secondary, resubmit (don't appeal) with primary EOB and Claim Adjustment Segment fields data populated. |
### Coding / medical necessity
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | -------------------------- | ------------------------------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO96, CO204 | Non-covered charge | Procedure not covered by payer | Check remittance codes, confirm correct CPT and diagnosis codes were used, [submit a corrected claim](https://help.elationhealth.com/articles/filing-a-corrected-claim) if needed. |
### Documentation
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ------------------------------------------------------------------------------ | ------------------------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO252 | An attachment/other documentation is required to adjudicate this claim/service | Specific documentation is needed; the accompanying RARC identifies what. | Read the paired RARC to identify the required document. Print and mail the claim with documents attached, or [file an appeal](https://help.elationhealth.com/articles/claim-appeals) with documents attached. |
### Duplicate
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ----------------------------- | ----------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO18 / OA18 | Exact duplicate claim/service | Already received by payer. Per X12, code 18 should use group code OA except where state workers' comp regulations require CO. | No action required if a true duplicate. If submitting a [corrected claim](https://help.elationhealth.com/articles/filing-a-corrected-claim), use claim frequency code 7 (replacement) or 8 (void). For separate same-day services, use distinguishing modifiers (59, XE, XS, XP, XU). |
### Eligibility / coverage
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO31, CO32 | Patient cannot be identified as our insured | Patient ID doesn't match payer records, or patient is not an eligible dependent (CO32). Often means claim went to the wrong payer. | Review eligibility, verify insurance card, contact patient, update payer. Afterwards send the claim to the correct payer or [appeal](https://help.elationhealth.com/articles/claim-appeals) with proof of eligibility. |
| CO27 | Expenses incurred after coverage terminated | Policy is no longer active | Review eligibility, contact patient, update payer. Afterwards send the claim to the correct payer or [appeal](https://help.elationhealth.com/articles/claim-appeals) with proof of eligibility. |
### Medical necessity
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | -------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| CO50 | Non-covered services - not deemed a 'medical necessity' by the payer | Service does not meet the payer's medical necessity criteria (for example, LCD/NCD for Medicare). NOT a contract exclusion — that's CO96/CO204. | [Appeal](https://help.elationhealth.com/articles/claim-appeals) with clinical documentation that maps to the payer's medical policy/LCD criteria. Consider peer-to-peer review for high-dollar denials. |
### Timely filing
| Common CARCs | Rejection / denial message | Explanation | Possible solutions |
| ------------ | ----------------------------- | --------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| CO29 | Time limit for filing expired | Missed timely filing window | If originally filed timely, [appeal](https://help.elationhealth.com/articles/claim-appeals) with claim history. Otherwise, write-off with reason documented. |
## Related Articles
* [Claims Queue](/articles/claims-queue)
* [Managing Denials in Elation Billing](/articles/managing-denials)
* [Claim Appeals](/articles/claim-appeals)
* [Filing a Corrected Claim](/articles/filing-a-corrected-claim)
* [Denials Reporting](/articles/denials-reporting)
* [Claim History](/articles/claim-history)
* [Add New Provider](/articles/add-new-provider)
# Patient Chart Guide- Managing confidential records
Source: https://help.elationhealth.com/articles/confidential-items-in-your-patient-chart
This article describes the confidential sections of the patient's chart which will allow you to withhold information from patients and anyone you are collaborating with to care for your patient.
## What are confidential records?
Confidential records are text, notes, orders, reports or other documents that you do not want to share with patients or anyone you are collaborating with to care for your patient outside of your practice. Confidential records in the patient's chart consists of:
1. a **Confidential** section in the Clinical Profile that allows you to document and store confidential and private notes for the patient that can only be seen by members of your office. Notes in the **Confidential** section will never be printed, will not be visible in Passport and will not be shared outside of your practice when you attach the Clinical Profile to any Provider Letters or Referral Orders.
2. ability to mark any record/document in the patient's chart as 'Confidential' to allow any member of your practice to take caution when sharing the record/document outside of your practice.
The **Keep as confidential** checkbox on visit notes is intended to call attention to visit notes marked as confidential to ensure that confidential visit notes are only shared explicitly (and not implicitly) with third parties (other than the patients) via features like Letters or Referral Orders — it does not impact which, and how, visit notes are shared with patients via Passport. A signed visit note will always be shared with the patient as a visit summary via Passport, whether the note is marked confidential or not, and those visit summaries include the information documented in the following sections of the visit note:
## What are the benefits of separating confidential records?
It is important to separate confidential records to allow you to confidently share only records you want to share with anyone outside of your practice.
* Notes in the **Confidential** section of the Clinical Profile will never be printed or shared outside of your practice.
* If you mark a record as 'Confidential, that record will always have a special indicator that can be seen from anywhere in the patient's chart- this will allow members of your practice to take caution when printing or sharing the record
* If you mark a record as 'Confidential, that record will not be shared when you generate [C-CDA (CCDA) files](/articles/Supported-Elation-CCDA-types) for the patient
## Confidential section of the Clinical Profile
Every patient chart has a **Confidential** section in the [Clinical Profile](/articles/clinical-profile-record-patient-medical-history) section of their chart. The **Confidential** section is at the very bottom of the Clinical Profile. Any information added to this **Confidential** section by any member of your practice:
1. can be viewed and edited by anyone in your practice
2. will never be printed or shared whenever you print the Clinical Profile or share the Clinical Profile through Patient Passport or Letter/Referral
3. will never be exported when exporting the contents of the patient chart as a [C-CDA (CCDA) file](/articles/Supported-Elation-CCDA-types)
4. will never be shared with or visible to other providers using the Patient Longitudinal Record or Collaborative Health Record features (if you are using these features).
![Confidential section at the bottom of the Clinical Profile, highlighted with a red border, showing the privacy notice "The information in this section will never be shared outside this practice" and an "add confidential item" field.]()
## Marking records as confidential
Any member of your practice can mark any notes, orders, reports or documents as **Confidential** in the patient's chart. To mark records as confidential:
1. Use the **Keep this confidential** checkbox at the bottom of notes and orders
!["Keep this confidential" checkbox highlighted with red outline in three locations: the Lab Requisition Form, a New Non-Visit Note, and the Visit Note panel.]()
1. Click the **Action** >> **Mark Confidential** button next to any signed notes, orders, reports or documents
![Actions dropdown menu open on a report in the Chronological Record, with "Mark Confidential" highlighted and indicated by a red arrow.]()
If you need to remove the **Confidential** marker on any record, click **Actions** >> **Unmark Confidential**.
Letters, referrals, prescriptions and office messages cannot be marked as **Confidential** using this feature.
## Confidential Records and Patient Passport
To withhold confidential or sensitive information from patients for patient safety reasons, we recommend using the [Confidential section of the Clinical Profile](#confidential_section).
The **Keep this confidential** checkbox on documents is intended to call attention to records marked as confidential to ensure that these confidential records are only shared explicitly (and not implicitly) with patients when sharing records via Patient Letters; with the exception of visit notes. The confidential checkbox on visit notes does not impact which visit notes are shared with patients via Passport. Visit summaries for all signed visit notes are always automatically shared with Patient Passport Users regardless of whether or not the visit note is marked as confidential, and those visit summaries include the information documented in the following sections of the visit note:
* **Vitals**
* **Plan** (\*SOAP [Visit Note Format](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) only)
* **Proc** (Procedure)
* **Tests/Treatments**
* This includes any Referrals, medications and diagnostic test orders.
* **Care Plan** (Instructions)
* **F/U** (Follow-up)
## Confidential records & shared charts
The[Collaborative View](/articles/the-collaborative-view-hi-only) and [Patient Longitudinal Record (PLR)](/articles/introducing-elations-patient-longitudinal-record-enterprise-only) are special features used by large groups of Elation users who are part of the same geographic location or Enterprise.
By marking certain records as **Confidential** in your patient's chart, you will be able to withhold the data within those records and prevent the records from being seen by collaborating providers.
Only records that are automatically shared through these features (visit notes, non-visit notes, reports, and orders) can be marked as **Confidential**. Anything marked **Confidential** can still be manually shared via Letters or Referrals but you will see a **Confidential** marker on the record to allow you review the record before choosing to share it outside of your practice.
## 21st Century Cures Act and Information Blocking
The 21st Century Cures Act Information Blocking provision was effective beginning April 5, 2021. The Information Blocking Provision requires health care actors, like providers, to not take any action that constitutes blocking of Electronic Health Information (EHI). There are some exceptions that allow for patient information to not to be shared with patients and Elation recommends only using the Confidential section of the Clinical Profile for information that fits the Information Blocking exceptions conditions. If you are not sure if your use case meets the exception conditions, consult a legal resource. ([Read more about the 21st Century Cures Act here](/articles/21st-Century-Cures-Act-and-Elation-EHR) and [read more about Information Blocking Provisions here](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions).)
## Frequently Asked Questions (FAQ)
### Can I set it so that only specific members of my practice can edit 'Confidential' information and records?
The **Confidential** feature can be used by both staff and provider and you cannot set it so that only specific members of your practice can use this feature. Elation has a
[VIP Charts](/articles/vip-chart-feature)
feature that will give you more control over who in your office has access to patient records. Please feel free to explore the
[VIP Charts](/articles/vip-chart-feature)
feature.
### Can I set it so that only specific members of my practice can view 'Confidential' information and records?
**Confidential** information and records can be seen by anyone that has access to your Elation EHR practice. You can set additional security around chart access using the
[VIP Charts](/articles/vip-chart-feature)
feature. Please feel free to explore the
[VIP Charts Guide](/articles/vip-chart-feature)
to learn more about the feature.
### Why can't I mark letters, referrals, prescriptions and office messages as 'Confidential'?
This feature is not available in Elation at this time. Elation will notify you when this feature becomes available.
## Related Articles
* [Clinical Profile Guide- A snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
* [VIP Charts- Limiting access to certain patient charts](/articles/vip-chart-feature)
* [Collaborative Health Record View Guide](/articles/the-collaborative-view-hi-only)
* [Patient Chart Guide- Using the Patient Longitudinal Record (PLR) to share patients within a network](/articles/introducing-elations-patient-longitudinal-record-enterprise-only)
* [21st Century Cures Act Guide- Staying compliant with Information Blocking Provisions](/articles/Cures-Act-Staying-compliant-with-Information-Blocking-Provisions)
# Visit Note Documentation Guide- Converting paper or other external visit notes into Elation visit notes
Source: https://help.elationhealth.com/articles/converting-paper-or-electronic-visit-note-to-elation
This article provides some tips on how to migrate your existing progress notes into Elation.
## Why should I convert external visit notes into Elation visit notes?
At Elation we believe that you should never sacrifice clinical effectiveness for administrative efficiency. That is why we have designed Elation to allow you to take your existing visit notes from either paper or another EMR system and seamlessly transform them into an Elation visit note.
By converting your existing visit notes into Elation visit notes you will be able to add structured clinical data such as vital signs and diagnoses. You will also be able to streamline clinical communication through letters and even create a [create a super bill](/articles/billing) or [patient invoice](/articles/patient-invoicing) from the visit note.
## Conversion options
There are a few ways to convert your external visit notes into Elation visit notes:
1. If your external visit notes are all on paper
2. scan the paper notes onto your computer as PDF files using a scanner
3. fax the paper notes from a physical fax machine to your[Elation fax number](/articles/Fax-Inbox-Introduction#options) so that your paper notes become PDF files in the [Fax Inbox](/articles/Fax-Inbox-Introduction)
4. If your external visit notes are in another electronic health record system, export the visit notes from the other system as PDF files and [upload the PDF files into Elation](#upload)
## Uploading PDF visit notes into Elation
You will use the
[drag-and-drop feature](/articles/filing-documents-to-a-patient-chart)
to upload your external visit notes into Elation.
1. Open the patient's chart
2. Find the old visit note you want to file into your patient's chart on your computer
3. Click on the file from your the folder on your computer, hold down on your mouse cursor and drag the file anywhere over the patient's chart in Elation and release your mouse cursor to drop the file
![Dragging "SOAP Note.pdf" from the Desktop folder and dropping it onto the patient chart's "Drop Here to Upload" zone in Hailey Jones's chart.]()
1. Fill out the reviewer's name, date of document, select the document type **New Visit Note** and check off **File on behalf of Reviewer**.
!["File Document into Chart" dialog for SOAP Note.pdf with Reviewer set to "Karly Smith, MD", Date "03/23/2022", type "New Visit Note", and "File on behalf of Reviewer" checked.]()
1. Click **Upload File** when you are ready to upload the old visit note
2. Wait for the document to upload and process before moving or removing it from the original location on your computer or the upload will fail.
3. Once processed, the document will appear as a visit note in your patient's Chronological Record.
The visit note format used for this feature will be based on the reviewer's default visit note format as selected from the reviewer's user preferences. Frequently Asked Questions (FAQ) I have a large quantity of old visit notes I want to upload, is there a quicker way to achieve this? If you have a large quantity of old visit notes from another electronic health record system and the other electronic health record system can provide you with an export of all of your patients' visit notes, Elation can attempt to import those visit note files for you in bulk. Practices that are new to Elation may receive this bulk import free of charge as part of their Elation implementation. Please notify your implementation manager if you would like a bulk visit note import to discuss this option in more detail. Once the visit notes are imported to corresponding patient charts, you will see the visit notes in the Chronological Record section of each patient's chart. Can I use this same method to convert old reports to Elation reports? Yes, you can use this same method to convert old paper reports or reports from other electronic health record systems into Elation reports. Related Articles [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
[Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
[Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
[Billing Guide- Patient Invoicing- Generating invoices to patients for services rendered](/articles/patient-invoicing)
# Prescription (Rx) Templates Guide
Source: https://help.elationhealth.com/articles/create-and-use-custom-rx-templates
Save your most commonly prescribed medication scripts as prescription templates to complete your prescriptions with a few simple clicks.
## Recommended Readings
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
## What are Prescription (Rx) Templates?
Prescription (Rx) Templates allow you to easily save frequently used medications and its specifications (**Sig**, **Qty**, **Unit**, **Refills**,**Days Supply**,**Packaging (NDC)**) as a set of information to use and reuse at a later time. Rx Templates are available for use in the [Prescription Form](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds) and will always appear at the very top of the medication search drop down menu. Templates created by your practice will have the label **Rx Template** next to them in the drop down menu.
## Why are Prescription (Rx) Templates useful?
Prescription (Rx) Templates allows you to save time when prescribing medications because the specifications of the medication will be pre-entered for you depending on the Rx Template you saved and selected. This also reduces room for error and ensures consistency in your Prescriptions you write for your patients.
## Creating Prescription (Rx) Templates
To create a Prescription (Rx) template from the Prescription Form:
1. Click on the **Rx** button in the gray navigation bar at the top of a patient's chart
2. Select **Prescription Form (Rx/OTC/CS)**
3. Fill in the following fields
* **Medication name & strength**
* **Sig**
* **Qty**
* **Unit**
* **Refills**
* **Days Supply**
* **Packing (NDC)**
4. Click **Save as Rx template**
5. Click **Save**
![Prescription Form with CeleXA 20 mg Tab details filled in (Sig: 1 tablet orally daily, Qty: 30, Refills: 0), with an arrow pointing to the highlighted "Save as Rx template" button.]()
### Prescriptions Settings Page
The **Prescriptions** Settings page organizes your saved data into two separate paginated lists — one for **Rx Templates** and one for **Custom Rx Sigs**. Each list has its own **search bar** and **pagination controls**, and entries within each list are shown in **alphabetical order**.
1. Click on your email at the top right corner of Elation
2. Click **Settings**
3. Click **Prescriptions** under **Practice Settings**
4. In the **Rx Templates** section, use the **search bar** to confirm the medication isn't already saved, then click **+ Add Rx Template**
5. Fill in the following fields
* **Medication name & strength**
* **Sig**
* **Qty**
* **Unit**
* **Refills**
* **Days Supply**
* **Packing (NDC)**
6. Click **Save**
![Prescriptions Settings page with "Prescriptions" highlighted in the left nav under Practice Settings, and the "+ Add Rx Template" button highlighted in the Rx Templates section.]()
## Applying Prescription (Rx) Templates
When prescribing medications, begin searching for the medication in the **Medication Name & Strength** field and you will find Rx Templates for those medications at the very top of the search drop down menu with the label \*\*Rx Template \*\* next to the medication name. Select an Rx Template and Elation will automatically fill in any **Sig**, **Qty**, **Unit**, **Refills**,**Days Supply** and **Packaging (NDC)** associated with the template.
![Prescription Form medication search results for "las" showing "Lasix 20 mg Tab, 1 qd #90 tab RFx3 180 days" at the top with an "Rx Template" label highlighted.]()
## Managing Prescription (Rx) Templates
The **Prescriptions** Settings page in Elation is dedicated towards managing prescription templates and custom Sigs. You can [add new templates](#creating_templates), edit existing templates or delete templates you no longer need from this page.
The page organizes your saved data into two separate lists — **Rx Templates** and **Custom Rx Sigs**. Each list is paginated, searchable, and alphabetized, so you can browse and search within each list independently rather than loading everything at once.
1. Click on your email at the top right corner of Elation
2. Click **Settings**
3. Click **Prescriptions** under **Practice Settings**
### Searching for a Rx Template or Custom Rx Sig
To find an existing Rx Template or Custom Rx Sig:
1. Click on your email at the top right corner of Elation
2. Click **Settings**
3. Click **Prescriptions** under **Practice Settings**
4. Use the **search bar** within either the **Rx Templates** section or the **Custom Rx Sigs** section to filter that list by name
5. If a list has many entries, use the **pagination controls** at the bottom of that section to browse through additional pages
### Updating a template that has a discontinued or off-the-market medication
When a medication is discontinued by the manufacturer and/or taken off the market, its NDC code will be made obsolete and you will not be able to prescribe the medication or retrieve formulary or coverage information for that medication. If one of your prescription templates has a discontinued or off-the-market medication, you will run into an error when applying the template to a Prescription Form. To avoid running into this error:
* update the prescription template with an active medication
* delete the prescription template if it's no longer needed
## Frequently Asked Questions
[Click here to view our comprehensive list of 'Frequently Asked Questions' about the Rx Templates Feature](/articles/Prescriptions-Guide-Frequently-Asked-Questions#prescription_templates_and_custom_rx_sigs).
**Next Step**
**Create a Rx Template today and start using it for prescriptions!**
## Related Articles
* [Prescription Form Guide- ePrescribing and ordering medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [Prescriptions Guide- Frequently Asked Questions](/articles/Prescriptions-Guide-Frequently-Asked-Questions)
# Reporting Guide- Custom report options
Source: https://help.elationhealth.com/articles/custom-reports
This article discusses custom report options, available for a fee, within Elation.
## What are custom reports?
Custom reports are reports for EHR data that is not available within the existing Reporting options provided by the Elation application. Custom reports are generated in the backend by our Data Services Team and will come with a fee that is dependent on the requirements and complexity of the reporting needs.
Existing free Reporting options are as follows and these reports are all available within the **Reports** dropdown at the top of your Elation account:
* Patient List Report
* Appointment Report
* Billing Home
* Patient Payment Report
* Membership Report
Ad-hoc aggregations, counts, and summaries across clinical data domains — such as medications prescribed, referrals sent, immunizations administered, problem/diagnosis lists, lab orders, or patient documents — are **not** available as built-in reports in Elation. Reporting on this data requires either the [Hosted Database](/articles/Hosted-Database-Introduction) (self-serve, for customers with that add-on) or a custom report request (described below).
## How does the custom report process work?
Elation's Data Services Team will review each and every request to determine whether or not such a report can be made available. If a report can be made available, Elation will offer a quote on the cost for the service. Customers can review the cost and timeframe for delivery and then sign a Statement of Work if they would like to use this service. The report will then be delivered to the customer securely within the agreed upon time frame.
Elation cannot guarantee delivery of every requested report.
## How do I request custom reports?
To request a custom report, use the **I need help** -> **Contact Elation Support** option and send the following details to the Support Team:
1. Preferred contact Name & Email Address
2. What is the business purpose of the report you are requesting?
3. What information do you need included in your report? (Ex. Patient’s Name, Date of Birth, Full Address, etc)
4. Do you require this report one time, or is this something you will need on a recurring basis?
An Elation Team member will follow up with you within 10 business days about your request.
## How will custom reports be delivered to me?
Custom reports will be delivered securely to the preferred contact listed in the request. The preferred contact will have 7 days to download the report from the secure link provided.
## Frequently Asked Questions (FAQ)
### How do I know if a report I need exists in Elation?
Use these steps to figure out whether the data you need is available in a built-in report, through the Hosted Database, or only through a custom report request:
1. **Check the standard reports first.** The free in-app reports listed above cover patient demographics and panel filtering ([Patient List](/articles/find-patients-with-elations-patient-list)), appointments ([Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments)), billing and payments ([Billing Home](/articles/Billing-Home), [Patient Payments](/articles/using-elation-to-securely-collect-patient-payments)), and membership ([Membership Management](/articles/Membership-Management-How-To-Receive-Payments)). Those reporting for MIPS can also use the [Clinical Quality Measure](https://help.elationhealth.com/articles/elations-cqm-dashboards#clinical-quality-measures-reports-guide) and Promoting Interoperability reports. Premium EHR users can also use [productivity reports](https://help.elationhealth.com/articles/Reporting-Guide-Built-in-appointment-and-visit-note-productivity-reporting) to check on practice performance.
2. **If your need falls outside those domains, it likely is not a built-in report.** Common examples include medications prescribed over a date range, outgoing referrals, immunizations administered, problem/diagnosis lists, lab orders, patient documents, structured history data, or any custom date-range aggregation not exposed in the Elation UI.
3. **Hosted Database (HDB) customers have a self-serve option.** If your practice has the [Hosted Database](/articles/Hosted-Database-Introduction) add-on, many clinical data exports — including [Medication Orders](/articles/hdb/med-orders), [Lab Orders](/articles/hdb/lab-orders), and [Lab Results](/articles/hdb/lab-results) — are available as queries you can run yourself. Check the HDB common queries before submitting a custom report request.
4. **Otherwise, submit a custom report request.** Use the request flow described in [How do I request custom reports?](#how-do-i-request-custom-reports) above. The Data Services Team will confirm whether the report can be produced and provide a quote.
### What are the kinds of reports I can request?
Customers usually request reports that are tied to their patient data and can include, but are not limited to: full demographics exports, appointments, medications prescribed, outgoing referrals, patient documents, problem diagnosis, immunizations, medical/surgical/family/social histories, etc. If you have a particular report in mind, do not hesitate to send in a request and our Data Services Team will provide you with feedback on whether or not the request report can be made available.
### How long will it take for us to receive the requested report?
The request will be reviewed within 10 business days. A Statement of Work will be provided if Elation is able to supply the requested report. The Statement of Work will come with a timeframe of when the report will be delivered. The timeframe is dependent upon the complexity of the requested report. The average timeframe for delivery of the report is 5 business days from when the Statement of Work is signed.
## Related Articles
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
* [Calendar Guide- Searching for appointments using the Appointment Report](/articles/Calendar-Guide-Searching-for-appointments-with-the-Appointments)
* [Billing Home Guide- A dashboard for managing your bills](/articles/Billing-Home)
* [Patient Payments Guide- Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Membership Management- How To Manage Payments](/articles/Membership-Management-How-To-Receive-Payments)
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
# Customizing the Clinical Profile Column
Source: https://help.elationhealth.com/articles/customize-clinical-profile-patient-summary
What you can and can't change about the layout of the Clinical Profile column, including how to collapse and expand sections.
## What you can customize in the Clinical Profile
The **Clinical Profile** is the column in the patient's chart that summarizes the patient's health status—including **Allergies**, the **Problem List**, medications, and more. The set of sections and their order is fixed, but you can still control a few things:
* **Reordering sections** (for example, moving the Problem List above Allergies) is **not** available. Sections are arranged to match the [Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) available in Elation.
* **Hiding or removing sections** you don't use is **not** available—but you can collapse them (see below).
* **Reordering items within a section** is available. Use the 3-horizontal-line handle next to a problem or a free-text record to drag and reorder it.
## Collapsing and expanding sections
You can't hide individual sections, but you can collapse them to make the Clinical Profile more compact:
1. Click the **Collapse** button above the **Allergies** section to collapse all sections at once.
2. Expand only the sections you want to see by clicking each section header.
Clicking **Expand** (or reloading the chart) expands all sections again.
## Frequently Asked Questions
#### Can I reorder the sections of the Clinical Profile?
No. The sections are arranged to match the [Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats) available in Elation, and that order can't be changed.
#### Can I hide sections I don't use?
No, sections can't be hidden or removed. You can collapse all sections with the **Collapse** button above the **Allergies** section, then expand just the ones you need.
## Related Articles
* [Clinical Profile Guide — A snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
* [Visit Note Documentation Guide — Using Clinical Profile documentation to facilitate charting](/articles/no-double-documentation-with-the-clinical-profile)
* [Problem List Guide](/articles/managing-your-problem-list)
# Delaware Health Information Network (DHIN) Interface
Source: https://help.elationhealth.com/articles/delaware-health-information-network-dhin-integration
This article describes the Delaware Health Information Network (DHIN) Interface and how to request the interface.
## Overview
### What is the Delaware Health Information Network (DHIN)?
The [Delaware Health Information Network (DHIN)](https://dhin.org/) is an aggregator of Delaware laboratories and the oldest health information exchange in the country.
### What is the DHIN interface?
Elation has partnered with [Delaware Health Information Network (DHIN)](https://dhin.org/) to bring you a unidirectional interface. Practices with a DHIN interface can receive results from 26 laboratories and diagnostic centers directly into their Elation inbox. This interface does not include the Delaware immunization registry.
**Which labs are part of the DHIN interface?**
The following labs are part of the DHIN interface:
* Accu Reference Lab
* Atlantic General Hospital
* Avero Diagnostics
* Beebe Healthcare
* Bayhealth
* Christiana Care Health Systems
* CNMRI
* DCMFM
* Delaware Diagnostic Imaging
* Delaware Division of Public Health
* Doctors Pathology Services
* Limestone Radiology
* Mid-Delaware Imaging
* Medical Diagnostic Laboratories (MDLAB)
* Mercy Diagnostics Lab
* Nanticoke
* Natera Labs
* Nemours Blood Bank
* Ocean Medical Imaging
* Papastavros Radiology
* PRMC Blood Bank
* Saint Francis
* TriState Radiology (ELITE)
* Union Hospital
## Set-up
If you are interested in setting up a DHIN interface for your practice, click the **Contact Elation Support** button to submit a request. A membership with DHIN is required, but there is no membership cost and no fee for receiving results. DHIN does have an optional upgrade for \$400 to have access to search the DHIN database for results not routed to the practice (e.g. for a new patient not yet part of the practice, for results the practice was not copied on).
# Denials Reporting
Source: https://help.elationhealth.com/articles/denials-reporting
Learn how to use denial reports in Elation Billing to track and manage claim denials
This article explains how to use the denial reporting features in Elation Billing to track and manage claim denials.
## Overview
### What is Denials Reporting?
Elation Billing includes several reports that help you track and manage claim denials. Electronic Remittance Advice (ERAs) are integrated into these reports, ensuring that denial information is accurate and up to date.
### Why is Denials Reporting important?
Denial reporting keeps you up to date on why claims are being denied. By spotting trends early, you can tackle issues at the source—helping improve claim acceptance and speed up payments.
## Workflow Instructions
### Using the Denied Claims Report
1. Click **Reports** → **Lightning Insights**
2. Click **Visualization**
3. Click **Denied Claims**
4. You will see the denied claims for the timeframe specified at the top of the page
* Click **Show Filters** to see and adjust filters as needed
* Click on the **Claim Count #** to see associated claims
***
### Using the Denied Claims by Payer Report
1. Click **Reports** → **Lightning Insights**
2. Click **Visualization**
3. Click **Denied Claims by Payer**
4. You will see the top 10 payers with denied claims for the timeframe specified
* Click **Show Filters** to adjust filters as needed
* Click a code in the legend to exclude it from the chart (it will appear crossed out but still show in the table)
* Click on the **Claim Count #** to see associated claims
***
### Using the Denial Reason Codes Report
1. Click **Reports** → **Lightning Insights**
2. Click **Visualization**
3. Click **Denial Reason Codes**
4. You will see the top 10 denial reason codes for the timeframe specified
* Click **Show Filters** to adjust filters as needed
* Click a code in the legend to exclude it from the chart
* Click on the **Claim Count #** to see associated claims
![Denial Reason Codes report in Lightning Insights showing top 10 codes for Feb 1–12, 2025. CO96 tooltip displays "Non-covered charges, 58 claims." Table lists CO132 as highest with 18 claims.]()
***
### Using the Denied Procedure Codes Report
1. Click **Reports** → **Lightning Insights**
2. Click **Visualization**
3. Click **Denied Procedure Codes**
4. You will see the top 10 denied procedure codes for the timeframe specified
* Click **Show Filters** to adjust filters as needed
* Click a code in the legend to exclude it from the chart
* Click on the **Claim Count #** to see associated claims
***
### Using the Denials Report (Downloadable)
1. Click **Reports** → **Lightning Reports**
2. Click **Options** next to Denials Report to apply additional filters as needed
3. Click **Download Report** → **Save as Excel (CSV)**
4. Open the report on your computer using Excel-compatible software
## Frequently Asked Questions
### Can I see more than 10 denial reason codes in the Denial Reason Codes report?
No, the Denial Reason Code report can only show the top 10 denial reasons for the timeframe specified.
### Can I see more than 10 Payers in the Denied Claims by Payer report?
No, the Denied Claims by Payer report can only show the top 10 Payers for the timeframe specified.
### Can I download the Denials Report as a PDF?
No, you can only download the Denials Reports as a CSV file.
## Related Articles
* [Common Code Denials](/articles/common-code-denials)
* [Claim Appeals](/articles/claim-appeals)
* [Viewing ERAs and Auto-Posting](/articles/viewing-eras-and-auto-posting)
# Visit Note Documentation Guide- Documenting amendment requests from patients
Source: https://help.elationhealth.com/articles/documenting-amendment-requests-from-patients
This article will describe how you can track patient requests to amend their visit note records in Elation.
## What are visit note amendment requests?
Patients may have access to your visit note documentation for their encounters and may request amendments to your documentation for various reasons (ex. the patient gave you the wrong date for an injury). Since a signed visit note has certain legal indications, providers would want to document amendment requests from patients for proper record tracking.
Elation's *Patient Amendment Request* feature allows providers to record requests from patients to amend visit note documentation as well as allows providers to specify whether or not they approve of the request.
## Documenting an amendment request from a patient
1. Find the visit note that your patient has requested to amend in the Chronological Record.
2. At the bottom left corner of the note click **Actions** >> **Pt Amendment Request**
![Actions menu expanded on a signed SNF visit note, with "Pt Amendment Request" highlighted in red at the bottom of the menu options.]()
1. Fill out the **Patient Amendment Request** form that appears
2. Request= A brief description of the patient amendment request.
3. Conveyed by= Who expressed the amendment request to you.
4. Status= Choices are to accept or deny the request. Choosing to accept the request will automatically open the visit note for you to document the amendment.
5. Requested on= Date and time of the amendment request. The form will pre-fill these fields with the current date and time.
![Patient Amendment Request form with required fields: Request text area (empty), Conveyed by set to "Patient", Status showing "Choose one", and Requested on pre-filled with 06/26/2014 at 6:48 pm.]()
1. Click **Save** to save the amendment request
Once saved, the Patient Amendment Request will be documented at the bottom of the Visit Note, in the **For physician's record only** section. Documented amendment requests do not appear on the patient's visit summary, nor do they print out when printing the Visit Note.
## Accepting an amendment request
If you choose to accept an amendment request, the visit note will automatically open for you to make necessary amendments. Once you finish making your amendments, click **Sign Amended Visit Note** to save your changes. All changes will be tracked for auditing and legal purposes.
![Accepted patient amendment request documented at the bottom of a signed visit note, showing the patient's request, accepted status, and timestamp.]()
## Related Articles
* [Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
# Visit Note Documentation Guide- Procedures
Source: https://help.elationhealth.com/articles/documenting-procedures
Elation supports documentation of procedures performed during an encounter.
## Adding Procedures to Visit Notes
In any Visit Note draft click **+ Add procedure** or start typing the **Proc:** section to enter a procedure administered to the patient during a visit.
When your cursor is in the **Proc:** field, a drop-down list of your popular CPT® (procedure) codes will appear automatically. Start typing a procedure name or procedure code to narrow the list of codes in the drop-down.
If you perform and bill for a procedure frequently, we recommend adding that procedure and its associated procedure code to your list of Popular Procedure codes in Settings. This will expedite the documentation and billing process, as with one click, you can add the procedure name to your note and its procedure code to your bill. Learn more about [setting up Popular CPT Codes here.](/articles/billing-settings---service-locations--procedure-codes)
![Proc field in a visit note with dropdown showing popular CPT codes: 99214 (moderate complexity office visit) highlighted, and 99213 below it.]()
Click a procedure name from the drop-down list to add a procedure from your Popular CPT Codes or type in any procedure name.
**Next Step:** Populate your Popular CPT Codes and start using it for documenting procedures!
## Related Articles
* [Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Visit Note Templates Guide](/articles/elation-visit-note-templates)
* [Visit Note Documentation Guide- Assessments](/articles/visit-note-assessments)
* [Visit Note Documentation Guide- Physical Exam (PE) & Review of Systems (ROS) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Billing Guide- Billing Report](/articles/lightning-reports)
*CPT c* *opyright 1995 - 2022 American Medical Association. All rights reserved.*
# Drug Decision Support Guide- Monitoring drug interactions
Source: https://help.elationhealth.com/articles/drug-decision-support
This article describes the medication drug-to-drug and drug-to-allergy decision support functionality within the prescription form.
## What is Drug Decision Support?
Elation’s Drug Decision Support feature displays drug to drug interactions or drug to allergy interactions directly in the prescription form when a provider is prescribing a medication.
The drug interactions definitions are risk-rated from Mild > Moderate > Major. The definitions for these ratings are based on Medispan data provided by [Wolters Kluwer](https://www.wolterskluwercdi.com/drug-data/why-medispan/).
## Why is Drug Decision Support valuable?
The Drug Decision Support feature allows providers to make informed decisions when writing prescriptions for their patients by using the allergy, drug intolerances and medications information already stored in the patient's chart to inform providers when there is risk for drug or allergy interactions against the medication being prescribed.
The alerts will also supply providers with the severity, onset and details of the interaction to allow providers to make the best choices when prescribing medications for their patients.
## How to turn on Drug Decision Support
To turn on the Drug Decision Support feature please follow the steps below:
1. Click on your email in the top right-hand corner and then click **Settings**
2. Under **User Settings**, Click **Preferences**
3. Scroll down the page until you see the section shown labelled Drug Decision Support
4. Click on the Drug-to-Drug drop-down box and select which alert settings you would like on.
![Drug Decision Support settings with Drug-to-Drug dropdown open showing three options: "Major alerts only," "Major and moderate alerts only," and "All alerts" selected (highlighted in blue).]()
*
**Please Note** : **All Alerts** = you will receive Minor, Moderate and Major Alerts
**Major and Moderate Alerts only** = you will not receive Minor alerts
**Major Alerts only** = you will not receive Minor or Moderate alerts
1. Click on the Drug-to-Allergy drop-down box and select whether you would like Drug-to-Allergy alerts turned **On** or **Off**.
![Drug Decision Support settings with Drug-to-Allergy dropdown open, showing "On" selected and "Off" as the alternative option.]()
## How to ensure for high quality alerts
The Drug Decision Support feature uses information documented in the
*Allergies*
,
*Drug Intolerances*
and
*Medication History*
sections of the patient's chart to provide you with information about possible interactions against the medication you are drafting for your patient.
To ensure for high quality alerts, make sure you select the allergen, ingredient or drug name from the drop down menu that appears in the
\*Allergy \*
or
*Substance*
boxes when you document
\*Allergies \*
or Drug Intolerances. When documenting a medication or writing prescriptions, always select the drug from the drop down menu (medication database). These databases supply the special codes used to compare the drugs and substances against each other.
## How interaction alerts are displayed
### Drug-to Drug Alerts:
Drug-to Drug alerts will show up in the prescribing box when you select the medication. Minor alerts will show up in a box with a yellow border, Moderate alerts in a box with a red border and Major alerts in a red box.
![Prescription form for Warfarin Sodium 1 mg showing three interaction severity levels: Major (red) with Aspirin, Moderate (red border) with Tylenol with Codeine #3, and Minor (yellow border) with hydroCHLOROthiazide and Spironolactone.]()
To view more information about the alert, Click on Alert to view details of the interaction.
![Prescription form for Warfarin Sodium 1 mg showing the Interactions panel with a Major interaction with Aspirin alert expanded, with a "Click for details" tooltip visible.]()
### Drug-to-Allergy Alerts:
Similarly, Drug-to-Allergy alerts will show up in the prescription box with a Major red alert box.
![Prescription Form showing a red "Patient has allergy to Penicillin V" alert in the Interactions panel, with a required "Reason for overriding contra-indication" field flagged on the form.]()
**Next StepStart documenting allergies, drug intolerances and medications in your patient's chart to use the Drug Decision Support feature!**
## Related Articles
* [Prescription Form Guide- ePrescribing & Ordering Medications](/articles/Prescriptions-Forms-Guide-ePrescribing-and-ordering-meds)
* [How to e-Prescribe Controlled Substances](/articles/how-to-e-prescribe-controlled-substances)
* [Clinical Profile: A summary snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
# Letter & Referral Guide - Faxing lab, radiology or other orders to vendors
Source: https://help.elationhealth.com/articles/efaxing-lab-and-radiology-orders
After you have created and signed a lab or radiology (imaging) order in Elation, you can electronically fax it to the vendor via Elation's Letter to Provider feature.
📖
**RECOMMENDED READING**
[Click here for an introduction to the Letter and Referral features](/articles/letter-and-referral-introduction)
.
If the Lab Vendor you are working with accepts electronic lab orders, simply click **eOrder** from the Lab Order Form - you do not need to fax the lab order to them. [Click here for more information about eOrdering](/articles/Electronic-Lab-Order-Form).
The workflow outlined in this article is an example of a way you can share test orders with testing facilities. Adjust the workflow (e.g. what you attach) as needed.
## Faxing orders to test vendors
After you create and sign any lab, radiology (imaging) or other test orders in Elation, you can electronically fax it to a test vendor via the Letter to Provider feature.
1. Locate the order that you’d like to send in your patient’s chart. Hover over the order, and click **Actions** -> **Provider Letter**.
![Chronological Record with the Actions menu open on an X-ray order, showing the Provider Letter option highlighted for selection.]()
1. In the **To** field, type the fax number of the vendor. If a search result appears in the [Provider Directory](/articles/Using-the-Provider-Directory) dropdown, click on the result to select an existing contact.
* If no results are found, press the **TAB** key on your keyboard and a dialogue window will appear prompting you to save the fax number to a new contact. Select **Organization**, type the name of the vendor, and click **Save**.
![Save number dialog with "An organization" selected, name field filled with "HDRS", and Save button highlighted for fax number 888-888-8888]()
1. Type a subject and message to the vendor as needed.
2. Next, click **Select Chart Items to Attach**.
![Fax compose form with the Subject field empty (highlighted in orange) and pre-filled message body, with "Select Chart Items to Attach" button highlighted at the bottom.]()
1. Check off the box for **Patient Demographics** and click **Attach Items**.
![Attach Chart Items dialog with Patient Demographics checked (highlighted) and 04/12/2017 Imaging Order checked; both appear in Attachments section; Attach Items button highlighted.]()
1. At the bottom of the letter, check off the box for **Also fax copies of attachments**.
2. Click **Sign & Send** to fax the order to the vendor.
![Completed fax letter showing "Also fax copies of the attachments" checkbox checked and "Sign & Send" button highlighted, ready to send order to vendor.]()
To fax the order outside of Elation with your physical fax machine print the order by clicking **Actions** -> **Print** and then use your fax machine.
**Next StepFax a lab or radiology to your local vendor for a patient!**
## Related Articles
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
* [Letter & Referral Guide - Sending a fax](/articles/how-to-send-a-fax)
* [How to Share a Patient's Entire Chart](/articles/how-to-share-a-patients-entire-chart)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
# Elation AI — Frequently Asked Questions
Source: https://help.elationhealth.com/articles/elation-ai-faq
Answers to common questions about how Elation AI works, what data it can access, safeguards against errors, and tips for getting the best results.
## What AI features does Elation offer?
Elation brings artificial intelligence into the EHR to help you do work more efficiently, surface information when you need it, and capture the visit so you can stay present with your patient. See the [Elation Health - Building Clinical-First AI](https://help.elationhealth.com/articles/Building-Clinical-First-AI) article for more information\*\*.\*\*
[Note Assist](/articles/Note-Assist-Guide), [Elation AI](https://help.elationhealth.com/articles/using-the-search-tool-in-your-patient-chart#what-is-elation-ai), [Wordsmith](https://help.elationhealth.com/articles/Auto-drafting-letters-and-referrals-with-Wordsmith), and [AI Billing](https://help.elationhealth.com/articles/AI-Billing-Introduction#ai-billing-introduction) are custom-built to integrate into your Elation workflows. Elation uses models from Anthropic, OpenAI, and Google to deliver the best results.
## What is Elation AI?
Elation AI is an AI-powered tool built into the patient chart that helps you explore a patient's record, surface relevant clinical information, and think through questions during or after a visit. It works alongside your clinical judgment. For setup instructions and workflow details, see the [Chronological Record Guide](/articles/using-the-search-tool-in-your-patient-chart#what-is-elation-ai).
## Does Elation AI have access to the full patient chart?
Not entirely. Elation AI works with a defined subset of the patient's Elation record. Understanding what is included — and what is not — helps you interpret responses and know when to look further.
### What Elation AI can access
* **Demographics** — name, date of birth, age, sex, pronouns
* **Problem list** — active and resolved problems
* **Medications** — current and discontinued medications
* **Allergies and intolerances** — allergies and drug intolerances
* **Clinical history** — past medical, surgical, family, and social history; smoking status
* **Vitals** — historical vital sign trends
* **Preventive care** — vaccinations and health maintenance reminders
* **Labs and forms** — structured lab reports (last 10); clinical forms (e.g., PHQ-9 scores)
* **Visit notes** — up to 20 most recent signed visit note summaries
* **Non-visit notes** — up to 20 most recent phone notes, email notes, etc.
* **Appointments** — upcoming appointments (next 12 months), including date, reason, clinician, location, and status
### What Elation AI cannot access
* **Unsigned or draft notes**
* **Confidential notes**
* **Insurance or billing information**
* **Images** — Elation AI can only read text extracted from reports, not visual content like X-rays or scanned documents
* **Data from outside Elation** — outside records, patient-reported information not entered into the chart, or verbal conversations
Because Elation AI can only reason about what it can see, its responses may be incomplete without flagging the gap. If relevant information exists outside this scope, the AI does not know about it.
## Does Elation AI make clinical decisions?
No. Elation AI surfaces information and generates responses based on the data available to it. Every output is a starting point for your review, not a conclusion. You remain the clinician.
## What kind of AI powers Elation AI?
Elation AI is powered by Large Language Models (LLMs). An LLM is trained on enormous amounts of text — books, articles, medical literature, websites — and learns patterns in how language works. When you ask a question, it generates a response by predicting what words are most likely to come next based on patterns learned during training.
This is sophisticated pattern recognition, not clinical reasoning. An LLM can produce text that sounds confident, coherent, and authoritative — even when it's wrong. It doesn't weigh evidence or consider the full patient context the way you do. Always verify the information against the patient's full medical record and apply your own expertise before making any clinical decisions.
## What is a "hallucination"?
A "hallucination" is when the AI generates information that sounds plausible but is factually incorrect or fabricated. This can include made-up citations, invented lab values, or clinical details that are not present in the patient's record. Hallucinations happen because the model is optimized to produce fluent, plausible-sounding language — not to verify whether what it's saying is true. Always verify the information against the patient's full medical record and apply your own expertise before making any clinical decisions.
## What is a knowledge cutoff?
Large Language Models (LLMs) are trained on data collected up to a specific date, known as the knowledge cutoff. The model has no awareness of anything that happened after that date. This means that if a clinical guideline was updated, a drug was recalled, or new evidence was published after the cutoff, the model won't know about it — and may still present outdated information as if it were current. Always verify the information against the patient's full medical record and apply your own expertise before making any clinical decisions.
## Why is Elation AI open-ended instead of limited to preset questions?
Primary care is broad, unpredictable, and deeply individual — a rigid tool that only answers predefined questions would not match the way you think and work. Elation AI is designed to be useful across the full range of what comes up in your day, from a quick medication interaction check to thinking through a complex differential.
You can ask Elation AI questions in your own words about a patient's specific situation. You are not limited to a dropdown menu or a preset workflow. You can ask it to summarize a long record, flag gaps in preventive care, help you think through a diagnosis, or pull together information scattered across visits.
## What kinds of questions is Elation AI best suited for?
Elation AI tends to work well for:
* Synthesizing information across a patient's chart
* Identifying patterns over time
* Summarizing visit histories
* Surfacing relevant details you might not have time to search for manually
It works well as a thinking companion for complex patients.
## When should I question the output?
Be more cautious with:
* Very specific clinical recommendations
* Dosing information
* Rare conditions
* Anything where being wrong carries real risk
If something in the output surprises you — whether it seems too good to be true or just feels off — trust that instinct. The tool works best when you treat its responses as a starting point, not a final answer. Always verify the information against the patient's full medical record and apply your own expertise before making any clinical decisions.
## **What can go wrong with AI-generated clinical content?**
There are a few common ways the output can fall short.
* **Hallucinations** — The model generates plausible-sounding information that isn't in the patient's record or isn't clinically accurate.
* **Confident wrong answers** — The model presents incorrect information with the same tone and fluency as correct information, making errors harder to catch.
* **Missing context** — The model may not have access to the full picture — outside records, verbal conversations, your clinical judgment — and may produce responses that miss important nuances.
* **Outdated information** — The model's training data has a cutoff date, so it may reference guidelines or evidence that have since been updated.
Always verify the information against the patient's full medical record and apply your own expertise before making any clinical decisions.
## What has Elation done to reduce these risks?
Elation has built several layers of safeguards into Elation AI:
* **Data scoping** — Elation AI works with data in the patient's Elation record, reducing the risk of fabricated information from outside sources.
* **Prompt design** — the instructions that shape how the model responds are engineered to encourage accuracy, flag uncertainty, and discourage fabrication.
* **Model selection** — Elation evaluates and selects models based on their performance in clinical contexts, not just general benchmarks.
* **Ongoing monitoring** — Elation continuously monitors how Elation AI performs in real-world use and updates its approach as needed.
## Can Elation guarantee the AI will not make mistakes?
No. Elation cannot guarantee that the AI won't make mistakes. Safeguards reduce risk — they don't eliminate it. No AI system in healthcare can promise zero errors. Elation AI is designed to support your judgment, not replace it. The safeguards make errors less likely, but your review is what makes the output safe.
## Does how I ask the question matter?
Yes. LLMs are sensitive to how questions are framed. A vague question tends to produce a vague answer. A specific question with context — the patient's situation, what you're trying to decide, what you've already considered — will generally produce a much more useful response.
## Tips for getting better results
* **Be specific.** Instead of "tell me about this patient," try "summarize this patient's diabetes management over the last 12 months, including A1c trends and medication changes."
* **Give context.** If you are considering a specific diagnosis, say so. "I'm thinking about lupus given the joint pain and rash — what in the chart supports or argues against that?" produces better results than "what's going on with this patient?"
* **Ask it to show its work.** Prompts like "what evidence in the chart supports this?" or "what are you basing that on?" help you evaluate the quality of the response.
* **Iterate.** If the first response isn't quite right, refine your question. You can narrow the focus, ask for more detail on a specific point, or redirect the conversation.
## How do I know when to trust the output?
Build your own sense of when the AI is helpful by starting with questions you already know the answer to. This lets you calibrate — you develop a feel for what a reliable response looks like versus one that's subtly off. Over time, you'll get faster at knowing when to trust it and when to double-check.
## What if something feels wrong?
Trust that feeling. If an AI-generated response does not match your clinical instinct, your instinct is more likely to be right. The tool does not have your training, your experience with the patient, or your ability to sense when something does not add up. When in doubt, verify independently — the same way you would with any other reference source.
Elation AI is designed to support your clinical practice, not direct it. You are the clinician. The AI is a tool in your toolkit, useful when used thoughtfully and most powerful when paired with the judgment you've spent your career developing. What Elation AI surfaces is a starting point for your review. Always verify the information against the patient's full medical record and apply your own expertise before making any clinical decisions.
## Do I have to use Elation's AI features?
Elation's AI features are opt-in, so if you'd prefer not to use them, you're welcome to simply skip them. There isn't a global setting to disable access, but you'll never be required to engage with them.
## Is my patient data used to train AI models?
When you choose to use Elation AI features, any patient data involved is used only to power those features — nothing more. Neither Elation nor our third-party AI providers use your patient data, including de-identified data, to train AI models.
## Related Articles
* [Chronological Record Guide — Searching for records in the patient's chart](/articles/using-the-search-tool-in-your-patient-chart)
* [PREVENT](/articles/prevent-calculator)[™](https://help.elationhealth.com/articles/prevent-calculator)[ Calculator Guide](/articles/prevent-calculator)
# Elation Billing FAQs
Source: https://help.elationhealth.com/articles/elation-billing-faqs
Frequently asked questions about Elation Billing
This article provides answers to frequently asked questions about Elation Billing.
## General
### What Clearinghouse does Elation Billing use?
[Claim.MD](http://claim.md) is the clearinghouse that Elation Billing uses. See their [Payer List](https://www.claim.md/payer_list.html) for available payers.
Some payers transmit their ERA through a separate Trading Partner before reaching Claim.MD. Contact Elation Billing Support for details about a specific payer's Trading Partner.
## Patients
### How do I delete a Patient?
At this time, deleting a patient is not a feature provided. This may be added in the future. See [Removing a Patient](/articles/removing-a-patient) for current best practices.
## Statements
### How do I Generate and Send Statements?
See [Sending Statements](/articles/sending-statements) for a complete guide.
### How do I Text/Email Statements?
You'll need to [Activate Online Payments](/articles/activate-online-payments) first.
### Can I automatically send Text/Email Statements?
Yes! See [Text/Email Bot](/articles/textemail-bot) for instructions.
### How do I View Statements?
See [Viewing and Printing Statements](/articles/viewing-and-printing-statements) for guidance.
### What are the Statement Fees?
* **Mailed statements:** \$0.85 per statement
* **Text and Email statements:** Included in your Elation Billing subscription
### Can I Print and Send my own Statements?
You cannot print and mail your own statements in the billing software. You must use the automated mailing house. Once statements have been sent, you can print, download, or email them.
## Billing
### How do I use Custom CPTs?
You can enter whatever information you like into the CPT field. You cannot store custom CPTs to your Elation Billing fee schedule.
If your EHR Billing Settings has a **Popular CPT Codes** section, you can store a custom code and its rate. If your EHR Billing Settings has a Fee Schedules section, Fee Schedules has replaced Popular CPT Codes and you can create fee schedules with custom codes and rates that are associated with payers, providers, or service locations. See [Add a code that is not in the list](/articles/fee-schedules-in-the-ehr#add-a-code-that-is-not-in-the-list).
### How do I delete a Payment?
At this time, deleting a payment is not a feature provided. See [Clearing Out a Payment](/articles/clearing-out-a-payment) for current best practices.
### How do I print a patient receipt?
For **Elation EHR + Billing** users, the best source of a Patient Receipt is in the EHR's Patient Payment Report.
To print proof of a payment posted in **Elation Billing**, print the Patient History.
![Patient page showing the bottom toolbar with an arrow pointing to the History button, the second-to-last option before EHR Record.]()
### Why can't I delete a Claim Line?
If a claim has any payments associated with it, you cannot delete a claim line. See [Claim Line Can't Be Deleted](/articles/claim-line-cant-be-deleted) for instructions on resolving this.
### How do I attach a file to a Claim?
At this time, this is not a feature supported. This may be added in the future.
### How do I bill Worker's Comp?
At this time, Worker's Comp claims must be paper-billed. This functionality may be added in the future.
### Why is my Payment or Autopost stuck on "Working"?
If your payment is stuck on "Working" for over 60 seconds, the server took too long to respond. This may happen with large payments containing many charge lines.
Don't worry! Your data was already sent and the server is processing it. Refresh the page or close and reopen the billing software in another tab. Allow a few minutes for the payment to complete.
## Settings
### Where can I find the Clearinghouse's Trading Partner ID?
Trading Partner ID and other EDI enrollment information is provided in the Instructions when starting a Payer's Enrollment.
## Related Articles
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
* [Sending Statements](/articles/sending-statements)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
# Automatic Coding Guide- Automatically code for BMI, Blood Pressure, and negative PHQ-9 documentation
Source: https://help.elationhealth.com/articles/elation-coding-automation
This article describes how Elation will help you automatically code the appropriate ICD-10, CPT®, or CPT Category II® codes in the billing section of your encounter when you complete a BMI, BP or PHQ-9 screening.
## What is the automatic coding feature?
Elation's automatic coding feature is designed to help you get credit in quality programs for the documentation already present in your visit note by automatically adding CPT and/or ICD-10 codes to the billing information section of your visit notes based on certain information you store in your visit notes.
Currently this feature applies to body mass index assessments (BMI), blood pressure (BP) recordings, and negative PHQ-9 depression screening results documentation.
## What are the benefits of automatic coding?
When automatic coding is enabled for body mass index assessments (BMI), blood pressure (BP) recordings, and negative PHQ-9 depression screening results documentation, Elation uses the documentation already present in your visit note to automatically apply the corresponding CPT or ICD-10 codes to the Billing Information section of your visit note. Your practice no longer need to (1) remember to code, or (2) remember which code needs to be added to the bill, based on the resulting vitals or screening results. This will reduce time spent on double documentation on your practice, allowing you to focus more time on patient care.
## Using the automatic coding feature
### Enabling automatic coding
Admin Level Users within your practice can turn the automatic coding features on or off by using the toggle in the Settings section.
To adjust your automatic coding preferences:
1. Click on your email at the top of your Elation account and then click **Settings** --> **Billing**
2. Use the toggles next to turn the corresponding coding automations ON (green) or OFF (grey) for any of the listed workflows. Once enabled, the coding automation will work for all users in your practice.
![Billing settings page showing Automatic Coding section with Body Mass Index, Blood Pressure, and PHQ-9 toggles all enabled (green), and Admin only toggle active in the top right.]()
*
When the **Admin only** toggle at the top right of the page is turned on, only Admin Level Users will be able to turn the feature on or off. For more information on Admin privileges, please reference the [User Accounts Guide- Administrative privilege](/articles/administrative-privileges) .
### Applying coding automation in visit notes
When automatic coding is turned on, taking certain actions in the visit note, such as entering blood pressure information or importing a PHQ-9 result from the Clinical Profile, will result in associated CPT or ICD-10 codes being automatically inputted in the Billing Information section of associated visit note. Reference the information below to understand how each coding automation works.
## Using vitals related coding automations
Simply use the corresponding, structured **Vitals** section in the visit note to record your patient’s BMI and blood pressure to trigger the coding automations listed below.
### Using the Body Mass Index (BMI) coding automation
For the *Body Mass Index* coding automation, enter the patient's height and weight in the **Vitals** section of the visit note and Elation will automatically input the calculated BMI value's corresponding ICD-10 code in the billing section of the visit note.
*
BMI coding automation is available for patients who are 20 years or older as of the visit note creation date. BMI coding automation is not available for patients under 20 years of age. Manually input the diagnosis codes associated with the BMI percentiles for patients 20 years of age and younger as needed.
The ICD-10 added will correspond to this chart:
| BMI value | ICD-10 Code |
| ------------------------------------------ | ----------- |
| Body mass index (BMI) 19 or less, adult | Z68.1 |
| Body mass index (BMI) 20.0-20.99, adult | Z68.20 |
| Body mass index (BMI) 21.0-21.99, adult | Z68.21 |
| Body mass index (BMI) 22.0-22.99, adult | Z68.22 |
| Body mass index (BMI) 23.0-23.99, adult | Z68.23 |
| Body mass index (BMI) 24.0-24.99, adult | Z68.24 |
| Body mass index (BMI) 25.0-25.99, adult | Z68.25 |
| Body mass index (BMI) 26.0-26.99, adult | Z68.26 |
| Body mass index (BMI) 27.0-27.99, adult | Z68.27 |
| Body mass index (BMI) 28.0-28.99, adult | Z68.28 |
| Body mass index (BMI) 29.0-29.99, adult | Z68.29 |
| Body mass index (BMI) 30.0-30.99, adult | Z68.30 |
| Body mass index (BMI) 31.0-31.99, adult | Z68.31 |
| Body mass index (BMI) 32.0-32.99, adult | Z68.32 |
| Body mass index (BMI) 33.0-33.99, adult | Z68.33 |
| Body mass index (BMI) 34.0-34.99, adult | Z68.34 |
| Body mass index (BMI) 35.0-35.99, adult | Z68.35 |
| Body mass index (BMI) 36.0-36.99, adult | Z68.36 |
| Body mass index (BMI) 37.0-37.99, adult | Z68.37 |
| Body mass index (BMI) 38.0-38.99, adult | Z68.38 |
| Body mass index (BMI) 39.0-39.99, adult | Z68.39 |
| Body mass index (BMI) 40.0-44.99, adult | Z68.41 |
| Body mass index (BMI) 45.0-49.99, adult | Z68.42 |
| Body mass index (BMI) 50-59.99, adult | Z68.43 |
| Body mass index (BMI) 60.0-69.99, adult | Z68.44 |
| Body mass index (BMI) 70 or greater, adult | Z68.45 |
### Using the Blood Pressure (BP) coding automation
For the **Blood Pressure** coding automation, enter blood pressure readings into the **BP** section of the visit note for any of your hypertensive or diabetic patients and Elation will automatically input the resulting systolic and diastolic value's CPT® codes in the billing section of the visit note.
If multiple blood pressures are recorded in the **BP** fields, the coding automation will input codes for the lowest systolic and diastolic readings across all values entered in the visit note.
*
BP coding automation only applies to hypertensive and diabetic patients who are between 18-85 years of age as of the visit note creation date, and will only occur when documented BP levels are within a controlled range (\<140 for systolic and \<90 for diastolic). BP coding automation will not occur for patients without an active or controlled diagnosis of hypertension or diabetes in their Clinical Profile or visit note.
The CPT Category II code added will correspond to this chart:
| **Blood Pressure Reading** | **CPT Category II® Code** |
| -------------------------- | ------------------------- |
| Systolic 130-139 | 3075F |
| Systolic \<130 | 3074F |
| Diastolic 80-89 | 3079F |
| Diastolic \<80 | 3078F |
## Using the PHQ-9 depression screening coding automation
For the *PHQ-9* coding automation, use the **Depression (PHQ-9 Questionnaire)** to record a patient’s PHQ-9 depression screening results in their Clinical Profile. Afterwards, when you export the completed PHQ-9 screening into a visit note, Elation will automatically input the G8510 CPT code in the billing section of the visit note if the screening results were negative (the PHQ-9 score is between 0-4).
See below for an example:
![Patient chart for Sample Test (age 8) showing the Clinical Profile left panel with Depression PHQ-9 Score: 3 recorded under Psych, and an arrow pointing to the Clinical Profile section.]()
*
Coding is not automated for patients who have a positive screening result (PHQ-9 score of 5 or higher) through this version of the coding automation. If you would like to automate coding for patients who have a positive screening result, [click here to learn more about the Premium EHR coding automations](/articles/Automatic-Coding-Guide-Advanced-Coding-Automations) .
For more information about how to fill out the PHQ-9 clinical form in the Clinical Profile, please see [Clinical Profile Guide- Structured Questionnaires](/articles/structured-questionnaires).
## Frequently Asked Questions (FAQ)
### Are there additional coding automations available in Elation?
Yes, there are additional coding automations available as part of Elation's Premium EHR subscription. [Click here to learn more about the Premium EHR coding automations](/articles/Automatic-Coding-Guide-Advanced-Coding-Automations).
### Can I create my own coding automations in Elation?
Yes, you can automatically apply CPT, CPT II, or HCPCS codes to a bill by using the Document Tags feature. To create your own coding automations using Document Tags:
1. First, you need to create a Document Tag with an associated CPT, CPT II, or HCPCS code.
2. Click the **Tag** button in a Report or Document.
3. Enter a name for the Document Tag in the **Edit Document Tags** window.
4. Click the **Add new tag** button at the bottom of the window.
5. Enter a description if needed.
6. Select whether the code you want to associate with the tag is a *CPT*, *CPT II* or *HCPCS* code.
* Coding automation is not available for *ICD-9*, *ICD-10*, *LOINC* or *SNOMED* codes.
6. Enter the code for the Document Tag in the code field.
7. Click **Save** to save the Document Tag and associated code.
8. Next, apply the Document Tag to the a visit note to input the associated code in the bill.
[Click here to learn more about Document Tags](/articles/tag-reports-and-notes-with-document-tags).
## Related Articles
* [Automatic Coding Guide- Advanced coding automations (Premium)](/articles/Automatic-Coding-Guide-Advanced-Coding-Automations)
* [Visit Note Documentation Guide- Best practices for documenting a patient encounter](/articles/Best-practices-for-documenting-a-patient-encounter)
* [Billing Guide- Creating a Super Bill and coding for your visit](/articles/billing)
* [Clinical Profile Guide- Structured Questionnaires](/articles/structured-questionnaires)
# Elation EHR + Billing - Can't Send Claims to Elation Billing from EHR Billing Home
Source: https://help.elationhealth.com/articles/elation-ehr-billing-cant-send-claims-to-elation-billing-from-ehr-billing-home
Troubleshoot issues sending claims from EHR Billing Home to Elation Billing
This article explains why claims may fail to send to Elation Billing from the EHR Billing Home and how to resolve the issue.
## Overview
### Why Claims Won't Send to PMS
When attempting to send claims to PMS, either individually or in bulk, some claims either respond back with an error code or don't get sent at all.
The most common reasons for this error are:
* The affected notes were signed prior to your Go Live with Elation Billing
* The setting **Delayed Bills** was not turned on in the EHR during that time
These two items combined will cause an ERROR message when attempting to send those claims to Elation Billing.
## Workflow Instructions
### Bypassing the Error
These steps can only be done by an Authorized Delegate with permissions to **Edit Signed Bills**. See [User Accounts Guide - Utilizing Authorized Staff Delegates](/articles/staff-permissions--staff-delegates#provider-billing-delegates) for more information.
1. **Open Actions Menu** - On the affected bill in the Billing Home, click on the Actions icon (three dots to the left of the claim \[...]).
2. **Open the Bill** - Select **Open Bill**. If this is grayed out, see the note above about Authorized Delegates.
3. **Update and Save** - Update anything on the bill if necessary; otherwise, you can immediately save and close the bill.
4. **Resend to PMS** - This will now allow you to resend this note to PMS.
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
# Elation EHR + Billing - Collecting a Patient Payment in Elation Billing
Source: https://help.elationhealth.com/articles/elation-ehr-billing-collecting-a-patient-payment-in-elation-billing
Learn how to collect patient payments from Elation Billing for EHR + Billing practices
This article explains the different ways to collect patient payments from within Elation Billing for Elation EHR + Billing practices.
## Overview
### What is Collecting a Patient Payment in Elation Billing?
For Elation EHR + Billing practices, there are several ways to initiate patient payment collection from Elation Billing. All paths lead back to the EHR for payment processing.
At this time, opening the Patient Payment Request dialogue from Elation Billing will not automatically open a dialogue for that specific patient. This workflow will be streamlined in the near future.
## Workflow Instructions
### Collect From the Patient's Page
1. Within the patient's Elation Billing page, select the **Collect Now** button.
!["Collect Now" dropdown expanded in the Balance pane showing $200 balance, with arrow pointing to "Process Payment" option to open the EHR payment tool.]()
2. Select **Process Payment** to automatically open the Patient Payment tool in the EHR.
3. Follow the instructions in [Collecting a Patient Payment in the EHR](/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr).
***
### Collect From the Superbill
1. In the **Copayment Collected** panel, select **Collect Now** to automatically open the EHR's Patient Payment tool.
2. Make sure the Date of Payment matches the Date of Service, then follow the EHR payment instructions.
If dates don't match, the copay will not automatically apply to the claim once balance responsibility transfers to the patient. Copays can always be applied manually.
***
### Patient Pays via Elation Billing Statement (ElationPay.com)
When a patient receives an Elation Billing statement, they are directed to pay online at ElationPay.com. After entering their DOB and Account ID and reviewing their balance, they are redirected to your Practice's Payment Page.
See [Sending Statements](/articles/sending-statements) for more information.
## Related Articles
* [Elation EHR + Billing - Collecting a Patient Payment in the EHR](/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr)
* [Sending Statements](/articles/sending-statements)
* [Activate Online Payments](/articles/activate-online-payments)
# Elation EHR + Billing - Collecting a Patient Payment in the EHR
Source: https://help.elationhealth.com/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr
Learn how to collect patient payments directly in the EHR with automatic sync to Elation Billing
This article explains how to collect patient payments directly in the EHR, with payments automatically flowing into Elation Billing.
## Overview
### What is Collecting a Patient Payment in the EHR?
With this workflow available to Elation EHR + Billing users, patient payments collected in the EHR automatically flow into Elation Billing.
### Requirements
Collecting Patient Payments in the EHR requires that your practice has activated Stripe. See [Activate Online Payments](/articles/activate-online-payments) for instructions.
## Workflow Instructions
### Step 1 - Initiate Payment Collection
#### Option 1 - Collect via the Calendar
In the Appointment Calendar, select the patient, then click **Collect Payment**.
![Appointment detail popup for Peregrin Took showing a Follow-Up on Sep 13 at 2:30pm, insurance Active with 15 copay, current balance 200, and the Collect Payment button highlighted.]()
#### Option 2 - Collect via the Payment Button
1. From your EHR Practice Home, select **Payment**.
![The Payment button highlighted in the top navigation toolbar of Elation Practice Home, located as the rightmost icon after Fax Inbox.]()
2. Begin typing the patient's name and select them from the list.
![Patient Payment Request dialog showing "peregr" typed in the Patient field, with Took, Peregrin selected from the autocomplete dropdown, showing DOB and last visit date.]()
***
### Step 2 - Enter Payment Amount and Reason
![Patient Payment Request form for Took, Peregrin with Amount 30 entered and Payment Reason dropdown open showing "Copay" and "Outstanding Balance" options. Copay shows 30, Current Balance $431.]()
The patient's standard Copay and Current Balance are immediately available. Click **\[...]** in Current Balance to navigate to the patient's Elation Billing page.
Enter the **Payment Amount** and select the **Payment Reason**:
#### Copay
Denoting a payment as Copay will apply this payment to the Visit Note. Assuming the Date of Payment matches the DOS, once balance responsibility transfers to the patient in Elation Billing, the copay will automatically apply.
#### Outstanding Balance
An Outstanding Balance payment will immediately and automatically apply to the balance in Elation Billing.
#### Patient Payment Note
**Add Patient Payment Note** allows you to leave a note for the patient that will be included in their email receipt.
![Payment form showing 30 amount, "Outstanding balance" reason, a patient payment note, 30 copay, $431 current balance, Credit/Debit selected, and "Send patient a request" payment option.]()
#### Cash/Check - Reference Number
When recording a Cash or Check payment, leaving a Reference Number will also populate in Elation Billing.
***
### Step 3 - Select Payment Method
#### Credit/Debit - Stripe
Requires that your practice has enrolled with Stripe.
#### Credit/Debit - Non-Stripe Merchant
If using a different merchant:
1. Collect the payment as Cash or Check
2. Navigate to Elation Billing Payments
3. Open the payment collected
4. Edit and add the merchant's transaction reference number
5. Save
#### Check
At this time, the EHR does not support direct recording of Check Numbers. To record:
1. Navigate to Elation Billing Payments
2. Open the payment collected
3. Edit the payment
4. Add the Check Number
5. Save
#### Cash
Select Cash for cash payments.
***
### Step 4 - View Summary and Print Receipt
Once you collect the payment, you'll be presented with a Patient Payment Summary.
![Patient Payment Summary dialog showing Took, Peregrin, $50.00 paid by Check for Outstanding Balance, with status Paid and Print receipt button available.]()
You can print the patient's receipt directly from this pane.
#### To Print a Receipt Later
1. Navigate to the EHR
2. Go to **Reports** → **Patient Payment Report**
3. (Optional) Search for the patient
4. Under the Actions column, select **\[...]**
5. Select **View Receipt**
## Related Articles
* [Activate Online Payments](/articles/activate-online-payments)
* [Elation EHR + Billing - Integrated Refunds](/articles/elation-ehr-billing-integrated-refunds)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
# Elation EHR + Billing - Integrated Refunds
Source: https://help.elationhealth.com/articles/elation-ehr-billing-integrated-refunds
Learn how to process patient refunds that sync between EHR and Elation Billing
This article explains how to process patient refunds in the EHR with automatic updates to Elation Billing.
## Overview
### What are Integrated Refunds?
In the EHR, using **Refund** or **Mark Refunded** will apply the following changes in Elation Billing:
* Update the Payment amount to \$0
* Update the Check Number to **Refunded**
It will NOT update or remove any Superbills that have been added to the Payment.
## Workflow Instructions
### Processing a Refund
1. **Navigate to Patient Payment Report** - In the EHR (not Elation Billing), navigate to **Reports** → **Patient Payment Report**.
2. **Refund or Mark Refunded** - Once you've found the Patient Payment you wish to refund, use the Actions button:
### For Cash/Check Payments → Mark Refunded
![Actions menu expanded showing three options: Mark Refunded (highlighted), Resend receipt, and View receipt. Arrow points to Mark Refunded for cash/check payments.]()
### For Credit Card Payments → Refund
![Actions menu expanded on a payment row, with an arrow pointing to the Refund option for processing credit card payment refunds.]()
3. **Review in Elation Billing** - Verify the refund was processed correctly.
### Before the Refund
The payment will look something like this:
![Payment #761 for payer Took, Peregrin showing 100 payment, no Check Number, and CPT 99213 on Superbill 464 fully paid and settled with 0 balance.]()
### After the Refund
* The Check # has been updated to **Refunded**
* The Payment amount has been updated to \$0
* The Unapplied amount will represent the amount that is now over-applied to any Superbills
![Payment #761 after refund: Check # shows "Refunded" (arrowed), Payment is 0, and Unapplied shows -100.00, indicating the over-applied amount on Superbill 464.]()
## Related Articles
* [Elation EHR + Billing - Collecting a Patient Payment in the EHR](/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr)
* [Clearing Out a Payment](/articles/clearing-out-a-payment)
# Elation EHR + Billing - Manually Record Patient Payment in Elation Billing
Source: https://help.elationhealth.com/articles/elation-ehr-billing-manually-record-patient-payment-in-elation-billing
Learn how to manually record patient payments directly in Elation Billing
This article explains how to manually record patient payments directly in Elation Billing for EHR + Billing practices.
## Overview
### What is Manually Recording a Patient Payment?
To record a Patient Payment manually, directly in Elation Billing, you will need to activate the Legacy Payment Workflow. With this workflow enabled, you can manually post and edit Patient Payments.
Patient Payments created or edited this way will NOT update payments in the EHR.
## Workflow Instructions
### Enabling Legacy Payment Workflow
1. In Elation Billing (not the EHR), navigate to **Settings** → **Practice Settings**.
2. Select the **Billing Rules** tab.
3. Enable **Legacy Payment Workflow**.
***
### Recording a Patient Payment
Once the workflow is active:
1. In Elation Billing, select **Payments** → **+New Insurance Payment** (you'll change to Patient in the next step).
2. In the New Payment pop-up, update the Payment Type from **Insurance** to **Patient**.
3. Select the patient.
4. Supply the payment information.
5. Click **Save**.
## Related Articles
* [Activating Legacy Payment Workflow](/articles/activating-legacy-payment-workflow)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
* [Elation EHR + Billing - Collecting a Patient Payment in the EHR](/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr)
# Elation EHR + Billing - Self Pay Patients
Source: https://help.elationhealth.com/articles/elation-ehr-billing-self-pay-patients
Learn how to handle self-pay patients in Elation EHR + Billing
This article explains how to collect payments and bill for self-pay patients in Elation EHR + Billing.
## Overview
### Self-Pay in the EHR
When collecting a Patient Payment in the EHR, there is no "Self-Pay" reason available at this time. While this feature is being developed, follow the steps below for billing self-pay patients and collecting/applying their payments.
## Workflow Instructions
### Step 1 - Collect Payment
#### Option A - Collect Payment in EHR
See [Collecting a Payment in the EHR](/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr) for detailed instructions.
**Payment Reason Options:**
* **Copay** - Locks the payment to the patient's DOS that matches the Date of Payment. Leftover funds will need to be manually applied.
* **Outstanding Balance** - Allows funds to be applied to any of the patient's balances until exhausted.
**Optional - Internal Note:**
Add an Internal Note (which will NOT be sent to the patient) indicating "Self Pay". This note will be found in the EHR Patient Payment Report but will NOT transfer to Elation Billing.
![Patient Payment Request for Took, Peregrin showing $100 amount, "Outstanding balance" payment reason, "Self Pay" internal note, Cash payment method selected, dated 11/15/2023.]()
#### Option B - Collect Third-Party Payment, Record in Elation Billing
If your practice:
* Collects Patient Payments through a third-party vendor, and
* Wants to record the Patient Payments directly in Elation Billing (bypassing the EHR)
See [Manually Recording Patient Payments in Elation Billing](/articles/elation-ehr-billing-manually-record-patient-payment-in-elation-billing).
***
### Step 2 - Create the Claim
Create the Visit Note and subsequent Superbill as you typically would.
***
### Step 3 - Lightning Bill to Patient
When you Lightning Bill the Superbill, select **PATIENT** (not Self Pay), then click **Bill Now**. This transfers the balance to the patient in Elation Billing.
![Lightning Bill dialog with "Patient" selected in the Select Payer dropdown, and Go Back, Mark as Billed, and Bill Now action buttons visible.]()
***
### Step 4 - Apply the Payment
Use [Applying Patient Payments with ⚡️Apply Patient Payments](/articles/applying-patient-payments-with-apply-patient-payments) to automatically apply unapplied funds to patient balances.
> **Reminder:** Copays are locked to the patient's DOS that matches the Date of Payment. Leftover copay funds will need to be manually applied.
## Related Articles
* [Elation EHR + Billing - Collecting a Patient Payment in the EHR](/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr)
* [Applying Patient Payments with ⚡️Apply Patient Payments](/articles/applying-patient-payments-with-apply-patient-payments)
* [Filing a Claim](/articles/filing-a-claim)
# Elation Go- The Mobile App for Practices
Source: https://help.elationhealth.com/articles/elation-go-the-mobile-app-for-practices
## What is Elation Go?
Our mobile app for iOS devices, [Elation Go](https://www.elationhealth.com/elation-go) , is a secure communication app that allows providers and staff to take certain actions they would be able to take in the EHR.
With Elation Go, you can:
* Securely \[upload documents]\(#Documents Upload) into patient charts directly from your mobile device
* Quickly [access the clinical profiles](#ClinicalProfile) of patients with upcoming appointments
* [Capture profile photos](#UploadProfilePics) of your patients and upload them directly into their charts
* Easily \[compose]\(#Send Message) and \[reply]\(#Requiring Actions) to patient letters when it’s top of mind to minimize disruptions in your day (Providers only)
* [Electronically send a non-controlled substance medication prescription](#send_non_controlled_erx) to a pharmacy (Providers only)
* [View your Elation Calendar](#view_calendar) (Providers only)
* [Join Telehealth visits](#telehealth) using Elation integrated video (Providers only)
* Easily call patients or other providers on the Care Team to seamlessly collaborate across the care continuum
## Why is Elation Go useful?
Elation Go extends the value of our EHR by providing a mobile-platform that enables providers and practice staff to more efficiently and effectively manage patient panels and perform practice activities on the go. The Elation Go allows you to take quick actions from any phone or mobile device.
## Where to download the Elation Go app
The mobile app is currently for iOS users only, and can be found in the Apple Store © on your mobile device by searching Elation Go or by [clicking here](https://itunes.apple.com/us/app/elation-go/id1290449454?mt=8) .
![Elation Go app listing in the Apple App Store, showing the app name, "for Practices" subtitle, and an OPEN button indicating it is already installed.]()
*Copyright © 2023 Apple Inc. All rights reserved.*
## How to use Elation Go
### Logging in to Elation Go
Log in to Elation Go with the same credentials you use when logging into Elation EHR on a regular browser.
You can also enable [Elation's Single Sign-On feature](/articles/single-sign-on) to log in to the Elation Go app using Single Sign-On.
1. Launch the Elation Go app on your mobile device
2. Click the **Sign In** button.
3. Click **Continue** on the pop-up that indicates ***Elation Go wants to use elationemr.com to sign in.***
4. An in-app browser window will open, displaying the Elation EHR login page. This is the same login page used by the web application.
5. Login using the credentials and authentication method you typically use to log into the web application - your login credentials will not change with this update.
6. Upon successful login, the in-app browser window will close automatically and you will be granted access to your account on the Elation Go app.
![Three-screen login flow for Elation Go: app launch screen with Sign In button, iOS prompt asking to use elationemr.com to sign in with Cancel/Continue options, and the Elation EHR Provider & Staff Login page.]()
### Viewing the Clinical Profile
The Clinical Profile is visible when you open any patient's chart and is designed to be 'view only', which means no edits to this section can be made. All information in the Clinical Profile is synced from the patient's chart in Elation. This page can be refreshed by pulling down on your screen when scrolled all the way to the top.
Additionally, you can press on the phone number for both the patient, or providers in the Patient’s Provider list, to make a call directly from your phone to the patient or provider.
### Uploading patient profile pictures
To upload a patient's profile photo
1. Search for the patient in question and open their profile in the mobile app
2. Press on the **+** button (Options Menu) at the corner of the patient's portrait
3. Press **Take Photo** to take a picture of the patient
4. Use the app to position the photo so the patient's face is in the middle of the photo square and then press **Use Photo**.
This will save the photo to the patient's chart in both the mobile app and Elation in a HIPAA-compliant manner.
![Three-panel sequence showing how to add a patient profile photo in Elation Go: the + button highlighted on Swan, Misty's chart, the camera view with "Retake" and "Use Photo" options, and the saved photo appearing in the patient's Clinical Profile.]()
### Scanning and uploading documents directly into a patient's chart
To scan and upload a document direct into a patient's chart
1. Search for the patient and open their profile in the mobile app
2. Press the **+** button (Options Menu) in the top right corner and choose **Scan Document**
3. Capture images of the document with your phone camera. You can take up to 20 pages for a single document.
4. Once all of the photos are taken, you can rearrange the order of the pages by holding on the image and dragging it to the desired position/order. You can also take the image to take a closer look at it, rotate the image, and/or delete the image.
5. Once you're satisfied with the images, press **Next** to complete the following document details:
* Reviewer
* Date
* Document Type
* Tags (optional)
* Title (optional)
* Mark Urgent
* File on behalf of Reviewer
6. Press **Upload** to file the document into the patient's chart.
The images below will give you a better idea of what the document upload process looks like. To view the uploaded document, go to the patient's chart on the Elation Desktop App.
![Four-step mobile workflow for scanning a document into a patient chart: Step 1 shows patient profile with "Scan Document" option highlighted in the + menu; Steps 2–3 show camera capturing two document pages; Step 4 shows "Prepare Upload" screen with both scanned pages ready to reorder.]()
![Steps 5–8 of document upload: selecting Laboratory Report as document type, completed form with date and title filled, upload progress spinner, and Upload Successful confirmation screen.]()
### Responding to patient messages
The Requiring Actions queue of the Home section shows all patient letters that are addressed to you that require your attention. Users can also pull down to refresh this page.
From this queue, you will be able to Reply, Sign Off, End, and Acknowledge messages. You will find a breakdown of these actions below:
* **Reply**: Providers can reply to the message and choose whether they’d like to end the conversation (patient can’t reply and would need to initiate a new message to reach back out), or just reply (leaving the conversation open).
* You cannot add new attachments to message responses.
* **Sign Off**: Signing Off a conversation will remove it from the Requiring Actions queue. When choosing to Sign Off on a letter, if there are attachments, providers can choose to file one, multiple, or all the attachments as a Miscellaneous Report in the patient's chart.
* **End**: Pressing **End** will officially end the conversation — preventing a patient from being able to reply to the message.
* **Acknowledge**: Like in the browser app, Acknowledge is used to recognize a comment (a reply) on a letter and remove it from the Requiring Actions queue.
For all these actions, we will surface a notification at the top of the app to confirm what the user has done.
### Sending messages to patient's Passport accounts
To send a message from the Home section, press the **+** button (Options Menu) at the top of the screen and choose **Message Patient**. You will then be asked who you want to send your letter to, and be given the option to select from a list of your panel.
![Three-step workflow showing how to send a patient message from the Home screen: tap the + button, select "Message Patient," search for a patient by name, then compose and send the letter.]()
To send a message from the patient's chart, press the **+** button (Options Menu) at the top of the chart and choose **Message Patient**. We will automatically populate that patient’s name in the **To** field.
![Side-by-side comparison of the Elation desktop calendar and Elation Go mobile Calendar view, both showing Dr. Kary Jones's appointments for Thursday, January 19, 2023.]()
### Receiving notifications about new patient messages
You can set up or turn off Notifications from the Account page, by pressing on the gear icon in the top left corner of the app, and flipping the toggle next to **Notifications** on/off. Set the **Push Notifications** option to green to turn it on or set it to gray to turn it off. With notifications on, you will receive a notification whenever patients send you a message via their Patient Passport account and then you can log in to Elation Go to respond.
Please also make sure notifications are enabled on your mobile device.
### Sending a non-controlled medication prescription to a pharmacy
Providers can send non-controlled substance medication prescriptions to pharmacies directly from the Elation Go Mobile App.
The ePrescribing experience on Elation Go will allow you to:
* send new, non-controlled substance medication prescriptions to pharmacies
* view allergies, drug interactions and drug interaction alerts while e-Prescribing
* select from the patient’s list of preferred pharmacies or the pharmacy database
To send a new non-controlled substance medication prescription to a pharmacy:
1. Open the patient’s chart in Elation Go
2. Click on the **+** button (Options Menu)
3. Press on the **ePrescribe** option
4. Fill out the prescription details (Medication name & strength, Sig, Qty, Unit & Refills)
* The patient’s allergies and drug intolerances will be listed at the top of the form
5. Press the **Select a pharmacy** button to select a pharmacy for the patient. The patient’s preferred pharmacies will appear for selection first. You can also search for any pharmacy in the pharmacy database.
6. Fill in the diagnosis codes for the prescription as needed. Diagnosis codes from the patient’s Problem List will be available for selection first. You can also search for any diagnosis code from the diagnosis database.
7. Click **Next** once you finish filling out the prescription form
8. Review the prescription & then click **ePrescribe** once you are ready to send the prescription to the pharmacy
* The Elation Go application does not support failed prescription notifications. Please continue to monitor your “Urgent” inbox in the Elation desktop application for failed prescription notifications.
![Seven-step visual walkthrough of sending an ePrescription in Elation Go: opening ePrescribe from the patient chart options menu, filling out the prescription form with Lisinopril 2.5mg Tab, Sig 1qd, Qty 90, 3 refills, selecting a preferred pharmacy from the Find Pharmacy screen, tapping Next to review, clicking ePrescribe to send, and confirming the "Prescription saved" status on the patient's clinical profile.]()
The following functionality will be supported at a later point in time: Refilling existing medications from the Medication List
Rx Templates and Custom Rx Sigs
Controlled substance medication e-Prescribing
Electronic refill requests
### Viewing your Elation Calendar as a Provider
Provider Level Users can view their Elation Calendar directly in the Elation Go App by pressing the **Calendar** button at the bottom of the App. You will see a list of all your appointments listed on a day by day basis. Pressing on the appointment will display the full details of the appointment.
![Elation desktop calendar (left) and Elation Go mobile calendar (right) showing the same Thursday Jan 19 appointments for Dr. Kary Jones side by side.]()
Updates to events in the Calendar (such as the time you blocked off for lunch or meetings) will only be visible after you refresh the Elation Go application by closing the Elation Go application completely and then logging in again. This will be addressed in a future upgrade.
### Launching Telehealth visits from Elation Go
Providers can start any of their scheduled video visits with patients directly through the Elation Go application. To join a video visit using Elation integrated video, press on the appointment from your Calendar to view the full details and click **Start Video**. ![Appointment detail screen in Elation Go showing a confirmed telemedicine visit for Carl Jones on Thu, Jan 19, 9:00–9:15am with Kary Jones, MD, and the Start Video button to launch the Zoom visit.]()
This will automatically open the Zoom app on the device and log you into the video visit as the host. From here, providers will be able to admit patients into the video visit from the waiting room!
The **Start Video** button will only appear after a provider has activated their Elation integrated video account. This option does not appear for staff users, as they do not have their own Elation integrated video accounts.
For more information about Elation integrated video, see our help center articles:
* [How to set-up Elation integrated video](/articles/Elation-Telehealth-powered-by-Zoom)
* [Elation Integrated Video: Frequently Asked Questions](/articles/Elation-Integrated-Video-FAQ)
## Additional information about Elation Go
Additional App Details:
* Elation Go is an iOS app. We do not have any Android apps yet.
* The minimum iOS version we support is iOS 12.0.
* If the user has a version below this, they might not be able to see it in the app store.
* The app is free from the App Store.
* We currently support iPhone, iPod Touch, and iPad (Universal).
* Users need an existing Elation account to log in.
* This app is rated for ages 17+ and is only available in the US.
**Session Timeout**: Sessions last 2 hours - if you take any actions on your device after this time (outside of the app), the app will return you to the login screen where you'll be required to re-login.
## Frequently Asked Questions (FAQ)
### Will there be an Android version of Elation Go?
All Elation mobile applications are currently for iOs only. Elation will notify customers if we introduce an Android version of Elation Go in the future.
### Can I send a prescription or respond to refill requests from Elation Go?
Users can send a new non-controlled substance medication prescription to the pharmacy via Elation Go. Learn more about this feature [here](#send_non_controlled_erx). Controlled substance medication prescription related features are not available in Elation Go at this time. Refill requests are also not available in Elation Go at this time.
### Can I receive notifications when I receive a new message from a patient?
Yes, you can turn on notifications for the Elation Go app. Reference the [Receiving notifications about patient messages](#notifications) section for additional details.
### Can I use TouchID or FaceID with Elation Go?
The TouchID and FaceID features are currently not available for the Elation Go app. You will be notified via the App Store if these features become available.
### Can I switch between provider accounts within the Elation Go app?
No. Elation Go does not support a Context Switcher or linked accounts feature — you can only be logged into one provider account at a time. To access a different provider account, log out and log back in with that provider's credentials.
### Can I view referrals in Elation Go?
Referrals received are not currently viewable in the Elation Go mobile app.
### Can I view a patient's visit notes in Elation Go?
Visit notes in a patient's chart are not viewable in the Elation Go mobile app. If a visit note is attached to a patient letter, you can open the attached PDF from the message in Elation Go.
### I updated the patient’s information in Elation but I do not see the changes in the Elation Go Mobile App. What should I do?
Certain changes/updates require you to log out of the Elation Go application and then log back in to see the changes. If you have updated the patient’s information via the desktop application and do not see the changes in Elation Go, log out of your account in Elation Go and then log in again and then you will see the updated information.
**Next Step**
**Download Elation Go and explore the different features of the mobile app today!**
## Related Articles
* [How to set up Elation Integrated Video](/articles/Elation-Telehealth-powered-by-Zoom)
* [Elation Integrated Video: Frequently Asked Questions](/articles/Elation-Integrated-Video-FAQ)
* [How to use Elation's Single Sign-On feature](/articles/single-sign-on)
# Understanding identifiers in Elation – patient IDs, billing references, and your practice account
Source: https://help.elationhealth.com/articles/elation-identifiers
This article explains the different identifiers used in Elation and how to use them effectively for internal workflows, support requests, and patient communications.
This article explains the different identifiers used in Elation and how to use them effectively for internal workflows, support requests, and patient communications.
## Overview
### What are Elation identifiers?
Elation uses several types of identifiers to help you manage patient records, billing, and practice administration. These include patient chart IDs, billing reference numbers, and practice account details. Each identifier serves a specific purpose in your daily workflows.
### Why are identifiers important?
Understanding how identifiers work in Elation helps you communicate more effectively with Elation Support, cross-reference records between systems, and guide patients through the payment process. Using the correct identifier in the right context protects patient privacy and ensures accurate record management.
## Workflow Instructions
### What is a patient chart ID?
The patient chart ID is a unique numeric identifier assigned to each patient chart in Elation. It allows you to reference specific patient charts without sharing protected health information (PHI).
#### Where to find the patient chart ID
* **Demographics window**: Once a chart is created, the Elation patient chart ID number appears at the top of the demographics window.
![Patient Details panel for Carl Jones showing the Elation Patient ID field (335350791536641) highlighted with an orange border at the top of the demographics window.]()
* **URL bar**: The patient chart ID is also visible in the chart's URL.
![Browser URL bar showing app.elationnemr.com/patient/335350791536641/ with the numeric patient chart ID highlighted in an orange box.]()
#### How to use the patient chart ID
* **Support tickets**: When contacting Elation Support about a specific patient issue, include the patient chart ID instead of the patient's name or date of birth. This protects patient privacy while allowing Support to locate the correct chart.
* **Internal references**: Use the patient chart ID for internal communications, quality assurance, or cross-referencing between team members.
* **VIP patients**: When running reports, VIP patients display only their patient chart ID with all other identifiable information hidden.
![Patient List report showing a VIP patient row highlighted in orange, with name hidden and only chart ID "160583097778177" visible, demonstrating how VIP records protect PHI.]()
The patient chart ID is primarily for internal and Support use. Patients do not need to know or use this number.
### What is a billing reference number?
The billing reference number (shown as **Billing ref #** in **Billing Home**) is an identifier that links a bill in Elation to a corresponding claim or record in an external system, such as a Practice Management System (PMS).
#### Where to find the billing reference number
The **Billing ref #** column appears in **Billing Home** (accessible via **Reports** → **Billing Home**).
![Billing Home showing the "Billing ref #" column highlighted, with value "A1234" for Carl Jones's 03/10/2026 visit marked as billed under provider Kary Jones, MD.]()
#### How the billing reference number works
* **Manual entry**: When you use the **Mark as Billed** action, you can enter your own billing reference number (such as a claim number from your billing system).
* **PMS integrations**: If you use a PMS integration that confirms receipt of claims, the reference number returned by your PMS will automatically display in the **Billing ref #** field.
#### How to use the billing reference number
* **Cross-reference external systems**: Use the billing reference number to locate the corresponding claim in your PMS or billing software.
* **Follow up on claims**: If a bill in **Billing Home** is missing a billing reference number, it may indicate the claim has not been processed or sent.
* **Troubleshooting**: When a bill fails to send to your PMS, check the **View Bill History** action to see error messages and the billing reference number status.
### Practice account ID
Elation does not display a single numeric "account number" for your practice within the EHR interface. To obtain your practice account number, please contact Elation Support using the **I need help** option.
### Provider SPI (Surescripts Prescriber Identifier)
Elation does not display a provider's SPI (Surescripts Prescriber Identifier) anywhere in the EHR interface — unlike your NPI and DEA number, it isn't a field you enter or view on the **Account Details** or **Edit Profile** pages. If an external eRx vendor or system requires your SPI, such as during a vendor transition, contact Elation Support to request it.
### What should patients enter in the **"Statement or Invoice or Account #"** field?
When patients use your practice's Payment Site to submit a payment, they are prompted to enter a **Statement or Invoice or Account #**.
#### Recommended guidance for patients
While any value can technically be entered without validation, this field is for practices that require it to correctly post specific payments to the appropriate statements. Patients can enter:
* **Invoice number** from the invoice or statement you provided, if one was generated from your PMS software.
* **"N/A"** if there is no number or association you need to make for the payment.
## Frequently Asked Questions
### Can I search for a patient using their chart ID?
Yes, you can use the patient chart ID to locate a specific chart when working with Elation Support or for internal reference purposes.
### Where do I find the billing reference number for a claim?
Go to **Reports** → **Billing Home** and look at the **Billing ref #** column. If you manually marked a bill as billed, the reference number you entered will appear there. If you use a PMS integration, the reference number returned by your PMS will display automatically.
### How do I know if a bill was successfully sent to my PMS?
Check the **Billing ref #** field in **Billing Home**. If a reference number appears, your PMS received the bill and returned a confirmation. You can also click **View Bill History** in the **Actions Menu** to see the status and any error messages.
### Where do I find my SPI number?
Elation does not display the SPI number in the product. Contact Elation Support to request your SPI number if an external vendor or system needs it.
## Related Articles
* [Patient Demographics Guide](/articles/Patient-Demographics-Guide)
* [Billing Home Guide – A dashboard for managing your bills](/articles/Billing-Home)
* [Patient Payments Guide – Securely collect payments digitally from patients](/articles/using-elation-to-securely-collect-patient-payments)
* [Billing Guide – Patient Invoicing – Generating invoices to patients for services rendered](/articles/patient-invoicing)
# Patient Portal: Elation Passport Introduction
Source: https://help.elationhealth.com/articles/elation-patient-passport-an-introduction
In this article, you will learn what Patient Passport is — Elation's patient-facing portal, sometimes called the patient portal — how it can help you communicate with your patients, how to get started today, and details on advanced settings.
The Patient Passport invitation workflow and patient-facing web portal experience has recently been updated. Look in the following articles for more detailed information:
* [Elation Patient Passport Guide - Managing Passport invitations](https://help.elationhealth.com/articles/Managing-Passport-invitations)
* [**Elation Patient Passport Guide - Granting Family and Friends Access**](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access-staff)
* [Additional Resources](#additional-resources)
* [What's New in Patient Passport](https://help.elationhealth.com/articles/patient-passport-whats-new) (Patient's Point of View)
* [Using Patient Passport](https://help.elationhealth.com/articles/what-patient-passport-messaging-looks-like-to-a-patient) (Patient's Point of View)
Patient Passport is Elation's patient-facing portal — your patients may refer to it as "the patient portal."
## Overview
### What is Patient Passport?
Patient Passport is a secure online portal that gives your patients 24/7 access to health information you've shared. It also allows you and your patients to send secure messages to each other. Patient Passport is accessible via any web browser.
The Elation Passport app is available for iPhone and Android. Patients can download it from the App Store or Google Play. The app provides the same experience as the web version at [app.elationpassport.com](https://app.elationpassport.com).
### Who can use Patient Passport?
Patients and/or their family members and friends — such as parents, guardians, or caregivers — can use Patient Passport to access a patient’s health information as long as they have an email address they can use for registration.
### What are the benefits of Patient Passport?
With Patient Passport, you can:
* Make it easy for patients or their family members and friends to access health information anytime, anywhere — through any web browser.
* Improve communication through secure, non-urgent messaging.
* Support care coordination by enabling patients to share their records.
It’s a great way to enhance patient engagement and streamline communication.
### What patients can see by default in Passport (for practices)
Patients will automatically have access to the following once they have an active Passport account:
* Patient Letter messages and attachments you explicitly send
* Patients can receive written messages and attachments from your practice.
* Settings are available to control whether patients can respond to your message and start their own message threads.
* Demographics
* Patients have real-time access to the following demographics Information from their chart:
* **Date of birth**
* **Emergency Contact**
* **Provider Assigned in Practice**
* Clinical Profile
* Patients have real-time access to the following Clinical Profile details from their chart:
* **Allergies**
* **Drug Intolerances**
* **Medications**
* **Vaccines**
* Settings are available to share more from the Clinical Profile.
* Visit summaries for all signed visit notes
* Patients will automatically receive generated summaries when you sign a visit note. This includes the information documented in following sections of signed visit notes:
* **Vitals**
* **Proc** (Procedures)
* **Tests/Treatments**
* This includes any Referrals, medications and diagnostic test orders.
* **Care Plan** (Instructions)
* **F/U** (Follow-up)
* Appointment details
* Date of upcoming appointment
* Date of last appointment
* Link to your Booking Site (if your [Elation Patient Booking Site](/articles/Patient-Booking-Site) has been set up)
#### What is not shared automatically
* **Visit notes in Requiring Action or Outstanding Items** – Visit summaries cannot be shared until they are signed off.
* **Confidential records** – Notes in the **Confidential** section of the Clinical Profile are never shared via Passport.
* **Other chart documents** – Lab reports, imaging results, and other records are only shared if you explicitly attach them to a Patient Letter.
#### Clinical Profile sections and default sharing settings
Items in the patient's Clinical Profile can also be shared automatically; the specific sections and amount of information depend on the chosen sharing options:
* Objective Data Only
* Satisfies MIPS Requirements
* Entire Clinical Profile except the Confidential section
* Entire Clinical Profile, Expanded Summary, excluding Confidential
Passport sharing settings can be customized for each patient within the Passport dialog (globe icon) in their chart. The default sharing behavior is set via **Patient Sharing Defaults** in a provider's **User Settings**. These defaults apply to patients who have that provider listed as their **Provider Assigned in Practice** under their demographics. Any updates to the default settings will only affect *newly* invited patients.
[Click here for more details and instructions for customizing default sharing settings](/articles/Setting-up-Patient-Passport#customize_preferences_for_all).
## Patient Passport Guides
### For your practice
| | **Quick Start** | **Advanced** |
| ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Setup** | - [Set a default for how much of the Clinical Profile is shared](https://help.elationhealth.com/articles/Setting-up-Patient-Passport#basic-configurations).
- [Turn on/off patient-initiated messages](https://help.elationhealth.com/articles/Setting-up-Patient-Passport#specifying-messaging-preferences).
| - [Override the Clinical Profile sharing default per patient](https://help.elationhealth.com/articles/Setting-up-Patient-Passport#customizing-clinical-profile-sharing-settings-for-individual-patients).
- [Set notifications for unopened Patient Letters](https://help.elationhealth.com/articles/Setting-up-Patient-Passport#enabling-notifications-about-unopened-patient-letters).
- [Specify best practices for staff workflows](https://help.elationhealth.com/articles/Setting-up-Patient-Passport#training-staff-best-practice-workflows).
|
| **Inviting patients to Passport** | [Send invitation to a patient who’s new to Patient Passport](https://help.elationhealth.com/articles/Managing-Passport-invitations). | - [Invite patients to link passport accounts or invite legal representatives](https://help.elationhealth.com/articles/patient-passport-family-and-friends-access-staff).
- [Manage invitations for complex use cases](https://help.elationhealth.com/articles/Managing-Passport-invitations#resources).
|
| **Sending messages to patients** | [Write a Patient Letter](https://help.elationhealth.com/articles/Passport--Communicating-with-patients#sending-messages-records-via-a-patient-letter). | |
| **Responding to patient messages** | [Respond to a Patient Letter](https://help.elationhealth.com/articles/Passport--Communicating-with-patients#responding-to-messages-from-patients). | |
### For your patients
Patients can find the following details in this [Using Patient Passport ](https://help.elationhealth.com/articles/what-patient-passport-messaging-looks-like-to-a-patient)article.
| | **Quick Start** | **Advanced** |
| -------------------------- | --------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------- |
| **Registration** | Register for a Passport account for first time. | Reuse an email for Passport registration.
Link multiple Passport accounts to a single email. |
| **Using Patient Passport** | Message your Provider. | Switch between linked Passport accounts. |
| **Mobile access** | Download the Elation Passport app (iPhone or Android) and use it the same as the web version. | |
## Frequently Asked Questions
### Can I customize Passport access on a per-patient basis?
Yes. Sharing options can be overwritten on a per-patient basis when **Patient Sharing Defaults** do not suffice.
You can:
* **Override Clinical Profile sharing per patient** – Click the **Passport** button (globe icon) in the patient's Clinical Profile and select a different option under **Passport Sharing Options**.
* **Choose what you send to each patient** – You decide which letters, lab results, or other records to attach to Patient Letters for individual patients.
The behavior for visit summaries and default Clinical Profile sharing remains global per provider. Changes to your sharing defaults only apply to patients who register for Passport *after* the update; for patients already registered, adjust sharing settings individually in their chart.
## Additional Resources
### New Patient Experience 2026
Download the [New Patient Experience 2026 - Launch](/files/new-patient-experience-2026-launch.pdf) guide for details on the latest updates to the patient experience.
### Practice poster
Download and print the [Patient Passport practice poster](https://help.elationhealth.com/files/patient-passport-practice-poster.pdf) to display in your office and let patients know about the new Patient Passport experience.
### Patient Letter Template to notify patient's about the new web portal experience
Hi \[Patient First Name],
Passport, your secure connection to \[Practice Name], has a new app experience for both iPhone and Android—so you can manage your care from anywhere.
**Make sure you have the latest version:**
* **Android Users:** Download from the[ Google Play Store](https://play.google.com/store/apps/details?id=com.elation.patientpassportapp).
* **iPhone Users:** Download the[ latest version of Passport](https://apps.apple.com/us/app/elation-passport-for-patients/id1264836684). (Even if your auto-updates are on, it's worth checking.)
**Here’s what you can do:**
* Message your care team and attach documents
* View and cancel upcoming appointments
* Print immunization records for school or sports physicals
* Update your preferred name and personal details
* See your health records, medications, and documents in one place
* Help manage care for family members
* Log in with Face ID, Touch ID, or your password manager
* Use Passport in Spanish, Chinese, Japanese, and more
**Have questions?**
* [Check out the FAQ page](https://help.elationhealth.com/articles/Patient-Passport-Frequently-Asked-Questions-for-Patients)
Thank you for trusting us with your care.
\[Practice Name]
### Using Patient Passport (Patient's Point of View)
Learn what Patient Passport looks like from a patient's perspective, including registration, messaging, and navigating the portal: [What Patient Passport Messaging Looks Like to a Patient](/articles/what-patient-passport-messaging-looks-like-to-a-patient).
### Troubleshooting registration & access issues
[Click here for troubleshooting tips](/articles/troubleshooting-passport-with-patients).
## Related Articles
* [Elation Patient Passport Guide - Setting up Patient Passport](/articles/Setting-up-Patient-Passport)
* [Elation Patient Passport Guide - Managing Passport invitations](/articles/Managing-Passport-invitations)
* [Elation Patient Passport Guide - Communicating with patients & sharing records](/articles/Passport--Communicating-with-patients)
* [Elation Patient Passport Guide - Helping patients troubleshoot Passport issues](/articles/troubleshooting-passport-with-patients)
* [Elation Patient Passport Guide - Patient's Point of View](/articles/what-patient-passport-messaging-looks-like-to-a-patient)
# Visit Note Templates Guide
Source: https://help.elationhealth.com/articles/elation-visit-note-templates
Elation designed Visit Note Templates to reduce repetitive documentation during and after a patient encounter.
* [What are Visit Note Templates?](#WhatAreVisitNoteTemplates)
* [Why are Visit Note Templates useful?](#WhyAreVisitNoteTemplatesUseful)
* [How to Use Visit Note Templates](#HowToUse)
* [Visit Note Template management window](#ViewTemplates)
* [Create a custom Visit Note Template](#CreateTemplate)
* [Export one or more templates to a visit note](#ExportTemplate)
* [View or edit a Visit Note Template](#ViewOrEditTemplate)
* [Duplicate a Visit Note Template](#DuplicateTemplate)
* [Delete a Visit Note Template](#DeleteTemplate)
* [How template fields map to other Visit Note Formats](#MappingToDiffVisitNoteFormats)
* [Simple Note Format](#SimpleNote)
* [SOAP Note Format](#SOAPNote)
* [Complete H\&P Note (2 col-A/P) Format](#TwoColumnAP)
* [Complete H\&P (1 column) & Pre-Op Note Formats](#OneColumnFormats)
## What are Visit Note Templates?
Visit Note Templates are pre-created documents with clinical information that can re-used for any patient encounter.
Templates are created using the Complete H\&P Note (2-Column), however, they can be applied to any visit note format. Click on the relevant note type to see how the fields export to the
[Simple note](#SimpleNote)
,
[SOAP note](#SOAPNote)
,
[Complete H\&P Note (2-col-A/P) note](#TwoColumnAP)
,
[Complete H\&P Note (1 Column) and Pre-Op Note](#OneColumnFormats)
. Every customer will have 6 Elation (E\*) templates to get them started!
You can:
* Create custom templates that suit your practice needs
* Export templates across all visit note formats
* Add one or multiple templates to a visit note
* Associate CPT® codes and billing items
* Add POS and billing notes to auto-populate information needed for virtual billing
* Capture document tags to assist with reporting
* Manage templates easily within your workflow
## Why are Visit Note Templates useful?
Elation designed Visit Note Templates to reduce repetitive documentation during and after a patient encounter. Templates also encourage consistent workflows across providers and staff by clearly laying out the steps and questions to be addressed. This allows for a more efficient and streamlined workflow amongst your practice.
## How to Use Visit Note Templates
* [Visit Note Template management window](#ViewTemplates)
* [Create a custom Visit Note Template](#CreateTemplate)
* [Export one or more templates to a visit note](#ExportTemplate)
* [View or edit a Visit Note Template](#ViewOrEditTemplate)
* [Duplicate a Visit Note Template](#DuplicateTemplate)
* [Delete a Visit Note Template](#DeleteTemplate)
### Visit Note Template management window
There are two ways to open the visit note template management window. You can either:
1. Click on the **Templates** icon in a Patient Chart & select \*\*\*\*Visit Note Templates" from the dropdown menu
![Templates toolbar icon circled in red, with dropdown menu open showing "Visit Note Templates" highlighted as the first option among five template categories.]()
1. Open any visit note format in a Patient Chart & click on the **Visit Note Templates** button at the top left-hand corner of the visit note
![Visit Note Templates button highlighted with a red border in the top-left corner of an open Visit Note for Karly Smith, MD, dated 01/31/2022.]()
This will display the template management window where you can create new templates and export, edit or delete active templates. Elation has loaded 6 pre-built templates to give you a kick start!
The template management window lists every active template for your practice, including any custom templates your providers or staff have created, not only the 6 pre-built Elation templates. Use the **search bar** at the top of the window to filter the full list by template name.
### Create a custom Visit Note Template
You can customize visit notes with your own templates from the management window. All templates will be created using the Complete H\&P Note (2-Column) format, however, they can be applied across all visit note formats.
![Visit Note Templates management window with the "+ New Template" button highlighted in the upper right, and six pre-built E* templates listed below.]()
1. Press the **+ New Template** button
2. Enter a name for the template
3. Fill content into the appropriate sections
4. Include applicable document tags
5. Add relevant billing items
6. Add POS and billing notes (which are needed for virtual billing)
7. Press the **Save Template** button
Here is a preview of the template builder itself, especially the billing section.
![Visit Note Template builder for "E Cystitis" showing completed Subjective, Objective, Assessment (Cystitis, acute - no pyelonephritis, N30.00), and Plan sections with pre-filled clinical content and Save Template button.]()
* One of the main benefits of Elation templates is that you can include billing items (which will associate the relevant CPT codes with the visit note) and document tags.
![Visit Note Template builder showing the "+ Tag" link below the F/U field and the Billing Information section with CPT code 99213 and diagnosis N30.00 (Acute cystitis without hematuria), both indicated by red arrows.]()
#### Enter POS & Billing Notes:
Use the visit note template to include information needed for virtual billing by entering the place of service/ POS (i.e. telehealth of office) and adding billing notes.
* Add the service location/ POS (e.g. telehealth or office) to your visit note templates to auto populate it into the visit's billing information. Adding a POS is important for proper claims submission.
* Billing Notes can be used to add a reminder to yourself or your biller when it is not clear what code to enter into the CPT billing field upfront. See image below for an example.
* Please note that a. Billing Notes will appear on detailed patient invoices b. Not all Elation/ PMS integrations will sync billing notes.
![Visit Note Template builder showing the Billing Information section with Service Location set to "Elation Location 2 (11)" and Additional Billing Notes containing telephone E/M time-based CPT codes (99441–99443), both highlighted with a red border.]()
\**CPT copyright 2019 American Medical Association. All rights reserved.*
#### Export one or more templates to a visit note
One of the key benefits of our Elation visit note templates is that you can choose whether to add one template or add multiple templates. It's up to you!
1. Open the **Visit Note Template** management window
2. Select one or more checkboxes next to the template(s) of interest
3. Click the **Export All Selected to Note** button
![Visit Note Templates dialog with "E* Cystitis" and "E* Urine Dipstick" checked, and a red arrow pointing to the "Export All Selected To Note" button.]()
If you would like to select only one template, then simply click the **Export to Note** button directly next to the template.
![Visit Note Templates dialog with the "Export to Note" button highlighted next to the E* Cystitis template, showing how to export a single template directly.]()
This will either create a new visit note based on your default type or apply the content to an already open visit note. The template information will be highlighted with a blue background to be distinguished from the rest of the content.
![Subjective section of a visit note showing exported template content highlighted in blue, including "Urine problem" with sub-items: frequency/pain/burning, no fever, no back pain. Arrow points to the empty second problem field.]()
#### View or edit a Visit Note Template
Templates can be adjusted at your discretion from the template management window.
1. Click on the **Templates** icon in the Patient Chart
2. Select **Visit Note Templates**
3. Find the template you would like to alter
4. Click **Actions** and select **View/Edit** from the dropdown menu
5. Make the necessary changes
6. Press the **Save Template** button
![Visit Note Templates window showing the Actions dropdown open for E* Cystitis, with View/Edit highlighted and indicated by a red arrow.]()
#### Duplicate a Visit Note Template
You can copy any template to quickly modify it for a similar purpose. For example, duplicate the E\* Annual Wellness for Women template and modify the appropriate fields so it can be used for a men's wellness visit.
1. Click on the **Templates** icon in the Patient Chart
2. Select **Visit Note Templates**
3. Find the template you would like to copy
4. Click **Actions** and select **Duplicate** from the dropdown menu
5. Make the necessary changes
6. Press the **Save Template** button
![Visit Note Templates management window with the Actions dropdown open on a template, showing "Duplicate" highlighted and indicated by an arrow.]()
#### Delete a Visit Note Template
You can remove visit note templates that are no longer relevant from the template management window.
1. Click on the **Templates** icon in the Patient Chart
2. Select **Visit Note Templates**
3. Find the template you would like to delete
4. Click **Actions** and select **Delete** from the dropdown menu
![Visit Note Templates management window with the Actions dropdown open for a template, showing View/Edit, Duplicate, and Delete options with Delete highlighted and indicated by a red arrow.]()
## How template fields map to other Visit Note formats
* [Simple Note Format](#SimpleNote)
* [SOAP Note Format](#SOAPNote)
* [Complete H\&P Note (2 col-A/P) Format](#TwoColumnAP)
* [Complete H\&P (1 column) & Pre-Op Note Formats](#OneColumnFormats)
### Simple Note Format
The majority of the template fields are populated into the single box of the Simple Note, as highlighted in the image below, other than vital information which has designated fields.
![Office Visit Note in Simple Note format with an arrow pointing to the main text body area where most template fields (Meds, Tx, FH, Allergies, PE Checklist, PH, PSH, Habits, SH, Tests, Assessments, ROS Checklist, Referenced Data, Prob) are populated.]()
In order to review the template procedure or care plan details, you will need to click on the dedicated button (**+ Add procedure** or **+ Add instr**) to expand the section.
![Visit note bottom section with a blue arrow pointing to the collapsed "+ Add instr" button, showing procedure and instruction sections must be expanded to view template details.]()
### SOAP Note Format
The template fields are divided across the 4 sections so that:
* Subjective information populates in the Prob section
* Data field appears in the O section
* Assessment is located in the A section
* Test and Tx display the Plan section
The first image captured the Prob and O sections, while the second image captured the A and Plan sections.
![SOAP note with an arrow pointing to the Prob section, showing template fields Meds, FH, Allergies, PH, PSH, Habits, SH, and Prob populated as subjective information]()
![SOAP note A and Plan sections showing Assessment field and Plan section with Tx and Tests fields, each indicated by blue arrows showing where template content maps]()
In order to review the template procedure or care plan details, you will need to click on the dedicated button (**+ Add procedure** or **+ Add instr**) to expand the section.
![SOAP Note format showing collapsed procedure and care plan sections, with a blue arrow pointing to the "+ Add instr" button to expand template details.]()
### Complete H\&P Note (2-col-A/P) Format
The alignment is identical, except for Assessment, Tests and Tx which is located in the Assessment/Plan section of the note.
In order to review the template procedure or care plan details, you will need to click on the dedicated button (**+ Add procedure** or **+ Add instr**) to expand the section.
![Visit note bottom section showing "+ Add procedure" and "+ Add instr" buttons with a blue arrow pointing to them, above the F/U field and action buttons including Sign Visit Note.]()
### Complete H\&P Note (1 Column) and Pre-Op Note Format
The two main distinctions between these notes and the Complete H\&P Note (2 Column) are that (1) HPI is located in Prob section and (2) Assessment, Tests and Tx will all be located in the Assessment/Plan section.
In order to review the template procedure or care plan details, you will need to click on the dedicated button (**+ Add procedure** or **+ Add instr**) to expand the section.
![Visit note bottom section showing "+ Add procedure" and "+ Add instr" buttons with a blue arrow pointing to them, above the F/U field and Sign Visit Note button.]()
## Frequently Asked Questions (FAQ)
### Do I have to have a visit note open to export a template?
No. The system will open a providers' default visit note type or a **Complete H\&P Note (2-Column)** for a staff member if they export a template from the template management window without a visit note open.
### Why does some template text remain blue?
We highlight the text exported from the template into the visit note in blue to distinguish what information has been added. The blue color will be removed once you click into the section to either review, edit or add to the section.
### How can I distinguish my templates from other providers at my practice?
We recommend adding your initials or name at the beginning of the template that way they are grouped together and easy to search within the toolbar. The Elation templates are a great example as they are all grouped with E\*.
### The template management window only shows a few templates. How do I see the rest of my practice's templates?
The template management window displays every active template for your practice, not a limited subset. If you don't see a template you're expecting, use the **search bar** at the top of the window to filter the list by name rather than scrolling through the full list.
### Can I use templates to document in house lab results?
Yes! We added the E\* Urine Dipstick template as an example of how you can use templates to capture lab result data cleanly within the visit note.
### I use a templating tool outside of Elation. Can I use also use Visit Note Templates?
Elation visit note templates can serve as your primary templating tool or work alongside third party solutions. The distinct value of using Elation templates is that you can:
* Export multiple templates to a visit note at once
* Associate document tags to assist with reporting
* Associate billing items to streamline visit note sign off
We have created 6 common templates (E\*) so you can get a feel for the experience and determine what works best for your practice.
**Next StepExport one of the Elation (E*) Visit Note Templates into a visit note and start utilizing it for a patient encounter!*\*
## Related Articles
* [Visit Note Types](/articles/visit-note-categories)
* [Physical Exam (PE) and Review of Systems (ROS) Templates](/articles/physical-exam-pe-and-review-of-systems-ros-templates)
# MIPS and CQM Dashboards: Clinical Quality Measures Reporting
Source: https://help.elationhealth.com/articles/elations-cqm-dashboards
This article describes the Clinical Quality Measures Reports dashboard.
## What are Clinical Quality Measures?
Clinical Quality Measures (CQMs) are tools that help measure and track the quality of health care services that eligible clinicians (ECs) provide, as generated by a provider's electronic health record (EHR). Measuring and reporting Clinical Quality Measures helps to ensure that our healthcare system is delivering effective, safe, efficient, patient-centered, equitable, and timely care.\*
Clinical quality measures (CQMs) play an important role in fulfilling the requirements for both the MIPS and various other reimbursement programs. Elation’s CQM Report dashboard provides an easy and efficient way to track progress on CQMs by giving users access to a real time snapshot into their practice’s current performance. MIPS participants can utilize this dashboard to stay on top of measures and ensure program success.
[Click here to learn the latest information about the MIPS Quality Category](/articles/Quality-Category-MIPS-2024).
## Leveraging the Clinical Quality Measures Report for MIPS
To view the Clinical Quality Measures Report dashboard for MIPS, click **Reports** >> **Clinical Quality Measures** from the blue bar at the top of your Elation account.
1. If you are participating in multiple programs, you will need to select **MIPS** under **Measure Set** to see your MIPS CQMs. If you are only participating in MIPS then the **Measure Set** will automatically say "MIPS"
2. Select whether you want to look at the report by **Tax ID** or **NPI**
3. Select the **Summary Period** & "Calendar Year" you want to view
4. Click **Generate Summary** to view your CQM Report
If you have questions about a specific measure, simply click on the CMS link just below the name of the measure and you will be taken to a Help Center article which will provide a detailed overview of that measure. [Each article](/admin-compliance) also contains step-by-step instructions, complete with screenshots and GIFs, demonstrating how to meet the measure in Elation.
## Viewing your CQM progress
The report will show you your:
1. Current Performance
2. Patients meeting criteria for a specific measure
3. Patients not meeting criteria for a specific measure
4. Total eligible patients for each specific measure
Click on the **View List** button to see a breakdown of patients who are meeting measures versus the patients who are not meeting criteria for each measure. From here, you can click on the patient’s name to access their chart, review their documentation and document completion of a screening, schedule the patient for a follow up visit, or take any other necessary actions to move the patient to **meeting criteria**.
![CMS122 v11 patient list modal showing Jordan Smith under the "Meeting Criteria" tab, opened by clicking "View List" on the CQM dashboard.]()
## Exporting your eCQM Data
[Click here to learn more about exporting your eCQM data](/articles/QRDA-Export-Guide).
\**U.S. Centers for Medicare & Medicaid Services*
## Related Articles
* [MIPS (2024) Overview](/articles/MIPS-2024-Overview)
* [MIPS (2024)- Quick Start Guide](/articles/MIPS-2024-Quick-Start-Guide)
* [Articles for various Clinical Quality Measures](/admin-compliance)
* [Health Maintenance Documentation & Reminders Guide](/articles/health-maintenance)
* [QRDA Export Guide- How to export QRDA files from Elation EHR](/articles/QRDA-Export-Guide)
# Sending a Progress Note Without Downloading It
Source: https://help.elationhealth.com/articles/email-send-progress-note-without-downloading
How to send a progress note (signed visit note in Elation) to another Elation EHR user or contact securely—without downloading or printing it—and why there is no plain-email option.
## Can I email a progress note instead of downloading it?
Elation does not send Provider Letters or Referrals directly by plain email. A progress note (a **signed visit note** in Elation) is shared securely instead—delivered to another Elation EHR user's chart, by Direct message, by fax, or through the Elation Connect secure portal. You can send it this way **without downloading or printing it**.
When email is involved, it is only a generic notification that prompts the recipient to log in to a secure portal; the email itself never includes the note or any PHI.
## Sending a signed visit note without downloading it
Only signed records can be attached to a Provider Letter or Referral, so the visit note must already be **signed** before you can attach and send it. Signed notes appear under the **Signed Visit Notes & Notes** attachment category.
1. Create a Provider Letter or Referral—either [from the patient chart](/articles/letter-and-referral-introduction#initiation) or from the **Actions** menu on the signed visit note.
2. Enter or select the recipient in the **To** field.
3. Under attachments, choose **Select Chart Items to Attach**.
4. Attach the signed visit note from **Signed Visit Notes & Notes**.
5. Click **Sign & Send**.
The correspondence is delivered based on the selected recipient or contact type and the contact details on file:
| Recipient | How it's delivered |
| --------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------- |
| Another Elation EHR user | Delivered directly to their Elation account and the patient's chart |
| Contact with a Direct address | Sent by [Direct message](/articles/how-to-use-direct-messaging) |
| Contact with a fax number | Sent by [fax](/articles/how-to-send-a-fax) |
| Non-Elation contact selected from your Provider Directory with an email or fax number on file | Invited to view the correspondence through [Elation Connect](/articles/secure-Provider-Portal), Elation's secure Provider Portal |
Depending on the contact's details and the delivery banner shown before you send, a faxed correspondence may also include an online-access option. In Elation Connect, the recipient can view what was shared and may optionally download the records after logging in to the secure portal.
For more detail, see [Sending correspondences to other Elation EHR users](/articles/share-documents-between-other-elationemr-users) and the [Letter & Referral Introduction](/articles/letter-and-referral-introduction).
## Why isn't there a plain-email option?
Email is not a HIPAA-compliant way to share clinical information, so Elation does not send Provider Letters, Referrals, or their attachments by plain email. A recipient may receive a generic email **notification** prompting them to log in and view the shared clinical information securely, but the email itself never contains the visit note or any PHI.
## Related Articles
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
* [Sending correspondences to other Elation EHR users](/articles/share-documents-between-other-elationemr-users)
* [Sending and receiving Direct messages](/articles/how-to-use-direct-messaging)
* [Sending a fax](/articles/how-to-send-a-fax)
* [Sending correspondences via a secure Provider Portal](/articles/secure-Provider-Portal)
# Enrolling for Claims Submission, ERA, and Real-Time Eligibility (EDI)
Source: https://help.elationhealth.com/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi
Learn how to enroll for electronic claims, ERA, and eligibility with payers
This article provides step-by-step instructions on how to enroll for electronic claims submission, ERA, and real-time eligibility with payers in Elation Billing.
## Overview
### What is EDI Enrollment?
EDI (Electronic Data Interchange) enrollment is the process of setting up electronic connections with insurance payers for claims submission, Electronic Remittance Advice (ERA), and Real-Time Eligibility (RTE) checks. These are three distinct services that each require their own enrollment per Payer. You may need to complete enrollment for one, two, or all three depending on which services your practice uses. Each service has its own enrollment type and status indicator in the **Insurance** Settings payer list.
The enrollment type is specified by the Payer. The system routes you through the appropriate process as specified by that Payer. There are 3 possible enrollment types:
* Quick enrollment
* Paper enrollment
* Electronic enrollment
Enrollment should be configured based on how you are contracted with the Payer. If each entity has its own contract then you must enroll for services for each entity. If each Provider has their own contract then you must enroll for services for each Provider.
Accurate NPI and TIN on each [practice entity](/articles/practice-settings-setup-and-overview#practice-entities) is important beyond enrollment — Elation also uses entity-level NPI and TIN as a fallback when routing incoming ERAs to the correct practice. Confirm every entity has its correct NPI and TIN configured before enrolling for ERA. See [How ERAs are matched to a practice](/articles/viewing-eras-and-auto-posting#how-eras-are-matched-to-a-practice).
### Why is EDI Enrollment important?
Electronic enrollment enables faster claims processing, automatic payment posting through ERAs, and real-time eligibility verification—all of which improve billing efficiency and reduce manual work.
### Timing enrollments
Timing enrollments is important if you are coming from another billing software.
* Claims - This service can be available in multiple billing softwares. To minimize delays, enroll in this service as soon as you can, especially for Medicare.
* Eligibility - This service can be available in multiple billing softwares. To minimize delays, enroll in this service as soon as you can, especially for Medicare.
* ERA - This service can only be available in one billing software at a time.
* For example, if you are currently receiving ERAs in your previous billing software and you don't want to switch to Elation until the start of the next month, then you should time your ERA service with Elation to start closer to the start of the next month. Refer to the [Checking enrollment statuses](https://help.elationhealth.com/#checking-enrollment-statuses) section below to learn how to determine the expected ERA enrollment timeline for a specific payer.
## Workflow Instructions
### Viewing your Payer List
Ensure you have an **Admin** or **Manager** role to access these settings.
Click **Settings** → **Practice Settings**.
Click on the **Insurance** tab.
If you have [multiple practice entities](https://help.elationhealth.com/articles/practice-settings-setup-and-overview#practice-entities), use the **Entity** dropdown to select the one you want to view payer enrollments for.
![Practice Settings Insurance tab with Entity dropdown open, showing two options: Asgard and Pediatrics, used to filter payer enrollments by entity.]()
***
### Identifying and favoriting Payers
Search for payers by name or payer ID. Click the heart icon to add them to your favorites list for easy access.
When searching for Medicare, Medicaid, or BCBS, search with the state prefix first (e.g., **CA Medicare**, **TX Medicaid**, **VA BCBS**).
#### Adding a Payer
If you search for a payer that is not present, add them manually by following the steps below.
Take caution when adding a Payer as they cannot be deleted.
Click **+ Add Payer**.
Use the [ClaimMD Payer List](https://www.claim.md/payer_list.html) to find official payer IDs and confirm supported electronic services.
After adding the necessary info, select **Verify Address.**
Click **Save**.
If a payer ID was entered incorrectly, create a new custom payer record with the correct ID.
***
### Completing enrollments
When you click **Enroll**, the system routes you through the appropriate process as specified by that Payer. There are 3 possible enrollment types:
* Quick enrollment
* Paper enrollment
* Electronic enrollment
You are completing YOUR portion of the enrollment. Payer processing times vary and you may not begin receiving the enrolled service right away.
#### Quick Enroll
You'll typically see this in the context of Eligibility enrollments.
Click **Enroll.**
Click **Start**.
If the payer allows for quick enrollment, then click the **Quick Enroll** button.
![Image]()
If the payer allows for quick enrollment, then click the **Quick Enroll** button.
![United Health Care payer (ID 87726) showing the Quick Enroll section with the Quick Enroll button to submit an electronic enrollment request.]()
Click **Mark Enrolled** in Elation Billing after clicking **Quick Enroll**.
#### Paper (Form) Enrollment
Click **Enroll**.
Click **Start**.
If a payer requires paper enrollment, then you see a pre-populated form (based on your Practice Entity details). Verify all of the details in the form are accurate.
Click **Submit** **Document** to submit the pre-populated form to the payer.
Click **Mark Enrolled** in Elation Billing after submitting the form.
If you did not submit the form or you exited out of the enrollment window before completing all required enrollment steps, click **No** instead of **Mark Enrolled**. This will indicate that there's a need to return to this enrollment at a later time.
#### Electronic Enrollment
You'll typically see this in the context of Medicare enrollments.
Click **Enroll**.
Click **Start**.
A new tab will appear with highlighted instructions (outlined in red) guiding you to another website where you can point the ERAs to our clearinghouse. Follow the exact instructions to complete the electronic enrollment steps.
* Any details you require from Elation such as **Trading Partner ID** will be provided.
Click the **Mark Completed** button at the bottom of the instructions (in the green box) once you complete the instructions to return to Elation Billing.
If the **Mark Completed** button is present, it must be selected once the instructions have been followed. If not selected, ClaimMD will be unable to finalize your enrollment.
Click **Mark Enrolled** in Elation Billing after completing the enrollment instructions in Step 3.
If you did not complete all enrollment instructions or you exited out of the enrollment window before completing all required enrollment steps, click **No** instead of **Mark Enrolled**. This will indicate that there's a need to return to this enrollment at a later time.
***
### Checking enrollment statuses
Elation Billing does not show whether a service has been approved. To confirm a service's status, look for successful eligibility checks, try submitting an electronic claim, or check for an ERA in your ERA report. Alternatively you can ask the Payer directly for the status of the enrollment.
Claims and eligibility services are typically active within 2 Business Days of completing quick/electronic enrollment.
* Medicare's average time for Claim enrollment approval is 4 weeks.
Paper enrollments or ERA service enrollments can take the most time. You may see processing time information under the **Enroll** button (e.g. 14 Days) for certain services (e.g. ERA).
![ENROLL button with "14 Days" processing time displayed beneath it, indicating estimated ERA enrollment approval time for this payer]()
* If the typical processing time has passed with no updates, contact the payer directly to confirm enrollment status.
#### Enrollment Statuses
Use the **Insurance** Settings to check the status of each service in the payer list.
| Status | Meaning |
| ---------- | ----------------------------------------------------------------------------------------------------- |
| Yes | Service is automatically available - no enrollment required. |
| No | Service is not offered/available. |
| Enroll | Enrollment incomplete. Click **Enroll** to start the enrollment process. |
| Enrolled\* | Enrollment was marked complete. |
| Custom | The Payer was manually created by your practice. Complete enrollments under the original Payer entry. |
Keep in mind that "Enrolled" only reflects that the enrollment process was completed on your end. To find out if the payer has approved the enrollment, you must contact them directly.
#### What should I do while I wait for enrollments to be approved?
* **Eligibility** - Check the patient's eligibility via external means (e.g. Payer Portal, calling the Payer, etc.)
* **Claims**
* Leave the claims in Elation Billing until the Claims service is active for that Payer. (e.g. you can add a special Worklist tag like 'Waiting for enrollment' to the claim for easy identification).
* Print paper claims and mail them to the Payer.
* **ERA** - Use your existing method of retrieving claims payment details (e.g. mail, Payer Portal, previous billing software, etc.) until ERA enrollment is active with Elation.
***
### Re-enrollment
**Note:** Centers for Medicare & Medicaid Services (CMS) updated their Medicare claim submission processes, which required all physicians and medical practices to re-enroll for Real Time Eligibility (RTE) verification by **May 11th, 2026**.
Sometimes a payer may require you to re-enroll for a service after a period of time. To do so:
Locate the payer + service that needs to be re-enrolled.
Click on the green **Enrolled** button (or blue **Enroll**, if not marked as enrolled when previously completed)
If the enrollment was previously completed, you will be routed to a page with Completion status details.
1. In the lower left of this page, click **Re-Enroll** to reset the enrollment.
Not all payers provide a self-serve re-enrollment option. If there is no **Re-Enroll** option, please open a support ticket with Elation so we can reset the enrollment on your behalf.
***
## Troubleshooting
### Enrollment not approved within the expected timeframe
Processing times vary by payer and enrollment type. If a payer displayed an estimated processing time (e.g., **14 Days**) and that window has passed with no status update:
Contact the payer directly to confirm they received and are processing the enrollment request.
If the payer confirms the enrollment was completed on their end but you're still not receiving the approved service, contact Elation Support.
### Enrollment was rejected
If the Payer tells you the enrollment was rejected, follow the instructions in the [Re-enrollment section](#re-enrollment) to submit enrollment again.
## Related Articles
* [Running Eligibility](/articles/running-eligibility)
* [Viewing ERAs and Auto-Posting](/articles/viewing-eras-and-auto-posting)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
# EPCS Guide - Frequently Asked Questions
Source: https://help.elationhealth.com/articles/epcs-faq-page
Frequently asked questions (FAQ) around setting up and using the electronically prescribed controlled substances (EPCS) feature in Elation.
## Questions
### Why do I have to complete a separate registration process for EPCS?
Our EPCS provider MDToolbox requires that each provider who wants to use EPCS must pass a thorough identity proofing process and set up two-factor authentication in order to ensure we’re complying to DEA requirements for EPCS.
### Do I, the prescriber, need to complete the EPCS registration on my own or can I have an office manager help me?
Each prescriber must complete majority of the EPCS process on their own. Another provider in your practice, or a trusted administrative staff, family or friend must assist with [Access Control Permissions](#second_user_for_access_control_permissions) set up portion of the registration.
### Why do I see "You do not have permissions to set up EPCS"?
This error appears when your Elation account does not meet the requirements to begin EPCS sign-up. To resolve this, verify the following:
**Confirm you have a Provider Level account** - Only Provider Level Users can sign up for EPCS. Staff Level Users cannot complete EPCS registration, even if they have Admin privileges. To check your account type: Either ask an Admin user to confirm • Or go to **Settings** and look for a **Google Calendar Sync** option under **User Settings**. If you do not have this, then you are using a Staff Level account.
**Confirm you have the correct Provider User Type** - Certain Provider User Types have restrictions on EPCS: **Non-Prescribing Providers** cannot ePrescribe controlled substances. • **On Call Providers** cannot ePrescribe controlled substances. • **Limited Use Providers** can only ePrescribe controlled substances if their license allows. Ask your practice Admin to verify your User Type in **Settings** → **Manage Accounts**.
**Confirm the EPCS feature is enabled for your practice** - If you do not see the **ePrescribing Controlled Substances (EPCS)** settings section at all, the EPCS feature may not be turned on for your practice. Click **I need help** → **Contact Elation Support** to request access.
**If you still see this error after verifying the above:**
Contact Elation Support with the following information so we can investigate:
* The email address associated with your Elation account
* Your role in the practice (for example, physician, NP, PA)
* A screenshot of the error message
Do not include any patient information when contacting Support.
### Why do I see "Unable to begin registration for EPCS with MDToolbox. Please make sure you have enabled eRx with Surescripts first"?
EPCS registration requires that standard (non-controlled substance) ePrescribing with Surescripts is fully enabled and active for your account first. MDToolbox blocks EPCS enrollment until that's confirmed.
Seeing eRx marked as enabled in your Elation settings doesn't necessarily mean Surescripts activation and credentialing are complete. If you still see this message after confirming eRx appears enabled, click **I need help** → **Contact Elation Support** so we can verify your Surescripts activation status before you retry EPCS registration.
### What do I need in order to complete the EPCS registration process?
As the prescriber, you will need the following in order to complete the EPCS registration process:
1. Stable internet connection
2. Access to your Elation EHR account on a desktop or laptop computer
3. Knowledge of your credit history
4. Access to the phone number that is listed as your main phone number in your Experian credit report
5. A mobile device (if you choose to use your mobile device to view your Security Code when ePrescribing)
6. Another provider in your practice, or a trusted administrative staff, family or friend to assist with [Access Control Permissions](#second_user_for_access_control_permissions)
If you need a copy of your credit report, you can request a free copy [here](https://www.experian.com/contact/personal-services-contacts.html#content-03) or call Experian at 888-397-3742.
### How long will the EPCS registration process take?
This EPCS registration process typically takes a total of 20 minutes of a prescriber’s time. However, depending on what information is used to share your one-time 2-Factor Authentication code with you, the overall process can span across 2-5 business days. See [Step #3 under Completing EPCS Sign Up](/articles/how-to-complete-the-epcs-sign-up-process#step-3-enter-2-factor-activation-code) for more information.
### What if I missed the phone call that delivers my Activation Code?
If you missed the phone call that delivers your Activation Code during EPCS sign-up, you can call 1-866-665-4386 back to obtain the code.
### Can I use EPCS in multiple systems (e.g. EHRs)?
Yes, you can use EPCS in multiple systems. Providers often have one EPCS account with Elation and then another EPCS account with the hospital they are affiliated with.
### How do I update my name in Elation if it differs from the name on my credit report?
You will need to change your name in Elation to the name that appears on your credit report before beginning the MDToolbox sign up process as your identity proofing is based on the details of your credit report. Go to **Settings** -> **Account Details** -> **Edit Profile**.
Revert your name back to the desired name in your Elation Settings once you have completed EPCS Sign Up and that will be the name that displays to the pharmacy and on printed prescription forms.
### How can I answer the identity proofing questions more effectively?
* You can request a copy of your credit report to assist with answering the questions by requesting one [here](https://www.experian.com/contact/personal-services-contacts.html#content-03) or calling Experian at 888-397-3742.
* The questions are based on your personal credit history and may involve details from your early credit history (as far as 20 years ago)
### Why am I only allowed 3 attempts every 24 hours to complete identity proofing for EPCS?
In case someone is fraudulently trying to claim your identity, each prescriber is only allowed 3 attempts every 24 hours to answer identity proofing questions to ensure the contents of the questions do not expose too much information about the true identity of the information owner.
### What do I do if I’m unable to pass EPCS identity proofing?
If you are unable to pass identity proofing, request a copy of your credit report from Experian to assist you with answering the questions by requesting one [here](https://www.experian.com/contact/personal-services-contacts.html#content-03) or calling Experian at 888-397-3742. You can attempt identity proofing every 24 hours.
The questions are based on your personal credit history and may involve details from your early credit history (as far as 20 years ago).
### What if the identity proofing questions seem to reflect an outdated address?
Experian generates these questions from your credit history, which may still list a previous address if a recent move hasn't yet been reflected in your credit file. If a question asks you to confirm your current address and none of the listed options look right, try selecting a previous address you've lived at instead.
### My camera is not working during EPCS Photo ID Verification. What should I do?
During EPCS sign-up, the docupass application requires camera access to take pictures of your ID and a selfie. If your camera is not working, follow these steps:
**On your mobile device:**
Close your mobile browser completely.
Go to your device’s **Settings** > **Apps** > select your browser > **Permissions** > enable **Camera** .
When the browser prompts you for camera access, tap **Allow** .
Try using a different browser (Chrome, Safari, or Firefox).
Restart your phone.
Reopen your mobile browser and try again.
**On your computer:**
Check that camera permissions are enabled in your browser settings: **Chrome:** Click the lock icon next to the website address > **Site settings** > set Camera to **Allow**. • **Safari:** Go to **Safari** > **Settings** > **Websites** > **Camera** > set to Allow. • **Firefox:** Click the lock icon > **Connection secure** > **More Information** > **Permissions** > Allow Camera.
Close any other applications that may be using your camera.
Try a different browser.
**Still not working?**
* Use a different mobile device with a working camera to complete Photo ID Verification.
* Ensure you have good lighting and a stable internet connection.
If you continue to experience issues after trying these steps, you will need to get a new QR code by logging out of Elation and logging back in to restart the EPCS Sign Up process.
### Can I use two different EPCS tokens at the same time?
Yes, you can register and use two tokens for EPCS if you wish. After you complete EPCS registration with your first token you can register a second token by clicking **Token Maintenance: Click here to Deactivate Token or Get/Setup a New Token** under **Setup 2-Factor Credentials**.
### Why do I need a second user to help me with Access Control permissions?
The DEA requires that two users, usually two prescribers OR the prescriber and a trusted administrative user, are present in order to enable EPCS within Elation. This is a checks and balances system to ensure that any provider who is given EPCS permissions can legally prescribe controlled substance medications.
### Who do I use as an Access Control Manager if I am a single-provider practice with no staff?
We recommend that you invite a trusted friend or family member to create an Elation **Admin** level Staff account for this one time only approval process. See the following article for more information on how to set up Access Controls: [EPCS Access Controls Guide](/articles/how-to-set-up-epcs-access-controls)
### Why is my prescription not going through?
If you, the Provider, have completed the EPCS signup process and the Token Password and Security Code you entered when e-Prescribing is accurate, there are a few other factors that may affect if a Controlled Substance can be sent electronically in Elation.
1. Be sure Patient Demographics are filled with no special characters or abbreviations in the following fields:
* Date of Birth
* Address:
* Spell out abbreviations
* Ave- Avenue, ST- Street, etc.
* PO Box addresses will not be accepted, it is strongly recommended to enter physical addresses.
* City & Zip Code
* Name:
* Entering a patient’s middle name is applicable, but DO NOT include a **nickname** or **goes by** in the Middle Name field, this information can be put into the **Notes** box.
1. Be sure that all of the Provider’s credentialing information has been uploaded to Elation:
* NPI
* SPI
* DEA
1. It is important to note that Schedule I & II drugs will not allow:
* Post-dated prescriptions
* Refill quantity amounts in the order form. Must be set to “0
### Why can't I e-prescribe custom or compound medications?
The database of medications that are available to e-prescribe through Elation are from the national Medispan medication database. We cannot add to this database or send through medications not in it as Surescripts will not approve without schedule information.
### What does the VIP Push button do?
The **VIP Push** button send a pop up notification to your smartphone and provides you the option to approve or deny the EPCS request rather than opening the app to enter a security code.
### Why can't I remove the controlled substance prescription from the Chronological Record?
The DEA requires that any prescription for a controlled substance remain documented within the patient chart.
### Why won't MDToolbox accept my Credential ID and/or Security Code?
Make sure to include the four letters ahead of the security code. In the example, below it would be SYMC35685736 with the letter and number combination with no spaces. Please make you enter the Security Code that is displaying in your Token at the time of clicking **Save** or **Prescribe** as the **Security Code** changes every 30 seconds.
![Symantec VIP Access app showing Credential ID "SYMC 35685736" and Security Code "360461" with both labels highlighted, illustrating the full Credential ID format to enter with no spaces.]()
### What should I do if I see an EPCS code mismatch error when prescribing?
If you see an EPCS code mismatch when attempting to prescribe controlled substances, this may mean the Credential ID registered in your EPCS account does not match the Credential ID on your current token (VIP Access App or key fob).
**To resolve this issue:**
Go to **Settings** → **ePrescribing Controlled Substances (EPCS)** → **Update Token/Password** .
Confirm the Credential ID displayed in your VIP Access App (including the four letters before the numbers) or on the back of your key fob matches what is registered in your EPCS account.
If the Credential IDs do not match, update your token registration. Follow the steps in the [EPCS Guide - Updating your EPCS Token or password](/articles/how-to-update-your-epcs-token) article to register your current token.
If you recently changed phones or devices, deactivate the token on your old device and register the token on your new device by following the steps under **Setup a New Phone** in the Update Token/Password workflow.
**If the issue persists after updating your token:**
Contact Elation Support by clicking **I need help** → **Contact Elation Support** at the top of your Elation account. When reaching out, please provide:
* The name of the provider experiencing the issue
* The exact error message text you are seeing
* A screenshot of the error (do not include any patient information in the screenshot)
* If possible, the Credential ID in settings and your VIP Access App or key fob
The Support team will verify your account configuration and follow up with next steps, which may include scheduling a screenshare to troubleshoot further.
### What should I do if I see a DEA number mismatch error during EPCS sign-up?
If EPCS sign-up tells you your DEA number does not match what's on file, the DEA number in your Elation account details doesn't match the DEA number you registered with during EPCS sign-up.
**To resolve this issue:**
Go to **Settings** → **Account Details** → **Edit Profile**.
Confirm the **DEA Number** field matches the DEA number you used when registering for EPCS.
If the numbers don't match, correct the **DEA Number** field and click **Update** to save your changes.
Once your DEA number is correct, restart EPCS sign-up from **Settings** → **ePrescribing Controlled Substances (EPCS)** → **Sign-Up**.
If your admin needs to correct the DEA number on your behalf, they can update the same **DEA Number** field from your account's Edit Profile page.
### Is my EPCS password (a.k.a Token Password) the same as my Elation password?
Your Elation password and your EPCS password (also known as Token Password) are separate pieces of data. For better security, we advise not reusing passwords across logins.
### How do I reset my Token Password?
Follow the steps in this article to reset your Token Password: [EPCS Token or Password Update Guide](/articles/how-to-update-your-epcs-token)
### I got a new cell phone and my controlled substance ePrescribing no longer works. How do I fix this?
If you have a new phone or device, you will first need to de-activate the token on your old device, and then set up a new token for your new device.
[Click here for step by step instructions on how to register the token on your new phone](/articles/how-to-update-your-epcs-token).
### Why do I need to register for a new Token when I change my phone?
Each phone is a unique Token and each Token has a unique **Credential ID**. To ensure that only the prescriber can electronically prescribe controlled substance medications, the correct Token must be registered to their account in order to use the **Security Code** on the Token.
### Why do I need to complete identity proofing again to reset my Token and password?
The Token and Token password are the two ways to ensure that the correct prescriber is approving the controlled substance prescription. If both the Token and the Token password need to be reset, then we must properly identify the identity of the prescriber again.
### How do I send controlled substance prescriptions for multiple states?
Currently Elation can only send one DEA number from your EHR account details along with your controlled substance prescriptions. If you prescribe controlled substances in multiple states, put the DEA number of the state you prescribe in most often in your EHR account details. When you need to prescribe controlled substances not in your main state, put your DEA number for that state in the **Instructions to Pharmacy** field of the prescription that gets sent to the pharmacy.
A provider's profile can only store one primary State License Number in addition to the one DEA number above. If you practice in multiple states, keep the state license you use most often in your account details and, for prescriptions issued under a different state's license, add that license number to the **Instructions to Pharmacy** field the same way.
### I'm trying to e-prescribe a controlled substance and get a message that it can't be e-prescribed due to a state-specific law. What should I do?
Some states restrict electronic prescribing for certain controlled substances by law, and Elation blocks the ePrescription to enforce that restriction. When this happens, print or fax the prescription to the pharmacy instead.
### Why is Elation blocking e-prescribing for a medication, like gabapentin, that isn't a federally controlled substance?
A medication's federal schedule isn't the only classification that applies. Some states classify additional medications as controlled substances under state law even when a medication isn't scheduled at the federal level. Gabapentin is a common example: it carries no federal schedule, but several states classify it as a controlled substance.
Elation determines a medication's controlled-substance classification based on the destination pharmacy's state, not the prescriber's or patient's state. This means the same medication can be sent electronically to a pharmacy in one state but not to a pharmacy in another, even for the same patient and the same prescriber.
If a medication is classified as controlled in the destination pharmacy's state and a state-specific law restricts electronic prescribing for it there, print or fax the prescription to that pharmacy instead. If the medication isn't classified as controlled in your own state, you can also send it electronically to a pharmacy located in your state. Your state's board of pharmacy or prescription monitoring program can confirm the current controlled-substance classification for a specific medication.
### Can my staff send controlled substance prescriptions for me?
No. DEA regulations require the prescriber to sign each controlled substance prescription with their own two-factor EPCS credential. Staff delegates cannot send controlled substance prescriptions on your behalf, even if they are Authorized Prescription Delegates.
Staff can draft controlled substance prescriptions and save them for you to review and sign later. You will need to enter your own **Token Password** and **Security Code** to complete the prescription.
### How do I purchase a new Key Fob?
To purchase a new Key Fob, have the provider follow these instructions:
Login to Elation.
Click **Settings** -> **ePrescribing Controlled Substances (EPCS)** .
Click **Update Token / Password** .
Click **Purchase a New Key Fob Token** .
Your Key Fob will be mailed to your verified home address. This can take 5-7 business days to receive. If you have not received it within 7 business days please let us know and we will follow up on your behalf.
Once you receive your new Key Fob, follow the instructions in [this article](/articles/how-to-update-your-epcs-token#i-have-a-new-phone-or-device) to link it to your account for EPCS.
**Related Articles**
* [EPCS Guide - ePrescribing controlled substance medications & troubleshooting](/articles/how-to-e-prescribe-controlled-substances)
* [EPCS (Electronic Prescribing of Controlled Substances) Introduction](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)
* [EPCS Guide - Signing up for EPCS](/articles/how-to-complete-the-epcs-sign-up-process)
* [EPCS Guide - Managing EPCS Access Controls](/articles/how-to-set-up-epcs-access-controls)
* [EPCS Guide - Updating your EPCS Token or password](/articles/how-to-update-your-epcs-token)
* [How to Complete Identity Proofing with Elation](/articles/how-to-complete-identity-proofing)
# EPCS Prescribing Workflow & Troubleshooting
Source: https://help.elationhealth.com/articles/epcs-prescribing-workflow-and-troubleshooting
Learn the complete workflow for electronically prescribing controlled substances (EPCS) and how to resolve common token and authentication issues.
Learn the complete workflow for electronically prescribing controlled substances (EPCS) and how to resolve common token and authentication issues.
## Overview
### What is EPCS prescribing?
Electronic Prescribing of Controlled Substances (EPCS) allows you to send prescriptions for Schedule II-V controlled substances electronically to pharmacies. This guide provides the complete end-to-end workflow for prescribing controlled substances and helps you troubleshoot common issues with token authentication.
## Prerequisites for EPCS prescribing
Before you can electronically prescribe controlled substances, confirm the following are complete:
1. **EPCS sign-up is complete** - You have finished identity proofing with Experian and set up two-factor authentication through MDToolbox.
2. **Your token is registered** - Your software token (**VIP Access App**) or hardware token (key fob) is registered to your EPCS account.
3. **Access Controls are configured** - An Access Control Manager has granted you the **Can Approve EPCS?** and **Can Sign & Send** permissions on the **EPCS Permissions- Logical Access Control Setup** page.
4. **You have access to your token** - Keep your smartphone (with the **VIP Access App**) or key fob available when prescribing.
### Verifying your EPCS sign-up status
To verify your sign-up is complete:
1. **Navigate to Settings** - Go to **Settings**.
2. **Open EPCS settings** - Scroll down and click **ePrescribing Controlled Substances (EPCS)** from the left-hand navigation bar.
3. **Check your status** - Click the **Sign Up** or **Update Token/Password** button.
If the sign-up is not yet complete, further steps will be available for you to do. If the sign-up is complete, you will be given options to update your **token passwords** instead.
## Workflow Instructions
### Prescribing a controlled substance
When everything is set up correctly, follow these steps to electronically prescribe a controlled substance:
1. **Open the patient chart** - Open the **patient's chart** and click **Rx** in the **gray navigation bar** at the top.
2. **Start a new prescription** - Click **Prescription Form (Rx/OTC/CS)**.
3. **Select the medication** - Search for and select the controlled substance **medication**.
Ensure the **medication** is not user-created. User-created medications cannot be **ePrescribed** as controlled substances.
4. **Complete required fields** - Complete all **required fields** (marked with an **asterisk**).
5. **Select the pharmacy** - Select an EPCS-certified pharmacy. Pharmacies that support **EPCS** display an **EPCS label** next to their name in the search results.
6. **Review the prescription** - Click **Prescribe**.
7. **Confirm the prescription** - Review the **Prescription Summary** and click **Prescribe** again.
8. **Enter your token credentials** - When the **token authentication prompt** appears:
* Enter your **Token Password** (the password you created during EPCS sign-up).
* Open the **VIP Access App** on your smartphone or retrieve your key fob.
* Enter the 6-digit **Security Code** displayed on your token. This code changes every 30 seconds.
9. **Send the prescription** - Click **Sign + Send**.
10. **Close the confirmation** - Click **OK** to close the confirmation screen.
The prescription is now sent to the pharmacy.
### Common issues and troubleshooting
#### No token prompt appears when prescribing
If you do not see the **Token Password** and **Security Code** prompt after clicking **Prescribe**, check the following:
* **EPCS enrollment status** - Confirm you completed the full EPCS sign-up process, including identity proofing and two-factor authentication setup. Go to **Settings** → **ePrescribing Controlled Substances (EPCS)** to verify your enrollment status.
* **Token registration** - Confirm your token is registered. If you recently changed phones, you need to deactivate your old token and register the new one.
* **Access Control permissions** - Contact your practice's Access Control Manager to confirm you have **Can Approve EPCS?** and **Can Sign & Send** permissions enabled.
* **Pharmacy selection** - Confirm you selected an EPCS-certified pharmacy. Only pharmacies with the **EPCS** label support electronic controlled substance prescriptions.
* **Medication selection** - Confirm you selected the controlled substance medication itself, marked with a **C** indicator in the search results, and not an **Rx Template** version of it. Rx Templates saved for a controlled substance don't carry the **C** indicator, so selecting one won't trigger the EPCS signing prompt.
#### Token PIN incorrect or token out of sync
If your **Token Password** or **Security Code** is not accepted:
* **Forgot Token Password** - Reset your password by going to **Settings** → **ePrescribing Controlled Substances (EPCS)** → **Update Token/Password**. Click **Reset my token password** and follow the prompts.
* **Credential ID mismatch** - Confirm the **Credential ID** you enter matches the ID shown in your VIP Access App (including the four letters before the numbers) or on the back of your key fob. If the IDs are different, proceed to the next suggestions.
* **New phone or device** - Deactivate the token on your old device and register the token on your new device. Go to **Settings** → **ePrescribing Controlled Substances (EPCS)** → **Update Token/Password** and follow the steps under **Setup a New Phone**.
* **Lost token and forgot password** - You will need to complete identity proofing again. Go to **Settings** → **ePrescribing Controlled Substances (EPCS)** → **Update Token/Password** and select **I don't have my old token- use IDP to setup Token and New Password**.
#### Prescription fails to send
If your controlled substance prescription fails after entering your token credentials:
* **Check patient demographics** - Confirm patient demographics are complete with no special characters or abbreviations in the **Name** and **Address** fields.
* **Verify patient address** - Confirm the patient has an address on file. If the patient is experiencing homelessness, enter **HOMELESS** in the **Address** field with the **City**, **State**, and **Zip** for your local area.
* **Check Schedule II restrictions** - Schedule I and II drugs do not allow post-dated prescriptions or refills. Ensure the **Refill** field shows **0** for these medications.
## Frequently Asked Questions
### Can my staff send controlled substance prescriptions for me?
No. DEA regulations require the prescriber to sign each controlled substance prescription with their own two-factor EPCS credential. Staff delegates cannot send controlled substance prescriptions on your behalf, even if they are Authorized Prescription Delegates.
Staff can draft controlled substance prescriptions and save them using **Save as Draft & Close**. You can then find drafted prescriptions in the **Draft Orders** inbox on your **Practice Home** page and complete them with your own **Token Password** and **Security Code**.
### Why do I need to register a new token when I change my phone?
Each phone is a unique token with a unique **Credential ID**. To ensure only you can prescribe controlled substances, the correct token must be registered to your account.
### Can I use two different EPCS tokens at the same time?
Yes. After completing EPCS registration with your first token, you can register a second token by:
1. **Navigate to Settings** - Go to **Settings**.
2. **Open EPCS settings** - Scroll down and click **ePrescribing Controlled Substances (EPCS)** from the left-hand navigation bar.
3. **Update token** - Click the **Update Token/Password** button.
4. **Register second token** - Enter your current **Token Password** in the **Register a 2nd Token** section.
### Where can I find more information about EPCS setup?
For complete information about electronic prescribing of controlled substances, see the Related Articles section below.
## Related Articles
* [EPCS (Electronic Prescribing of Controlled Substances) Introduction](/articles/introduction-to-electronic-prescribing-of-controlled-substances-epcs)
* [EPCS Sign Up Process Guide](/articles/how-to-complete-the-epcs-sign-up-process)
* [EPCS Access Controls Guide](/articles/how-to-set-up-epcs-access-controls)
* [EPCS Token or Password Update Guide](/articles/how-to-update-your-epcs-token)
* [Prescriptions Guide- ePrescribing controlled substance medications](/articles/how-to-e-prescribe-controlled-substances)
# [CMS139] Falls: Screening for Future Fall Risk- Fall Screening Resources
Source: https://help.elationhealth.com/articles/fall-screening-resources
This Help Center Article is no longer relevant for the current calendar year. This Help Center Article is retained in the event of an audit for fidelity of information to align with changes over time and so we keep this article hosted. If you are looking for current calendar year information please ensure the calendar year is included in the title of the Help Center Article.
**What is CMS 139- Falls: Screening for Future Fall Risk?**
CMS 139 (Falls: Screening for Future Fall Risk) is a MIPS measure that tracks the percentage of patients 65 years of age and older who were screened for future fall risk during the MIPS measurement period. [Click here to find more information about CQM measures](/admin-compliance).
## Tools for Falls Screening
These tools can be used to satisfy Clinical Quality Measure CMS139, Falls: Screening for Future Fall Risk
* [Morse Fall Scale](http://www.networkofcare.org/library/Morse%20Fall%20Scale.pdf)
* [Timed Get-Up-And-Go test](https://www.cdc.gov/steadi/pdf/TUG_Test-print.pdf)
**Related Articles**
* [Clinical Quality Measures Help Center Articles](/admin-compliance)
# Fax Outbox
Source: https://help.elationhealth.com/articles/fax-outbox
A single, practice-wide view of every outbound fax, with delivery status, automatic retry progress, and one-click tools to recover failed faxes.
The Fax Outbox gives your practice one place to see every fax you've sent and to fix the ones that didn't go through.
The Fax Outbox is being rolled out to practices in stages and may not yet be enabled for your account. If you don't see it, your existing fax failure notifications in the **Urgent** inbox and the patient chart **Requiring Action** section continue to work as before.
## What is the Fax Outbox?
The Fax Outbox is a page in your Practice Home that lists every outbound fax sent from your practice — Letters, Referrals, and orders faxed to vendors — in one consolidated view. For each fax, it shows where it was going, who sent it, how many pages it was, and its current delivery status.
Before the Fax Outbox, tracking a sent fax meant checking the status on the original correspondence in the patient chart and watching for failure notifications in your **Urgent** inbox. The Fax Outbox brings all of that together: every fax from every user in the practice, with the tools to resend or correct a failed fax without recreating the original Letter or Referral.
You reach it from the **Fax Outbox** icon in the Practice Home toolbar. A badge on the icon shows how many faxes currently need your attention, so you can tell at a glance whether anything has failed.
## Why is the Fax Outbox valuable?
* **One place for the whole practice.** The Outbox shows faxes sent by everyone in the practice, not just the faxes you sent yourself — so front-office staff can monitor and recover failed faxes on a provider's behalf. For Workspace-enabled practices, this means everyone in your current Workspace; admin-level users can switch to **Return to practice view** to see faxes across every Workspace.
* **Know when Elation is already handling it.** Failed faxes are retried automatically. The Outbox shows which faxes are still sending, which are mid-retry, and which have run out of automatic attempts and genuinely need you.
* **Recover a fax in one click.** Resend a fax, correct a wrong fax number, or stop the automatic retries directly from the Outbox — no need to rebuild the Letter or Referral.
* **See the full history.** Open any fax to view a timeline of every send attempt, including the reason each one failed.
* **At-a-glance status.** The toolbar badge and the summary line tell you whether anything needs attention before you even open the page.
## How the Fax Outbox works
### Workspaces and the Fax Outbox
For [Workspace-enabled](/articles/workspaces-guide) practices, the Fax Outbox is Workspace-aware:
* Faxes appear in the Workspace they were created in and are not visible from other Workspaces.
* The toolbar badge counts only faxes needing attention in your current Workspace.
* **Practice view is the exception.** Admin-level users who switch to **Return to practice view** see faxes from every Workspace in one list.
If your practice does not use Workspaces, the Outbox continues to show every fax sent by anyone in the practice.
### Status buckets
Every fax falls into one of five statuses:
| Status | What it means |
| ------------------- | --------------------------------------------------------------------------------------------------------------------- |
| **Delivered** | The fax transmitted successfully (including faxes that succeeded on an automatic retry). |
| **Sending** | The fax is currently being sent. |
| **Retrying** | A previous attempt failed and Elation is automatically trying again. |
| **Needs attention** | The fax failed and automatic retries are finished (or weren't possible). This is the bucket the toolbar badge counts. |
| **Cancelled** | Automatic retries were stopped, either by Elation or by a user. |
At the top of the page, a summary line tells you how many faxes **need your attention** and how many are **sending automatically**. When nothing is outstanding, it reads *"No faxes need your attention."*
![Fax Outbox grouped by status, showing 2 faxes needing attention with interrupted transmission errors, each offering Fix Number, Resend, and Cancel Fax actions.]()
### Finding a fax
* **Time range.** By default the Outbox shows the **last 7 days**. You can switch to **Last 14 days** or **Last 30 days**. (30 days is the maximum history available.)
* **Filter by number.** Click a fax number in the list to filter the view down to faxes to or from that number. Clear the filter to return to the full list.
* **Grouped or flat view.** Faxes can be grouped by recipient, or shown as a flat, date-sorted list with **Date** and **Status** columns.
### Viewing fax details and history
Open any fax to see its full detail, including a **history timeline** of every attempt in the retry chain — when each attempt was made, whether it was an automatic retry, and the reason any attempt failed. Because the detail view always shows the complete chain, you can trace exactly what happened even after several automatic retries.
![Fax detail modal for "Referral for care" to Sally Sample showing a failed transmission error, history timeline with one failed attempt, and Resend, Fix Number, and Cancel Fax actions.]()
### Recovering a failed fax
When a fax lands in **Needs attention**, the Outbox explains why it failed in plain language and offers the right next step:
* **Resend** — Send the fax again as-is. This is the right choice when the failure was temporary, such as a busy line, no answer, or no fax tones detected.
* **Fix number** — Correct the destination fax number and send again. This appears when the number looks wrong or disconnected. Fixing the number here changes the number for **this fax only** — it does not update the recipient's saved provider, contact, or directory records.
* **Cancel** — Stop the automatic retries and move the fax to the **Cancelled** bucket. Use this when you don't need to resend.
**Fix number** is available for faxes sent from Letters and Referrals. It isn't available for some other fax types (such as Patient Passport or clinical-profile faxes), which store their destination differently.
### Automatic retries
When a fax fails, Elation automatically tries to send it again. While that's happening the fax shows as **Retrying**, and the detail view shows how many attempts have been made and when the next one is scheduled. If every automatic attempt is exhausted without success, the fax moves to **Needs attention** so a person can decide what to do next.
Faxes that appear in the Fax Outbox **Needs attention** bucket — including those that have exhausted all automatic retries — are also surfaced in the Practice Home **Urgent** queue, so you can act on them from either location.
## Frequently Asked Questions
### Who can see the Fax Outbox?
The Fax Outbox shows faxes sent by all users in your practice, so anyone with access can monitor and recover failed faxes — not just the original sender. For Workspace-enabled practices, the Outbox only shows faxes sent from your current Workspace. Admin-level users can switch to **Return to practice view** to see faxes from every Workspace.
### How far back does the Fax Outbox go?
It shows the last 7 days by default, and you can extend the view to 14 or 30 days. 30 days is the maximum.
### What's the difference between Resend and Fix number?
Use **Resend** when the fax number is correct and the failure was temporary (busy line, no answer, no fax tones). Use **Fix number** when the failure suggests the number is wrong or disconnected — it lets you correct the number before sending again.
### Does fixing the number update the recipient's saved record?
No. **Fix number** changes the destination for that single fax only. It does not change the recipient's provider, contact, or directory information.
### Can I resend a fax that already delivered?
Not from the Outbox. A fax that already succeeded won't offer a resend action. If you need to send the same document again, use **Re-fax** from the patient chart.
### Does the Fax Outbox replace my failure notifications?
No — it complements them. You'll still receive failure notifications in your Practice Home **Urgent** inbox and in the patient chart **Requiring Action** section. The Outbox adds a single place to see and act on all of them together.
## Related Articles
* [Letter & Referral Guide — Sending a fax](/articles/how-to-send-a-fax)
* [Troubleshooting Outbound Fax Failures in Elation EHR](/articles/Troubleshooting-Outbound-Fax-Failures-in-Elation-EHR)
* [Fax Inbox Introduction](/articles/Fax-Inbox-Introduction)
* [Letter & Referral Guide — Monitoring fax usage](/articles/fax-usage)
* [Workspaces Introduction (Premium)](/articles/workspaces-guide)
# Letter & Referral Guide - Monitoring fax usage
Source: https://help.elationhealth.com/articles/fax-usage
This article describes the Fax Usage & Settings page and how your practice can use this Settings page to monitor fax usage to minimize overage changes.
## Overview
### What is fax usage?
Elation lets you send and receive electronic faxes right from your EHR.
* Incoming faxes are received in your Fax Inbox.
* Outbound faxes are sent with the Provider Letter or Referral features.
Your practice’s fax usage for a month is the total number of fax pages sent and received by everyone at your practice.
### Why should I monitor my practice’s fax usage?
Each practice gets a set number of free fax pages each month. If you go over this monthly amount, you'll be charged extra fees.
Keep an eye on your fax usage on a regular basis to avoid these overage fees.
### How many complimentary fax pages does my practice get each month?
Each **Regular (i.e. full-time, prescribing) Provider Level User** gets 1,500 free fax pages each month. Other user types do not receive free fax pages. Your practice’s total free pages each month is based on how many eligible providers you have. For example, if there are 2 eligible providers, your practice gets 3,000 free pages per month.
### How much does my practice get charged for fax overages?
Elation charges \$0.07 per page for fax use that goes over your practice’s free monthly allotment. Any extra charges will appear on your next month’s invoice.
### Premium EHR features
Premium EHR users can enable a setting to only allow Admin Level Users to view the **Fax Usage & Settings** page.
* If you are already a Premium EHR user and you are interested in using this feature, click the **I need help** -> **Contact Elation Support** button to notify Elation and a member of the Elation Team will activate the feature for you.
* If you are interested in upgrading to Premium EHR to use this feature, click the **I need help** -> **Contact Elation Support** button and a member of the Elation team will assist you.
## Workflow Instructions
### Monitoring your practice's fax usage
To view and monitor your practice's fax usage:
| **1** | Click on your email at the top of your Elation account and then click **Settings** . |
| ----- | ------------------------------------------------------------------------------------ |
| **2** | Click into the **Fax Usage & Settings** page. |
The **Fax Usage & Settings** page provides real time data about your practice’s fax usage. All inbound faxes received through your designated Elation fax number and all outbound faxes sent via the Provider Letters or Referrals features count towards your total fax usage and are visible on this page.
Failed faxes are not counted towards your total fax usage.
## Frequently Asked Questions
### How can I better manage my fax usage?
As a best practice to reduce your outgoing fax page count, limit how often you select the option to fax attachments when sending Provider Letters or Referrals. Instead, you can encourage recipients to access essential attachments through Elation’s secure [Elation Connect](/articles/secure-Provider-Portal) portal, which conserves your practice’s fax usage and gives your recipient on demand access.
[Click here to learn more about sending faxes via the Provider Letter or Referrals features](/articles/how-to-send-a-fax).
### Do I get charged if I go over my complimentary monthly allotment?
Yes, Elation charges \$0.07 per page for usage that goes over your practice’s free monthly allotment. Any extra charges will appear on your next month’s invoice.
### Can I purchase more fax pages for my practice at a discounted rate?
Yes, you can purchase more fax pages for your practice at a discounted rate. Click the **I need help** -> **Contact Elation Support** button to ask about our fax packages.
### The Fax Usage & Settings page is not showing my fax package. Why?
The **Fax Usage & Settings** page only shows your practice’s free fax pages for the current month. If you have a fax package, add your purchased pages to your free pages to calculate your total available fax pages for the month.
### Do failed faxes count towards my fax usage?
No, failed faxes do not count towards your fax usage numbers. If you successfully resend the fax, then it does count towards your fax usage.
### Is the fax cover page included in my fax usage count?
Yes, the Provider Letter/Referral fax cover page sent by Elation for HIPAA compliance does count towards your fax usage.
### Does the page instructing recipients to view the correspondence in Elation Connect count towards my fax usage?
Yes, the page instructing recipients to view the correspondence in Elation Connect does count towards your fax usage.
## Related Articles
* [Letter & Referral Introduction](/articles/letter-and-referral-introduction)
* [Letter & Referral Guide - Sending correspondences to other Elation EHR Users](/articles/share-documents-between-other-elationemr-users)
* [Letter & Referral Guide - Sending and receiving Direct messages](/articles/how-to-use-direct-messaging)
* [Letter & Referral Guide - Sending a fax](/articles/letter-and-referral-introduction)
* [Letter & Referral Guide - Sending correspondences via a secure Provider Portal](/articles/secure-Provider-Portal)
# Fee Schedules Guide — Setting charges in the EHR
Source: https://help.elationhealth.com/articles/fee-schedules-in-the-ehr
Create fee schedules in EHR Billing Settings, set Medicare-based and custom rates, and control which rates auto-fill on a bill.
Fee Schedules let your practice control the charge that auto-fills when a procedure code is added to a bill in the EHR. Billing staff and practice administrators use them to base rates on a percentage of Medicare, set custom rates per procedure code, and apply different rates for specific providers, payers, or service locations.
Fee Schedules is rolling out to practices in phases. If **Fee Schedules** does not appear in your Billing Settings yet, your practice is still using the **Popular CPT Codes** list — see [Billing Settings — Service Locations & Procedure Codes](/articles/billing-settings---service-locations--procedure-codes#how-to-manage-popular-cpt-procedure-codes) for managing that list. Your codes and charges carry over automatically when Fee Schedules is turned on for your practice; there is nothing to migrate.
## What is a fee schedule?
A fee schedule is a set of rates Elation uses to fill the **Charge** field when you add a procedure code to a bill. Each fee schedule has two parts:
* A **Default Billing Rate** — a percentage of the Medicare rate for your selected state and county.
* **Custom Rates** — per-procedure-code rates that override the Default Billing Rate.
Your practice always has one **Default** fee schedule. You can create additional fee schedules and scope them to specific providers, payers, or service locations.
## Setup
Fee Schedules live in the EHR, not in Elation Billing. To open them:
1. Click your email address at the top of your account, then click **Settings**.
2. Under **Practice Settings**, click **Billing**.
3. Scroll to the **Fee Schedules** section.
Your existing **Popular CPT Codes** appear in the **Custom Rates** table along with their charges. On your **Default** fee schedule, changing one of those charges updates it in your Popular CPT Codes list too. On any other fee schedule, the rate you set applies to that schedule only.
![List of practice's Fee Schedules]()
## Setting the Default Billing Rate
![Setting a default billing rate on a Fee Schedule]()
The Default Billing Rate calculates charges as a percentage of the Medicare rate for a procedure code.
1. In the **Fee Schedules** list, click on the fee schedule you want to change.
2. In the **Default Billing Rate** section, enter a **Percentage**. For example, enter `150` to charge 150% of the Medicare rate.
3. Select a **Medicare state**.
4. Select a **Medicare county**. You must select a state before the county list becomes available.
5. Click **Save**.
A fee schedule cannot be activated until both a Medicare state and county are selected. If either is missing, Elation displays **Select a Medicare state and county before activating.**
Medicare rates vary by state and county. Elation uses the state and county on the fee schedule — not the service location address — to look up the Medicare rate.
## Managing custom rates
![Managing custom rates in a Fee Schedule]()
**Custom Rates** override the Default Billing Rate for individual procedure codes. Click the **Manage rates** button to view the **Custom Rates** table. The **Custom Rates** table shows:
| Column | What it shows |
| ---------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **Procedure Code** | The CPT or custom code the rate applies to. |
| **Modifier** | The modifier the rate applies to, if any. A code with a modifier is a separate rate from the same code without one. |
| **Default Rate (\$)** | The rate calculated from the Default Billing Rate percentage. |
| **Medicare Rate (\$)** | The Medicare rate for the selected state and county. Shows **No Medicare rate** when Medicare publishes no rate for the code. |
| **Custom Rate (\$)** | The rate your practice set for this code. This is the value that overrides everything else. |
| **Source** | Where the rate came from — **Manual** for a rate entered in the EHR, or **Elation Billing** for a custom fee pulled from your Elation Billing account. |
### Edit a custom rate
1. Click the **Custom Rate (\$)** field on the row you want to change.
2. Enter the amount.
3. Click **Save** on the row, then **Save** on the fee schedule.
Save or cancel an in-progress custom rate row before saving the fee schedule. Elation blocks the save until the row is resolved.
### Add a code that is not in the list
You can add a rate for any code, including custom codes your practice created for services without a standard CPT code.
1. Click **Add** at the bottom of the **Custom Rates** table.
2. Enter the **Code** — for example, `99999`, or a practice-specific code such as `FORMS`.
3. Optionally enter a **Modifier** of up to two characters, for example `26`. A code with a modifier is priced separately from the same code without one, so you can charge different amounts for each.
4. Enter a **Description**.
5. Enter the **Custom Rate (\$)**.
6. Click **Save**.
Adding a code here prices it for this fee schedule. It does not add the code to your Popular CPT Codes list, so it will not appear in the procedure code picker — type the code on the bill as usual.
### Codes in the billing window
The procedure code picker in the billing window still comes from your practice's Popular CPT Codes list. The **Custom Rates** table on your **Default** fee schedule is where you now edit and remove those entries:
* Changing the charge on a code that is priced by your Popular CPT Codes list updates that charge.
* Deleting a code on the **Default** fee schedule removes it from your Popular CPT Codes list and from every procedure code picker.
* The order codes appear in the picker comes from your Popular CPT Codes list. Fee Schedules has no reordering control, so that order cannot be changed.
### Find a code
Use **Search by procedure code, modifier, or description** above the table to filter the list. Four checkboxes narrow it further:
![Filters available in the Manage Rates dialog for Fee Schedules]()
* **Custom rates only** — codes this fee schedule prices itself.
* **No Medicare rate** — codes Medicare publishes no rate for. Use this to find the codes that need a custom rate.
* **Legacy CPT codes only** — codes from your practice's Popular CPT Codes list.
* **Priced by default schedule** — codes that take their rate from the Default fee schedule rather than from this one. This filter is available for fee schedules other than the Default fee schedule.
**Custom rates only** does not include rates inherited from the Default fee schedule. To see those, use **Priced by default schedule** instead.
The Custom Rates table is paginated, so browser search (Ctrl+F or Cmd+F) only finds codes on the page you are viewing. Use the search field instead.
### Delete or export rates
Select rows with the checkboxes, or use **Select all rates** to take everything your filters currently show. The count above the table tells you how many of the selected rows can be deleted. Then:
* **Delete** removes the selected rates.
* **Export** downloads the rates your filters currently show, so you can review or edit them in a spreadsheet.
* **Import CSV** loads codes and rates from a file. See [Import rates from a spreadsheet](#import-rates-from-a-spreadsheet).
What **Delete** removes depends on which fee schedule you are in, and neither action can be undone:
* On an additional fee schedule, codes priced by the Default fee schedule fall back to that price.
* On the **Default** fee schedule, procedure codes priced in your Popular CPT Codes list are removed from there and from every procedure code picker.
Elation shows which case applies before you confirm.
### Import rates from a spreadsheet
Import a CSV to set many rates at once — for example, loading a payer's negotiated rates, or a fee schedule your practice already keeps in a spreadsheet. Your file needs one row per procedure code, with a column of codes and a column of amounts.
![Import a CSV file to update a Fee Schedule]()
Click **Manage rates**, then click **Import CSV**. The **Import Custom Rates** dialog opens.
Click **Choose file…** and select your CSV. Elation reads the file and shows how many rows it found.
Tell Elation which of your columns is which: **CPT Code column (required)**, **Amount column (required)**, **Modifier column (optional)**, and **Description column (optional)**. Your column headings do not need to match Elation's names. Click **Next**.
![Mapping columns when importing a CSV for a Fee Schedule]()
Leave both checkboxes clear to merge the file into the rates you already have. Select **Replace all existing custom rates (instead of merging)** to clear this fee schedule's current custom rates first, or **Remove custom rates not in this import** to delete the rates for any code your file does not list.
Click **Import**. If you chose to remove rates, the button reads **Yes, remove and import** instead, and that removal cannot be undone from this screen.
A few things to know before you import:
* A file can hold up to 10,000 rows. Split a larger file into batches and import each one separately.
* Elation checks every row before it writes anything, so a file with an error imports nothing rather than importing part of the way.
* If the same code and modifier appear on more than one row, only one rate is kept.
* An empty amount means "no rate given." It does not clear a rate the code already has. To charge nothing for a procedure, enter `0`.
* Importing sets rates on this fee schedule only. It does not add codes to your Popular CPT Codes list, so imported codes do not appear in the procedure code picker.
## Creating additional fee schedules
Create a second fee schedule when part of your practice bills at different rates — for example, one provider with a separate contract, or a payer with negotiated rates.
1. In the **Fee Schedules** section, click **+ Add Fee Schedule**.
2. Enter a **Name**, then click **Save**.
3. Set the scope for each of the three filter sections. Each section defaults to applying to everything:
![Specifying scope of a Fee Schedule]()
* **Providers** — keep **Use this fee schedule for all providers**, or click **+ Add Provider** or **+ Add User Group** to limit it.
* **Payers** — keep **Use this fee schedule for all payers**, or click **+ Add Payer** and search for an insurance company.
* **Service Locations** — keep **Use this fee schedule for all service locations**, or click **+ Add Service Locations**.
4. Set the **Default Billing Rate** and any **Custom Rates**.
5. Click **Save**, then click **Activate**.
The **Default** fee schedule applies to all encounters and cannot be restricted by provider, payer, or service location. Only additional fee schedules can be scoped.
Custom rates on the **Default** fee schedule apply to every fee schedule. Custom rates on an additional fee schedule apply only when that schedule is the one matched to the bill.
### Activating and deactivating
A new fee schedule is inactive until you click **Activate**. An inactive schedule displays **This fee schedule is inactive and won't be used to resolve claims** and is never matched to a bill. Click **Deactivate** to take a schedule out of use without deleting it.
The **Default** fee schedule cannot be deactivated or deleted. Every bill that matches no other fee schedule falls back to it, so it has to stay active. If you try to deactivate it, Elation shows a message suggesting you make another fee schedule the default first — but there is no way to do that. Treat the Default fee schedule as permanent.
If two active fee schedules would match the same encounters, Elation displays: **These criteria already match fee schedule "\[name]". You can save, but this schedule cannot be activated until the conflict is resolved.** Narrow the filters on one of the two schedules, then activate.
## How Elation picks a fee schedule
When you open a bill, Elation matches a fee schedule to it using the provider, payer, and service location on that bill. An empty filter section matches any value.
Filters are weighted, and the highest-weighted match wins:
| Filter | Weight |
| ----------------- | ------ |
| Providers | 4 |
| Payers | 2 |
| Service Locations | 1 |
Weighting means a schedule that filters on **provider alone** outranks a schedule that filters on **payer and service location combined** (4 versus 3). Check the weights before assuming the more narrowly targeted schedule wins.
If no fee schedule matches, Elation uses the **Default** fee schedule. Click the info icon next to a fee schedule's name to see this explanation in the product.
A provider filter matches whether you targeted the provider directly or through a user group — both carry the same weight of 4. If a provider is later added to or removed from a user group, two active schedules can end up tied. Elation then uses the most recently created schedule. Review your schedules after changing user group membership.
## Which rate is used for a procedure code
When you type a procedure code into a bill, Elation resolves the charge in this order and uses the first one it finds:
1. **Custom rate** with a **Source** of **Manual** — a rate your practice entered in the EHR.
2. **Elation Billing custom fee** — a custom fee configured in your Elation Billing account.
3. **Calculated custom rate** — the negotiated rate on the custom rate row, multiplied by the Default Billing Rate percentage.
4. **Medicare rate** for the selected state and county, multiplied by the Default Billing Rate percentage.
If none of these produce a value, the **Charge** field is left empty for you to fill in manually.
An Elation Billing custom fee takes precedence over a calculated rate in the EHR. If a charge auto-fills at an unexpected amount, check your Elation Billing custom fees before adjusting the Default Billing Rate percentage.
**Exception:** This order applies to charges that fill in as you type a procedure code. Service lines that Elation adds for you — for example when a visit note template applies a procedure — skip step 2 and price from the calculated or Medicare rate instead. All-in-One practices that rely on Elation Billing custom fees can therefore see a different charge on an automatically added service line than on one entered by hand. Review the **Charge** on service lines you did not enter yourself before signing the visit note.
## Fee schedules on a bill
Rates apply automatically as you enter procedure codes in the bill in the EHR:
* When you add a procedure code, the **Charge** field fills with the resolved rate. You can overwrite it — a charge you type is always kept.
* The bill header shows a **View fee schedule** link that opens the fee schedule Elation matched to that bill. The link does not appear when no fee schedule matched.
![Viewing a Fee Schedule from the Bill Dialog]()
Fee schedules resolve in the EHR only. The charges on the bill are what Elation Billing uses. An Elation Billing fee schedule only fills a charge on a claim line that is still empty when the claim is submitted.
## Elation EHR + Billing practices (All-in-One)
For All-in-One practices, Elation pulls your existing Elation Billing configuration into the EHR fee schedule:
* Your Elation Billing Medicare base rate and region settings pre-populate the **Default Billing Rate**.
* Your Elation Billing custom fees appear in the **Custom Rates** table with a **Source** of **Elation Billing**.
This is a one-way read from Elation Billing into the EHR. Changing a rate in the EHR does not write back to Elation Billing.
## Frequently Asked Questions
### Can I upload a fee schedule from a spreadsheet?
Yes. Your file needs a column of CPT codes and a column of amounts. Description and modifier columns are optional, and your column headings do not need to match Elation's names. See [Import rates from a spreadsheet](#import-rates-from-a-spreadsheet) for the steps.
### Can I set a separate fee schedule for cash-paying patients?
Not directly. Fee schedules match on the payer on the bill, and self-pay patients have no payer to filter on. Elation is evaluating letting users select a fee schedule manually on a bill. As a workaround, overwrite the **Charge** field on the bill for cash-paying patients.
### Why does a lab or drug code show "No Medicare rate"?
Medicare publishes lab and drug rates in separate fee schedules from physician procedure codes. Elation's Medicare rate lookup does not currently include the full Clinical Laboratory Fee Schedule, so some lab and drug codes have no Medicare rate to calculate from. Set a custom rate for those codes.
### Where do I find my existing Popular CPT Codes?
Your existing Popular CPT Codes are in the **Custom Rates** table of your **Default** fee schedule. To find them:
1. Under **Practice Settings**, click **Billing**.
2. Scroll to the **Fee Schedules** section.
3. Click on your **Default** fee schedule.
4. Click **Manage rates** to open the **Custom Rates** table.
5. Select the **Legacy CPT codes only** filter above the table to show only the codes carried over from your Popular CPT Codes list.
![Filtering for Legacy CPT Codes in the Manage Rates dialog for Fee Schedules]()
### Do I still use Popular CPT Codes?
Your Popular CPT Codes list still exists, and its charges are still used when a fee schedule has no rate of its own for a code. Fee Schedules shows those codes in the **Custom Rates** table, and a **Custom Rate** you set there is used instead. Manage rates from **Fee Schedules** so you also get Medicare-based rates and per-payer scoping.
### Does the charge apply to patient invoices?
Yes. Charges that auto-fill on the bill flow through to patient invoices when **Invoicing** is turned on. See [Patient Invoicing](/articles/patient-invoicing).
## Related Articles
* [Billing Settings — Service Locations & Procedure Codes](/articles/billing-settings---service-locations--procedure-codes)
* [Add/Update a Fee Schedule](/articles/add-update-a-fee-schedule)
* [Billing Guide — Creating a superbill & coding for your visit](/articles/billing)
* [Patient Invoicing](/articles/patient-invoicing)
* [Elation Billing — Using Elation's all-in-one billing solution](/articles/Elation-Billing-All-in-One)
*\*CPT copyright 1995 - 2022 American Medical Association. All rights reserved.*
# Fees Associated with Elation Billing
Source: https://help.elationhealth.com/articles/fees-associated-with-elation-billing
Overview of fees for services in Elation Billing
This article provides an overview of fees associated with Elation Billing services.
## Overview
While the Elation Billing subscription includes many powerful tools and features, some services do incur additional fees.
### Fee Summary
| Service | Cost |
| --------------------------------------- | -------------------------------------------------- |
| Electronic Claims, ERAs, and RTEs | Included |
| Text and Email Statements | Included |
| Mailed Statements | \$0.95 each (no extra charge for additional pages) |
| Mailed or Faxed Paper Claims | \$1.15 each |
| Mailed or Faxed Appeals (up to 5 pages) | $1.50 + $0.30 per additional page |
## Included Services
The following services are included in your Elation Billing subscription at no additional cost:
* Electronic Claim submissions
* ERA (Electronic Remittance Advice)
* Real Time Eligibility (RTE) checks
* Electronic Statements (requires activating Online Payments)
* Appeal Packet downloads
## Additional Fee Services
### Mailed Statements
Mailed Statements incur a flat fee of **\$0.95** per mailed statement.
Mailed Statements feature:
* Double-sided color printing for enhanced readability
* A perforated tear-off payment slip for patient convenience
* A return envelope included for ease of payment remittance
See [Sending Statements](/articles/sending-statements) for more information.
***
### Mailed or Faxed Paper Claims
Claims mailed or faxed through Elation Billing incur a flat fee of **\$1.15** per claim.
* Claims mailed through Elation Billing (using Payer ID "PAPER") will incur these fees
* Claims can be printed and mailed directly by the practice at no charge
See [Print a Claim](/articles/print-a-claim) for more information.
***
### Mailed or Faxed Appeals
Appeals mailed or faxed through Elation Billing incur a fee of **$1.50** for the first 5 pages, and **$0.30** for each additional page.
* Appeal Packets can be generated and downloaded by the practice at no charge
See [Claim Appeals](/articles/claim-appeals) for more information.
## Frequently Asked Questions
### How will my practice be billed for these services?
These charges will be reflected in your monthly invoice.
### Why is Elation charging for these services?
While we offer many services at no extra cost, the fees for these specific services are crucial for maintaining the quality of service you expect from us.
## Related Articles
* [Sending Statements](/articles/sending-statements)
* [Claim Appeals](/articles/claim-appeals)
* [Practice Settings Setup and Overview](/articles/practice-settings-setup-and-overview)
# Developers Application onboarding
Source: https://help.elationhealth.com/articles/fhir/app-client-registration
## Application Registration
1. Contact Elation Health to initiate the registration process for your FHIR application.
2. Provide the following details about your FHIR application:
* Application Name: Provide the name of your application
* Application Type: Choose [Backend](https://hl7.org/fhir/smart-app-launch/backend-services.html), ["Public", or "Confidential"](https://hl7.org/fhir/smart-app-launch/app-launch.html#support-for-public-and-confidential-apps)
* For Public or Confidential applications:
* Redirect URIs: Specify the allowed redirect URIs for your application
* Logo URI: An optional URI to your application logo that will be displayed during the authentication process.
3. An Elation Health representative will review your application details and assist you in the registration process.
4. Once your application is registered, you will receive the following credentials for the **sandbox environment**:
* Client ID: \[Your unique client ID]
* Client Secret (Confidential applications only): \[Your client secret]
**Note:** Keep these credentials secure and do not share them with unauthorized individuals.
5. Use the provided credentials to integrate and test your application against our sandbox environment. This allows you to familiarize yourself with our APIs and ensure the smooth functioning of your application.
6. When you are ready to deploy your application to the **production environment**, please follow these steps:
* Contact Elation Health and request the application to be registered in the production environment.
* Once approved, you will receive a new set of credentials specifically for the production environment.
## Additional Resources
* [SMART App Launch](https://hl7.org/fhir/smart-app-launch/index.html)
* [Elation FHIR environments](/articles/fhir/service-base-urls)
# Authorization
Source: https://help.elationhealth.com/articles/fhir/authentication-authorization
As described in the [SMART on FHIR Authorization Flow](/articles/fhir/smart-on-fhir-authorization), to make API calls to the Elation EMR FHIR API the app supplies an access token as a bearer token.
Access token **SHALL** be obtained during the auth flow by calling the authorize endpoint on the authorization server. The authorization endpoint URL is documented in [FHIR service base URLs](/articles/fhir/service-base-urls). An application using 2-legged authentication (system to system) can call the token endpoint directly to obtain an access token, while an application using 3-legged authentication must first call the authorize endpoint to request and obtain an end user's consent. The token endpoint response for 3-legged authentication applications may also contain an Id token, refresh token, or launch context.
**Note**: Proof key for code exchange, or “PKCE”, is required for all public FHIR clients not using a client secret.
## Authorize
The authorize endpoint is used for end-user login, to enforce limits on the application's requested scopes, and to capture consent before an access token is issued. Obtain the authorization endpoint URL from the [FHIR service base URLs](/articles/fhir/service-base-urls). During authorization, the server temporarily redirects the end user's browser to the Elation EMR FHIR API login. The user is asked to log in or may be automatically authenticated using an existing session. The user is then prompted for scope limitations and the consent form, and is finally redirected back to the requesting app with an authorization code. The app then sends that code to the token endpoint to obtain an access token.
This flow is a browser-only flow because the authorization server redirects the user's browser to the provided redirect URL.
The default value for the refresh token is 90 days. The application needs to use the offline token at least once during this period. Otherwise the offline session will expire.
**METHOD** *GET*
```
GET [authorization_endpoint]?response_type=code&client_id=[client_id]&redirect_uri=[redirect_uri]&scope=[scope]&state=[state]&aud=[aud]
```
**PARAMS**\
`authorization_endpoint` - authorization endpoint URL SHALL be observed from the [FHIR base url](/articles/fhir/service-base-urls) SMART `.well-known` configuration endpoint (authorization metadata)\
`client_id` - client ID for the registered developer application\
`redirect_uri` - URI for the developer's application to which the browser is redirected after successful authorization. Must exactly match a redirect URI configured for the application's client credentials during registration\
`scope` - requested optional scopes by application delimited by space, case sensitive. At minimum client must request the OpenID Connect scope (openid) for successful authentication and to obtain an ID token in the token endpoint response. To obtain a refresh token in the token endpoint response, the client must request the offline\_access scope. To perform a SMART App Launch sequence, the client must request either the launch or launch/patient scope (for provider EHR launch or patient standalone launch) in addition to resource-level scopes for those FHIR endpoints you will access through your app launch. For details, see [scopes](/articles/fhir/smart-on-fhir-authorization).\
`state` - a one-time use arbitrary string provided by the developer application (client) and subsequently returned by the authorize endpoint. The intent of this parameter, per OAuth specification, is for the application to compare the request and response values to prevent cross-site request forgery attacks.\
`aud` - [FHIR base URL](/articles/fhir/service-base-urls), used to specify the organization for which the end user will be authenticated\
`code_challenge` - PKCE code challenge generated from a cryptographically-random code verifier value. This parameter is only used by public FHIR clients without a client secret.\
`code_challenge_method` - Method used to generate the PKCE code challenge. The only supported value is `S256`. This parameter is only used by public FHIR clients without a client secret.
**RESPONSES**\
`code` - authorization code generated by Elation EMR FHIR API authorization server and required to make a token request\
`state` - identical value to the state parameter provided in client app’s authorize request
**Example**
```
https://sandbox.fhir.elationemr.com/smart/authorize?response_type=code&client_id=my-app&redirect_uri=https%3A%2F%2Fmy.app.com%2Fsuites%2Fcustom%2Fsmart%2Fredirect&scope=launch%2Fpatient+openid+fhirUser+offline_access+patient%2FMedication.read+patient%2FAllergyIntolerance.read+patient%2FCarePlan.read+patient%2FCareTeam.read+patient%2FCondition.read+patient%2FDevice.read+patient%2FDiagnosticReport.read+patient%2FDocumentReference.read+patient%2FEncounter.read+patient%2FGoal.read+patient%2FImmunization.read+patient%2FLocation.read+patient%2FMedicationRequest.read+patient%2FObservation.read+patient%2FOrganization.read+patient%2FPatient.read+patient%2FPractitioner.read+patient%2FProcedure.read+patient%2FProvenance.read+patient%2FPractitionerRole.read+patient%2FServiceRequest.read&state=e75c105d-04b4-47e6-b4af-a36773cc2600&aud=https%3A%2F%2Fsandbox.fhir.elationemr.com%2Ffhir
```
## Access token
Obtain an access token. The token endpoint is used for 2-legged authorization applications. This method works only if the client supports this type of authorization.
**METHOD** *POST*
```
[token_endpoint]
```
**PARAMS**\
\[token\_endpoint url] - token endpoint URL SHALL be observed from the [FHIR base url](/articles/fhir/service-base-urls) SMART `.well-known` configuration endpoint (authorization metadata)
**BODY**\
The body SHALL be provided as `application/x-www-form-urlencoded`
`client_id` - ID for the client registered app\
`grant_type` - 'client\_credentials'\
`client_secret` - client secret for the registered app. This parameter is only used by confidential FHIR clients that have a client secret.\
`scopes` - requested optional scopes delimited by space (e.g., `patient/*.read launch/patient`)\
`code_verifier` - the PKCE cryptographically-random code generated previously and used for obtaining the `code_challenge` authorization endpoint value. This parameter is only used by public FHIR clients without a client secret.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------ | ---------- | ----------------- | --------------------------------- |
| Content-Type | **string** | required | application/x-www-form-urlencoded |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | --------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully and access token returned |
| 400 | Bad request | Invalid request parameters, e.g. `client id` or `grant type` |
| 401 | Unauthorized | Invalid client secret |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response body is JSON. If a token was obtained successfully, the body SHALL contain:
* `access_token` - signed base64 JWT access token
* `id_token` - signed OpenID Connect ID token. This value is only returned when the `openid` scope is requested.
* `expires_in` - time in seconds to token expiration
* `refresh_expires_in` - time in seconds to token expiration
* `token_type` - fixed value: `Bearer`
* `scope` - list of the granted default client's scope
* `patient` - an optional identifier of the selected patient that is returned when any of the `patient/` scopes or the `launch/patient` scope were requested.
**EXAMPLE:**
```
curl --location --request POST 'sandbox.fhir.elationemr/smart/token' \
--header 'Content-Type: application/x-www-form-urlencoded' \
--data-urlencode 'client_id=my-app' \
--data-urlencode 'grant_type=client_credentials' \
--data-urlencode 'client_secret=QmFzZTY0IGVuY29kaW5nIHN0cmluZw' \
--data-urlencode 'scopes=patient/*.read launch/patient'
```
* decoded access\_token example
```
{
"ver": 1,
"jti": "AT.2Nj0aWpgoy2twvv7Xv3f46EvRKhuc0KmIA67-bcEcoA",
"iss": "https://sso.sandbox.elationemr.com/oauth2/aus12345678901234567",
"aud": "https://sandbox.fhir.elationemr.com/fhir",
"sub": "user@example.com",
"iat": 1688701088,
"exp": 1688704688,
"cid": "0oa12345678901234567",
"uid": "00u12345678901234567",
"auth_time": 1688701077,
"hsp": "sandbox1",
"patient_id": "sandbox1-1234567890",
"valid_consent": "true",
"scope": "fhirUser launch launch/patient patient/*.read openid",
"practice_ids": [
"sandbox1-1234567890"
]
}
```
## Token Introspection
Checks the status and content of a JWT token.
**METHOD** *POST*
```
POST [introspection_endpoint]
```
**PARAMS**\
\[introspection\_endpoint] - token introspection endpoint URL SHALL be observed from the [FHIR base url](/articles/fhir/service-base-urls) SMART `.well-known` configuration endpoint (authorization metadata)
**BODY**\
The body SHALL be provided as `application/x-www-form-urlencoded`
`client_id` - ID for the client registered app\
`client_secret` - client secret for the registered app\
`token` - token value for the introspection
This endpoint can only be used by confidential FHIR clients with a client secret.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------ | ---------- | ----------------- | --------------------------------- |
| Content-Type | **string** | required | application/x-www-form-urlencoded |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | --------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully and access token returned |
| 400 | Bad request | Invalid request parameters, e.g. `client id` or `grant type` |
| 401 | Unauthorized | Invalid client secret |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response body is JSON. If a token was obtained successfully, the body SHALL contain:
* `active` - true or false. If token is active the additional token information will be provided
* `exp` - time to token expiration (seconds since Unix epoch)
* `iat` - time when token was issued (seconds since Unix epoch)
* `jti` - JWT id, unique token id
* `sub` - list of the granted default client's scope
* `iss` - token issuer and signer
* `typ` - type of the token
* `azp` - client (application)
* `acr` - authentication context class
* `scope` - granted scopes for the token
* `clientId` - optional client id
* `clientHost` - optional host
* `clientAddress` - optional host
**EXAMPLE:**
```
curl --location --request POST 'https://sandbox.fhir.elationemr.com/smart/introspect' \
--header 'Content-Type: application/x-www-form-urlencoded' \
--data-urlencode 'token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.OTkgW2VudGFjdCBpcyB0aGUgbWVzc2FnZSBvZiA1MCBjaGFyYWN0ZXJzIHN0b3JlZCB0byBkZWFsIGVtYWlsIHZpYSBNSU1FLgo.MTU5IFt0aGVyZSBpcyBhIG5lZWQgZm9yIGVtYWlsIHZpYSBNSU1FLCB3aXRob3V0IG1vZGlmaWNhdGlvbiBpcyBjb21wbGV0ZWx5IHN0b3JlZCB0byBkZWFsIGVtYWlsIHZpYSBNSU1FLgo' \
--data-urlencode 'client_id=my-app' \
--data-urlencode 'client_secret=QmFzZTY0IGVuY29kaW5nIHN0cmluZw'
```
* RESPONSE:
```
{
"active": true,
"scope": "fhirUser launch launch/patient patient/*.read openid",
"username": "user@example.com",
"exp": 1688704688,
"iat": 1688701088,
"sub": "user@example.com",
"aud": "https://sandbox.fhir.elationemr.com/fhir",
"iss": "https://sso.sandbox.elationemr.com/oauth2/aus12345678901234567",
"jti": "AT.2Nj0aWpgoy2twvv7Xv3f46EvRKhuc0KmIA67-bcEcoA",
"token_type": "Bearer",
"client_id": "0oa12345678901234567",
"uid": "00u12345678901234567",
"hsp": "sandbox1",
"valid_consent": "true",
"patient_id": "sandbox1-1234567890",
"practice_ids": [
"sandbox1-1234567890"
]
}
```
## Token Revocation
Token revocation is a mechanism for clients to indicate to the Elation EMR FHIR API authorization server that an access token is no longer needed. This is used to enable a "log out" feature in clients, allowing the authorization server to clean up any security credentials associated with the authorization.
**METHOD** *POST*
```
POST [revocation_endpoint]
```
**PARAMS**\
\[revocation\_endpoint] - token revocation endpoint URL SHALL be observed from the [FHIR base url](/articles/fhir/service-base-urls) SMART `.well-known` configuration endpoint (authorization metadata)
**BODY**\
The body SHALL be provided as `application/x-www-form-urlencoded`
`client_id` - ID for the client registered app\
`client_secret` - client secret for the registered app\
`token` - token value for the revocation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------ | ---------- | ----------------- | --------------------------------- |
| Content-Type | **string** | required | application/x-www-form-urlencoded |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | --------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully and the token has been revoked |
| 400 | Bad request | Invalid request parameters, e.g. `client id` or `client_secret` or `token` |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request POST 'https://sandbox.fhir.elationemr.com/smart/revoke' \
--header 'Content-Type: application/x-www-form-urlencoded' \
--data-urlencode 'client_id=my-app' \
--data-urlencode 'client_secret=QmFzZTY0IGVuY29kaW5nIHN0cmluZw' \
--data-urlencode 'token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.OTkgW2VudGFjdCBpcyB0aGUgbWVzc2FnZSBvZiA1MCBjaGFyYWN0ZXJzIHN0b3JlZCB0byBkZWFsIGVtYWlsIHZpYSBNSU1FLgo.MTU5IFt0aGVyZSBpcyBhIG5lZWQgZm9yIGVtYWlsIHZpYSBNSU1FLCB3aXRob3V0IG1vZGlmaWNhdGlvbiBpcyBjb21wbGV0ZWx5IHN0b3JlZCB0byBkZWFsIGVtYWlsIHZpYSBNSU1FLgo'
```
# Bulk Data Export
Source: https://help.elationhealth.com/articles/fhir/bulk-data-export
Exporting large FHIR datasets from a FHIR server using regular RESTful API can be a tricky task: each resource type requires a separate API call and, taking pagination into account, it can result in hundreds of requests. Bulk Data Export is an operation that aimed to solve this issue.
The FHIR Bulk Export Service is intended to fulfill the 21st Century Cures bulk data export requirements. Bulk export operation allows to configure and invoke data export within one API call, whether that be data for all patients, data for a subset (defined group) of patients, or all FHIR data on the server. The export process happens asynchronously to lower the load on system performance and the results are available for several days to download from media storage.
The FHIR Bulk Export service enables API consumers to make export USCDI (United States Core Data for Interoperability) clinical data for all patients in a particular context.
This implementation based on [Bulk Data Access IG](http://build.fhir.org/ig/HL7/bulk-data/).
## Process overview
1. Client invokes Bulk Data Export process by sending Kick-Off request
2. Server validates the Kick-Off request and responds with a link to a job in the Content-Location header
3. Client checks job status by poling from the Content-Location header. If the export process is complete, the response will contain links to the generated files.
4. Client downloads generated files using links, provided in the job
A sequence diagram of the bulk export workflow provided by HL7 [here](https://build.fhir.org/ig/HL7/bulk-data/export.html#sequence-overview)
## Implementation notes
* Exported files are hosted in a protected AWS S3 compatible bucket in `.ndjson` format.
* The URLs returned in the job completion response manifest are AWS S3 Self-Signed URLs. These URLs are valid for a period of 7 days after manifest retrieval.
* When polling for job status, or canceling a job, FHIR client must have a valid auth token with the same client ID as the one used to initiate the export job.
* Group-level export targets Patient-Compartment for resources required by USCDI v2. This means we export resources that are referenced by a resource within the patient compartment and excludes resources with no data available on the patient record. Additionally, server provides Encounter, Location, Organization, and Practitioner resources as they are referenced as must support elements in required resources.
* For the Bulk Export JWT assertion-based authentication is required for the client regarding [SMART Backend Services Protocol Details](https://hl7.org/fhir/uv/bulkdata/authorization/index.html#protocol-details). For the supported authorization in Elation EMR FHIR API refer to the [link](/articles/fhir/smart-on-fhir-authorization).
## Authorization
* Bulk exports respect the scopes provided to the authentication process. For instance if the authentication request for the token used to trigger a bulk export to `[base url]/$export` only includes the scope `patient/*.read`, then the export will *only* include patient data, if it contains some combination of `/*.read` scopes then the export will contain all data that the scopes permit that token to access (`system/*.read` will grant access to all data).
* There are two additional scopes that need to be specified in order to allow a bulk export to be triggered and accessed upon completion, `system/Export.write` and `system/Export.read`. `system/Export.write` permits requests to trigger bulk exports (but not to access data, clients will need to include another scope in the request in order for the export to contain data), `system/Export.read` permits clients to check the status of bulk exports (this is required to access the final download URL of the export).
## Kick-Off request
Bulk Data Export process can be invoked via GET request for smaller sets of query params, or via POST request, supplying parameters in the FHIR Parameters Resource, for larger ones.
### Levels of export
There are three endpoints available to customize export for a particular case of use:
| Name | Description | URL Syntax |
| ------------------- | ----------------------------------------------------------------------------------------------------------------------------------- | ------------------------------- |
| System Level Export | Export data from a FHIR server, whether or not it is associated with a patient. | `[base url]/$export` |
| All Patients | FHIR Operation to obtain a detailed set of FHIR resources of diverse resource types pertaining to all patients. | `[base url]/Patient/$export` |
| Group of Patients | FHIR Operation to obtain a detailed set of FHIR resources of diverse resource types pertaining to all members of a specified Group. | `[base url]/Group/[id]/$export` |
### Parameters
* `_since` - FHIR instant
* Resources are included in the response if their state has changed after the supplied time (e.g. if `Resource.meta.lastUpdated` is later than the supplied `_since` time).
* Example: `_since=2022-07-13T00:00:00Z`
* `_type` - string of comma-delimited FHIR resource types
* Response is filtered to only include resources of the specified resource types(s).
* Example: `_type=Observation,Condition`
* **Note:** that for Patient and Group Level export referenced patients are always in the response
* `_elements` - string of comma-delimited FHIR Elements
* Unlisted, non-mandatory elements are omitted from the resources returned. Elements should be of the form \[resource type].\[element name] (eg. `Patient.id`) or \[element name] (eg. `id`) and only root elements in a resource are permitted. If the resource type is omitted, the element returned for all resources in the response where it is applicable. Mandatory elements are always returned whether they are requested or not.
* `patient` - FHIR Reference - Applied only for POST requests
* Return resources in patient compartments belonging to patients from the list.
* **Note**: Not applicable to system level export requests.
* Example
```json theme={null}
POST Example: {"name":"patient",
"valueReference": {"reference": "Patient/ec89d1cc-48f3-49ad-a80e-bc94f2f542af"}}
```
* `_typeFilter` - string of comma delimited values. String of comma separated FHIR REST search queries. When provided, the server filter the data in the response to only include resources that meet the specified criteria.
* **Note**: Currently not supported for Patient resource
* Example:
```json theme={null}
POST Example: {"name":"_typeFilter",
"valueString": "Condition?asserter=Practitioner/d010b87b-6d7d-460c-a52d-8f741b9b0a72"},
```
```json theme={null}
GET Example:
_typeFilter=Observation%3Fcode%3Dhttp://loinc.org|718-7,Condition%3Fcategory%3Dhttp://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis
```
* `_outputFormat` - string - Can be set to `application/fhir+ndjson` or `application/ndjson` or `ndjson`.
Note that for `Patient level Export` and `Group level export`, patients are always exported regardless of search params, if they are referenced by resources, present in the response.
### Headers
There are two required header parameters defined by the current \$export specification:
* `Accept` - `application/fhir+json`
* `Prefer` - `respond-async`
### Examples
* `_typeFilter` parameter use:
The example below demonstrates how to configure a kick-off request to export only patients from a group who had a reaction to immunization. In this case, `_typeFilter` contains a search immunization query with `:missing=false modifier`.
```sh theme={null}
curl --location --request GET 'https://kodjin-staging.edenlab.dev//fhir/Group/0a60d2a2-38ce-49f6-ac45-42347193af50/$export?_type=Immunization&_typeFilter=Immunization%3Freaction-date:missing%3Dfalse' \
--header 'content-type: application/json' \
--header 'prefer: respond-async' \
--data-raw ''
```
* POST request use:\
Some requests may contain lots of filter parameters. In this case, it is convenient to use a POST request and supply filter parameters in the body. The example below demonstrates how to export resources filtered by practitioner ID. The request contains the \_typeFilter parameter for each resource type.
```sh theme={null}
curl --location --request POST 'https://kodjin-staging.edenlab.dev//fhir/$export' \
--header 'content-type: application/json' \
--header 'prefer: respond-async' \
--data-raw '{"resourceType" : "Parameters",
"parameter" : [
{"name":"_since",
"valueInstant": "2022-01-01T00:00:00Z"},
{"name":"_type",
"valueString": "Observation, Condition, Procedure, Immunization"},
{"name":"_typeFilter",
"valueString": "Observation?performer=Practitioner/9bac339d-ac3b-4715-bf9a-1dab1dec7fa2"},
{"name":"_typeFilter",
"valueString": "Condition?asserter=Practitioner/9bac339d-ac3b-4715-bf9a-1dab1dec7fa2"},
{"name":"_typeFilter",
"valueString": "Procedure?performer=Practitioner/9bac339d-ac3b-4715-bf9a-1dab1dec7fa2"},
{"name":"_typeFilter",
"valueString": "Immunization?performer=Practitioner/9bac339d-ac3b-4715-bf9a-1dab1dec7fa2"}
]
}'
```
* `_elements` parameter use:\
In some cases, you will need only a short set of fields for analysis instead of the entire resource. The example below demonstrates how to export only condition and observation codes using an \_elements parameter.
```sh theme={null}
curl --location --request GET 'https://kodjin-staging.edenlab.dev//fhir/$export?_type=Observation,Condition&_since=2022-07-13T00:00:00Z&_elements=code' \
--header 'content-type: application/json' \
--header 'prefer: respond-async' \
--data-raw ''
```
## Status Request
When the Data Export process is invoked it can take time for the server to generate all the files. Client can check the status of the job export by polling from the `Content-Location` header, returned on Kick-Off Request.
Response can be one of:
* 'In-progress' - Returned by the server while it is processing the \$export request.
* Response Headers and Body:
```text theme={null}
Status: 202 Accepted
```
* 'Error' - Returned by the server if the export operation fails.
* Response Headers and Body:
`Status: 500 Internal Server Error`\
`Content-Type: application/json`
```json theme={null}
{
"resourceType": "OperationOutcome",
"id": "1",
"issue": [ {
"severity": "error",
"code": "processing",
"details": {
"text": "An internal timeout has occurred"
}
} ]
}
```
* `Complete` - Returned by the server when the export operation has completed.
* Response Headers and Body:
`Status: 200 OK`\
`Expires: Mon, 22 Jul 2022 23:59:59 GMT`\
`Content-Type: application/json`
```json theme={null}
{
"transactionTime": "2022-08-21T00:00:00Z",
"request" : "https://example.com/fhir/Patient/$export?_type=Patient,Observation",
"output" : [{
"type" : "Patient",
"url" : "https://example.com/output/patient_file_1.ndjson"
},{
"type" : "Patient",
"url" : "https://example.com/output/patient_file_2.ndjson"
},{
"type" : "Observation",
"url" : "https://example.com/output/observation_file_1.ndjson"
}],
"deleted" : [{
"type" : "Bundle",
"url" : "https://example.com/output/del_file_1.ndjson"
}],
"error" : [{
"type" : "OperationOutcome",
"url" : "https://example.com/output/err_file_1.ndjson"
}]
}
```
### Example of status request:
`GET https://kodjin-staging.edenlab.dev/fhir/export/5df2f390-2285-4f0d-8917-f1064fb6479a`
## Retrieving Data
When the server completes files generation, the response contains links to generated files that can be now downloaded by the client. Links are signed URLs. The files contain data in NDJSON format, each resource type in a separate file.
**Example of a response:**
```json theme={null}
{
"output": [
{
"type": "Observation",
"url": "https://kodjin-staging.edenlab.dev/io/kodjin-export/5df2f390-2285-4f0d-8917-f1064fb6479a/Observation.ndjson?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=user%2F20220805%2F%2Fs3%2Faws4_request&X-Amz-Date=20220805T085248Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=fe04d160c9405d322cf511bb2fb47f5c584ae8bdb2fba962db2b6a1c7c19125a"
},
{
"type": "Condition",
"url": "https://kodjin-staging.edenlab.dev/io/kodjin-export/5df2f390-2285-4f0d-8917-f1064fb6479a/Condition.ndjson?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=user%2F20220805%2F%2Fs3%2Faws4_request&X-Amz-Date=20220805T085248Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=b0ed0b70defe60154574ca9fb7ea927efeaf8b6cefaf33132c936cce0977eca3"
},
{
"type": "Patient",
"url": "https://kodjin-staging.edenlab.dev/io/kodjin-export/5df2f390-2285-4f0d-8917-f1064fb6479a/Patient.ndjson?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=user%2F20220805%2F%2Fs3%2Faws4_request&X-Amz-Date=20220805T085248Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=b3655b6c577f4f7c5860587d3379a6f2a42f2129636091005eb43c62c75acf87"
}
],
"request": "curl -X GET 'https://elation-staging.edenlab.dev/fhir/Group/3a457da3-b10e-48f9-b78e-467c396f8092/$export?_type=Observation,Condition&_since=2022-07-13T00:00:00Z&_typeFilter=Observation%3Fcode%3Dhttp://loinc.org|718-7,Condition%3Fcategory%3Dhttp://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis' -H 'prefer:respond-async'",
"transactionTime": "2022-08-05T08:52:45.692Z"
}
```
**Example of NDJSON file:**
```json theme={null}
{"id":"5c41cecf-cf81-434f-9da7-e24e5a99dbc2","name":[{"given":["Brenda"],"family":["Jackson"]}],"gender":"female","birthDate":"1956-10-14T00:00:00.000Z","resourceType":"Patient"}
{"id":"3fabcb98-0995-447d-a03f-314d202b32f4","name":[{"given":["Bram"],"family":["Sandeep"]}],"gender":"male","birthDate":"1994-11-01T00:00:00.000Z","resourceType":"Patient"}
{"id":"945e5c7f-504b-43bd-9562-a2ef82c244b2","name":[{"given":["Sandy"],"family":["Hamlin"]}],"gender":"female","birthDate":"1988-01-24T00:00:00.000Z","resourceType":"Patient"}
```
## Delete Request
Bulk Data Export process can be stopped by sending delete request to the URL, returned in Kick-Off response Content-Location header.
**Example:**
`DELETE https://kodjin-staging.edenlab.dev/fhir/export/da4438a9-e1d7-4400-9d80-4ed23fbbccc3`
# Attachments
Source: https://help.elationhealth.com/articles/fhir/elation-attachments
## Overview
Attachments are binary documents attached to DocumentReference entities in FHIR.
## Attachment by DocumentReference ID and Attachment ID
Requests the Attachment data for a specific attachment from a specific DocumentReference.
**METHOD** *GET*
```
[base url]/attachment/report/`{document_reference_id}`/`{attachment_id}`
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[document\_reference\_id] - The ID of the DocumentReference entity
\[attachment\_id] - The ID of the specific attachment to download
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
## **RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
***
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/attachment/report/123/456' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Errors and exceptions
Source: https://help.elationhealth.com/articles/fhir/errors
All resources communicate success or error condition with standard HTTP status code of an API request. Below is an overview of all the supported codes, along with some suggestions that might help you fix things.
In general:
* Codes in the 2xx range indicate success.
* Codes in the 4xx range indicate an error that failed given the information provided (e.g., a required parameter was omitted, a request wasn't found, etc.).
* Codes in the 5xx range indicate an error with Elation EMR FHIR API server.
All 4xx errors that could be handled programmatically (e.g., resource not found) include an OperationOutcome that explains the error reported
***
| Error | Description |
| --------------------------- | ----------------------------------------------------------------------- |
| 200 - OK | Everything worked as expected |
| 401 - Unauthorized | No valid Bearer token provided or enough scopes for requested operation |
| 404 - Not Found | The requested resource doesn't exist or wrong url route |
| 422 - Unprocessable Content | FHIR OperationOutcome for processing or validation errors |
| 500 - Server Error | Something went wrong on server API |
***
## Additional error information
A response with a code in the 4xx or 5xx may contain additional information in the form of a FHIR `OperationOutcome`.
Examples:
```
{
"resourceType": "OperationOutcome",
"issue": [
{
"severity": "error",
"code": "value",
"expression": [
"http.Accept"
],
"details": {
"text": "Server does not support given format. Acceptable formats are: application/fhir+json, text/json, application/json"
}
}
]
}
```
```
{
"resourceType": "OperationOutcome",
"issue": [
{
"severity": "error",
"code": "invalid",
"expression": [
"Observation.id"
],
"details": {
"text": "Observation with such id already exists"
}
}
]
}
```
# Getting started with the Elation FHIR API
Source: https://help.elationhealth.com/articles/fhir/getting-started-with-standardized-api
Elation EMR Standardized Patient and public health API adheres to the [HL7® FHIR® R4 specification](https://hl7.org/fhir) and requirements for the ONC Certified (g)(10) Standardized API.
## Who can access this API?
This documentation and API help our partners and customers (trusted developers) using Elation EMR integrate the API in their workflows to meet the requirements of the Standardized API for Patient and Population Services criterion § 170.315(g)(10) in the 2015 Edition Cures Update.\
Let us know you are interested in integrating with Elation. Submit [this form](https://www.elationhealth.com/contact-us/developer-sandbox-partnership/) to indicate your interest in integrating with Elation.
## Review and sign our API terms of service
The Elation API terms of service will be sent to your designated authorized individual who will review and sign the terms of service.\
You can access our full terms of use [here](https://www.elationhealth.com/api-license-and-usage-agreement/).
## Start using our API in our sandbox environment
After registering as a trusted developer, you can generate your own sandbox FHIR API credentials directly from **Settings > API Access** — no support ticket required. See [Self-service API credential management](/articles/self-service-api-credential-management) for step-by-step instructions. Test practices in our sandbox environment are PHI-free to keep your test data private.
Once registered, developers can register an application (client) and have grants approved by the Elation Administration for token generation. For production credentials, the Elation support team is available to help walk through the steps.
## Practice grants data-sharing consent and fees
The data sharing entity (i.e. practice) provides written consent to provide production access to integration.
Start using our API in production. For further details on our ONC Certification and API transparency conditions, please refer to the link [here](/articles/fhir/standardized-api-g10)\
For client registration and token generation, follow the [Authentication and Authorization](/articles/fhir/authentication-authorization) guide.
Additional monthly fees may apply to integrators. API pricing is available [here](https://www.elationhealth.com/drummond-certification) or upon request by contacting [questions@elationhealth.com](mailto:questions@elationhealth.com).
# Binary
Source: https://help.elationhealth.com/articles/fhir/hl7-fhir-binary
## Overview
A resource that represents the data of a single raw artifact as digital content accessible in its native format. A Binary resource can contain any content, whether text, image, pdf, zip archive, etc.
There are situations where it is useful or required to handle pure binary content using the same framework as other resources. Typically, this is when the binary content is referred to from other FHIR Resources. For instance, [DocumentReference](/articles/fhir/uscdi-clinical-notes-document-reference) A Binary resource can contain any content, whether `text`, `image`, `pdf`, `zip archive`, etc.
The Binary resource does not convey context of the file. If the context (information such as author, procedure, technique, etc.) should be conveyed, Media or DocumentReference resources are appropriate. The Binary resource may be used to convey actual binary file content conveyed by those resources.
**Security Considerations:**
Binary resources are not constrained to any list of safe content types (content types without active elements such as scripting or executable code), and therefore can be of any content type and encoding. Therefore, extra care needs to be taken to validate the content of the Binary resource against malicious or malformed content. For more details see Security of Narrative, since the security issues are similar.
## Binary By Id
Get Binary by ID.
**METHOD** *GET*
```
[base url]/Binary/[id]
```
or
```
[base url]/Binary?_id=[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for Binary resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
## **RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
***
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Binary/a12b7cf5-1237-a31b-a31c-b1a3ba1fa0b2' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Group
Source: https://help.elationhealth.com/articles/fhir/hl7-fhir-group
## Overview
Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.
This API supports the Group-level export FHIR Operation (i.e. GET `[base url]/Group/[id]/$export`). The '\$export' operation is invoked using the FHIR Asynchronous Request Pattern. Refer to the [FHIR Bulk Data Export](/articles/fhir/bulk-data-export) Documentation for more information about Bulk Data Export.
## Group By Id
Get Group by ID.
**METHOD** *GET*
```
[base url]/Group/[id]
```
or
```
[base url]/Group?_id=[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for Group resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Group/a12b7cf5-1237-a31b-a31c-b1a3ba1fa0b2' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Operations
### \$export
FHIR Operation to obtain a detailed set of FHIR resources of diverse resource types pertaining to all patients in specified Group.
**METHOD** *GET*
```
[base url]/Group/[id]/$export
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for Group resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Group/a12b7cf5-1237-a31b-a31c-b1a3ba1fa0b2/$export' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# RESTful API
Source: https://help.elationhealth.com/articles/fhir/kodjin-restful-api
FHIR is described as a 'RESTful' specification based on common industry level use of the term REST.
Each "resource type" has the same set of interactions defined that can be used to manage the resources in a highly granular fashion i.e. CRUDS (create, retrieve, update, delete, search).
Note that in this RESTful framework, transactions are performed directly on the server resource using an HTTP request/response. The API does not directly address authentication, authorization, and audit collection. All interactions are described for synchronous use, and an asynchronous use pattern is also defined.
The API describes the FHIR resources as a set of operations (known as "interactions") on resources where individual resource instances are managed in collections by their type. We provide a Capability Statement that specifies which interactions, resources and their profiles are supported.
**Interactions**: \
`create` - Create a new resource with a client assigned id.\
`read` - Read the current state of the resource\
`vread` - Read the state of a specific version of the resource\
`update` - Update an existing resource by its id (or create it if it is new)\
`patch` - Update an existing resource by posting a set of changes to it\
`delete` - Delete a resource\
`history` - Retrieve the change history for a particular resource
`search` - Search the resource type based on some filter criteria\
`delete` - Conditional Delete across a particular resource type based on some filter criteria\
`history` - Retrieve the change history for a particular resource type
HTTP request syntax used in this documentation is described in [General Guidance](/articles/fhir/us-core-guidance).
## Create
The create interaction creates a new resource in a server-assigned location. The create interaction is performed by an HTTP POST command as shown:
`POST [base]/[type]`
The request body SHALL be a FHIR Resource of the named type. The resource needs to have an id element (this is different from official FHIR spec where id is server generated). Client generated GUIDs as ids are preferable. If the request body includes a meta, the server ignores the passed `versionId` and `lastUpdated` values. Instead the server populates `meta`.`versionId` and `meta.lastUpdated` with the new correct values.
The server returns a 201 Created HTTP status code, and also returns a Location header which contains the new Logical Id and `versionId` of the created resource version:
`Location: [base]/[type]/[id]/_history/[vid]`
## Read
The read interaction accesses the current contents of a resource. The interaction is performed by an HTTP GET command as shown:
`GET [base]/[type]/[id]`
This returns a single instance with the content specified for the resource type. The server returns an ETag header with the `versionId` of the resource (if versioning is supported) and a Last-Modified header.
## Update
The update interaction creates a new current version for an existing resource. The update interaction is performed by an HTTP PUT command as shown:
`PUT [base]/[type]/[id]`
The request body **SHALL** be a Resource of the named type with an id element that has an identical value to the \[id] in the URL. If no id element is provided, or the id disagrees with the id in the URL, the server responds with an HTTP 400 error code. If the request body includes a meta, the server SHALL ignore the provided `versionId` and `lastUpdated` values. It populates `meta`.`versionId` and `meta.lastUpdated` with the new correct values.
If the interaction is successful and the resource was updated, the server returns a 200 OK HTTP status code. The server also returns a Location header which contains the new Logical Id and `versionId` of the created resource version:
`Location: [base]/[type]/[id]/_history/[vid]`
where \[id] and \[vid] are the existing or newly created `id` and `versionId` for the resource version.
Server returns an ETag header with the `versionId` and a Last-Modified header.\
The body of the response is the resource being updated.
## Patch
As an alternative to updating an entire resource, clients can perform a patch interaction. This can be useful when a client is seeking to minimize its bandwidth utilization, or in scenarios where a client has only partial access or support for a resource. The patch interaction is performed by an HTTP PATCH command as shown:
`PATCH [base]/[type]/[id]`
The body of a PATCH interaction **SHALL** be a JSON Patch document with a content type of `application/json-patch+json`\
**Example**:
```
curl --location --request PATCH 'https://kodjin-staging.edenlab.dev//fhir/Patient/ac5b5b83-8c6a-43c9-98cd-0ce842b888ad' \
--header 'content-type: application/json-patch+json' \
--header 'x-consumer-id: {{x-consumer-id}}' \
--data-raw '[
{ "op": "add", "path": "/address", "value":[]},
{ "op": "add", "path": "/address/0", "value":
{
"use" : "home",
"line" : ["23 thule st","avon"],
"city" : "Springfield",
"country" : "USA",
"text":"23 thule st"
}
}
]'
```
## Version read
The `vread` interaction performs a version specific read of the resource. The interaction is performed by an HTTP GET command as shown:
`GET [base]/[type]/[id]/_history/[vid]`
This returns a single instance with the content specified for the resource type for that version of the resource. The returned resource SHALL have an id element with a value that is the \[id], and a `meta`.`versionId` element with a value of \[vid]. The server returns an ETag header with the `versionId` and a Last-Modified header.
The `versionId` ("vid") is an opaque identifier that conforms to the same format requirements as a Logical Id. The id may have been found by performing a history interaction (see below), by recording the `versionId` from a content location returned from a read or from a version specific reference in a content model.
**Important:** The versioning feature works only if it is enabled in the FHIR server. This feature requires additional server resources. Versioning is disabled in the Elation EMR FHIR API.
## Delete
The delete interaction removes an existing resource. The interaction is performed by an HTTP DELETE command as shown:
`DELETE [base]/[type]/[id]`
A delete interaction means that the resource is no longer found through a search interaction. Subsequent non-version-specific reads of the resource return a 404 Not Found HTTP status code when the server wishes to indicate that the resource is deleted. Upon successful deletion, or if the resource does not exist at all, the server should return a 204 No Content with no response payload.
Many resources have a status element that overlaps with the idea of deletion. Each resource type defines what the semantics of the deletion interactions are. If no documentation is provided, the deletion interaction should be understood as deleting the record of the resource, with nothing about the state of the real-world corresponding resource implied.
For servers that maintain a version history, the delete interaction does not remove a resource's version history. From the perspective of version history, deleting a resource is equivalent to creating a special kind of history entry that has no content and is marked as deleted.
## Conditional update
The conditional update interaction allows a client to update an existing resource based on some identification criteria, rather than by logical id. To accomplish this, the client issues a PUT as shown:
`PUT [base]/[type]?[search parameters]`
When the server processes this update, it performs a search using its standard search facilities for the resource type, with the goal of resolving a single logical id for this request. The action it takes depends on how many matches are found:
* No matches, id provided and doesn't already exist: The server treats the interaction as an Update as Create interaction
* No matches, id provided and already exist: The server rejects the update with a 422 error
* One Match: The server performs the update against the matching resource
* Multiple matches: The server returns a 412 Precondition Failed error indicating the client's criteria were not selective enough
## Conditional delete
The conditional delete interaction allows a client to delete an existing resource based on some selection criteria, rather than by a specific logical id. To accomplish this, the client issues an HTTP DELETE as shown:
`DELETE [base]/[type]?[search parameters]`
When the server processes this delete, it performs a search as specified using the standard search facilities for the resource type. The action it takes depends on how many matches are found:
No matches or One Match: The server performs an ordinary delete on the matching resource\
Multiple matches: A server returns a 412 Precondition Failed error indicating the client's criteria were not selective enough.
# Search Operations
Source: https://help.elationhealth.com/articles/fhir/kodjin-search
The search operation lets you fetch resources by filtering them with supplied parameters. The parameters are a series of name=\[value] pairs. The syntax for Read and Search is described [here](/articles/fhir/us-core-guidance).
Parameters can be encoded in the URL in case of search by GET method:
```
GET [base]/[type]?name=value&...{&_format=[mime-type]}}
```
or as an application/x-www-form-urlencoded submission for a POST:
```
POST [base]/[type]/_search{?[parameters]{&_format=[mime-type]}}
```
The response to any search operation is always a list of resources in a `Bundle` or an `OperationOutcome`.
## Supported global search parameters
The following parameters apply to [all resources](https://www.hl7.org/fhir/resource.html#search):
| Parameters for all resources | Status |
| ------------------------------------------------------------------ | ----------- |
| [\_id](https://www.hl7.org/fhir/search.html#id) | supported |
| [`_lastUpdated`](https://www.hl7.org/fhir/search.html#lastUpdated) | supported |
| [\_tag](https://www.hl7.org/fhir/search.html#tag) | supported |
| [\_profile](https://www.hl7.org/fhir/search.html#profile) | supported |
| [\_security](https://www.hl7.org/fhir/search.html#security) | supported |
| [\_source](https://www.hl7.org/fhir/search.html#all) | supported |
| [\_text](https://www.hl7.org/fhir/search.html#text) | unsupported |
| [\_content](https://www.hl7.org/fhir/search.html#content) | unsupported |
| [\_list](https://www.hl7.org/fhir/search.html#list) | unsupported |
| [\_has](https://www.hl7.org/fhir/search.html#has) | unsupported |
| [\_type](https://www.hl7.org/fhir/search.html#_type) | unsupported |
## Supported search parameter types
Each search parameter is defined by a type that specifies how the search parameter behaves. These are the defined parameter types:
| Search Parameter Type | Status |
| ----------------------------------------------------------- | ----------- |
| [number](https://www.hl7.org/fhir/search.html#number) | supported |
| [date](https://www.hl7.org/fhir/search.html#date) | supported |
| [string](https://www.hl7.org/fhir/search.html#string) | supported |
| [token](https://www.hl7.org/fhir/search.html#token) | supported |
| [reference](https://www.hl7.org/fhir/search.html#reference) | supported |
| [composite](https://www.hl7.org/fhir/search.html#composite) | supported |
| [quantity](https://www.hl7.org/fhir/search.html#quantity) | unsupported |
| [uri](https://www.hl7.org/fhir/search.html#uri) | supported |
| [special](https://www.hl7.org/fhir/search.html#special) | unsupported |
## Support of modifiers/prefixes for number/date search parameter type
| Search Parameter Type/Modifier or Prefix | missing | gt | lt | ge | le | sa | eb | ne |
| ----------------------------------------------------- | ------- | -- | -- | -- | -- | -- | -- | -- |
| [number](https://www.hl7.org/fhir/search.html#number) | + | + | + | + | + | + | + | + |
| [date](https://www.hl7.org/fhir/search.html#date) | + | + | + | + | + | + | + | + |
| [dateTime]() | + | + | + | + | + | + | + | + |
| [instant]() | + | + | + | + | + | + | + | + |
| [Period]() | + | + | + | + | + | + | + | + |
| [Timing]() | - | - | - | - | - | - | - | - |
## Support of modifiers/prefixes for string search parameter type
| Search Parameter Type/Modifier or Prefix | missing | exact | contains |
| ----------------------------------------------------- | ------- | ----- | -------- |
| [string](https://www.hl7.org/fhir/search.html#string) | - | + | + |
| string.Address | - | - | - |
| string.HumanName | - | + | + |
## Support of modifiers/prefixes for token search parameter type
| Search Parameter Type/Modifier or Prefix | missing | text | not | above | below | in | not-in | of-type |
| --------------------------------------------------- | ------- | ---- | --- | ----- | ----- | -- | ------ | ------- |
| [token](https://www.hl7.org/fhir/search.html#token) | + | + | + | - | - | - | - | + |
## Support of modifiers/prefixes for reference search parameter type
| Search Parameter Type/Modifier or Prefix | missing | type | identifier | above | below |
| ----------------------------------------------------------- | ------- | ---- | ---------- | ----- | ----- |
| [reference](https://www.hl7.org/fhir/search.html#reference) | + | + | + | - | - |
## Support of modifiers/prefixes for uri search parameter type
| Search Parameter Type/Modifier or Prefix | missing | above | below |
| ----------------------------------------------- | ------- | ----- | ----- |
| [uri](https://www.hl7.org/fhir/search.html#uri) | - | - | - |
## Dynamic search
Search in Kodjin FHIR is dynamic. In order to enable search on some new parameter SearchParameter resource should be added via API. Elastic Search index should also be configured.
## Pagination
Search in Kodjin supports two types of pagination:
-offset pagination (with skip or page params). *Examples*:
```
curl --location --request GET 'https://test.fhir.edenlab.tech/fhir/Coverage' \
--header 'Prefer: pagination=offset-skip'
```
```
curl --location --request GET 'https://test.fhir.edenlab.tech/fhir/Coverage' \
--header 'Prefer: pagination=offset-page'
```
-cursor pagination. *Example*:
```
curl --location --request GET 'https://test.fhir.edenlab.tech/fhir/Patient?_count=3' \
--header 'Prefer: pagination=cursor'
```
Default one is the cursor.
## Handling errors
Kodjin will not return an error if a parameter refers to a non-existent resource e.g. `GET [base]/Observation?subject=101`, where "101" does not exist, or to an unknown code e.g. `GET [base]/Observation?code=loinc|1234-1`, where the LOINC code "1234-1" is not known to the server. The response will be an empty search bundle.
Kodjin will return an error if it receives parameters from the client that it does not recognize, or parameters it recognizes but do not support (either in general, or for a specific search).
By default Kodjin FHIR Server ignores unknown or unsupported parameters for the following reasons: various HTTP stacks and proxies may add parameters that aren't under the control of the client.
Clients can specify how the server should behave, by using the prefer header:\
-Prefer: handling=strict: Client requests that the server return an error for any unknown or unsupported parameter\
-Prefer: handling=lenient: Client requests that the server ignore any unknown or unsupported parameter
*Example:*
```
{
"resourceType": "OperationOutcome",
"issue": [
{
"severity": "error",
"code": "not-found",
"details": {
"text": "Unknown query param: test"
}
}
]
}
```
# Service Base URLs
Source: https://help.elationhealth.com/articles/fhir/service-base-urls
To obtain access to the sandbox and production Elation EMR FHIR APIs, register as an authorized application developer. If you are already registered, use the links below to get started.
## Production
| Description | URL |
| ---------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------ |
| SMART `.well-known` configuration (authorization metadata) | [https://fhir.elationemr.com/fhir/.well-known/smart-configuration](https://fhir.elationemr.com/fhir/.well-known/smart-configuration) |
| FHIR API Endpoint | [https://fhir.elationemr.com/fhir](https://fhir.elationemr.com/fhir) |
| FHIR R4 Base URL Endpoint | [https://fhir.elationemr.com/fhir/fhir-base-url](https://fhir.elationemr.com/fhir/fhir-base-url) |
## Sandbox
| Description | URL |
| ---------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------- |
| SMART `.well-known` configuration (authorization metadata) | [https://sandbox.fhir.elationemr.com/fhir/.well-known/smart-configuration](https://sandbox.fhir.elationemr.com/fhir/.well-known/smart-configuration) |
| FHIR API Endpoint | [https://sandbox.fhir.elationemr.com/fhir](https://sandbox.fhir.elationemr.com/fhir) |
| FHIR R4 Base URL Endpoint | [https://sandbox.fhir.elationemr.com/fhir/fhir-base-url](https://sandbox.fhir.elationemr.com/fhir/fhir-base-url) |
# SMART on FHIR Authorization
Source: https://help.elationhealth.com/articles/fhir/smart-on-fhir-authorization
Elation EMR FHIR APIs are secured by an OAuth 2.0 authorization server. FHIR API endpoint security is based on the SMART Authorization framework. This means that when making API calls to any FHIR API endpoint, the developer's app (client) must pass a `Bearer` token. This token is passed in the `Authorization` header for each request. Registered application developers are therefore issued OAuth client credentials used to request access tokens from the Elation EMR FHIR API authorization server.
References for this implementation:
* [OAuth 2.0](http://tools.ietf.org/html/rfc6749)
* [OpenID Connect](http://openid.net/specs/openid-authentication-2_0.html)
* [SMART App Launch Framework 1.0.0](http://hl7.org/fhir/smart-app-launch/1.0.0/)
We support the following methods for application authorization:
* 2-legged OAuth, in which apps use their OAuth client credentials to obtain an access token. This method is used for system-to-system interactions.
* 3-legged OAuth, in which apps must obtain the end user's authorization to obtain an access token, in addition to providing their client credentials and having scopes granted by the user to the app. This method is used for patient- or provider-facing apps accessing data in the Elation EMR FHIR API.
## Scopes
SMART on FHIR’s authorization methods use OAuth scopes to communicate (and negotiate) access requirements. An OAuth scope represents a permission. Scopes are used to let SMART on FHIR know what resources an application needs to have access to. The level of API access afforded to an access token is determined by the OAuth scopes granted from the token request.
### Scopes syntax
Under the SMART App Launch Framework there are three types of scopes: `patient`, `user`, `system`. The syntax for these scopes is:
`('patient' | 'user' | 'system') '/'([fhir-resource] | '*') '.' ('read' | 'write' | '*')`
`patient` or `user` or `system` - scope level\
`fhir-resource` - FHIR resource, e.g. `Condition/`\
`*` - wildcard could be used to substitute any resource (all resources)\
`read` or `write` or `*` - an access level. `*` - read & write access (full access)
**Examples**
* Would allow an application to read a patient’s Condition information for the particular patient:
```
patient/Condition.read
```
* Would allow an application to read Observations for all patients:
```
system/Observation.read
```
| Scope | Grants |
| ------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| `patient/*.read` | Permission to read any resource for the current patient (see notes on exposing wildcard scopes below) |
| `user/*.*` | Permission to read and write all resources that the current user can access (see notes on exposing wildcard scopes below) |
| `openid` `fhirUser` | Permission to retrieve information about the current logged-in user |
| `launch` | Permission to obtain launch context when app is launched from an EHR |
| `launch/patient` | When launching outside the EHR, ask for a patient to be selected at launch time |
| `offline_access` | Request a refresh\_token that can be used to obtain a new access token to replace an expired one, even after the end-user no longer is online after the access token expires |
| `online_access` | Request a refresh\_token that can be used to obtain a new access token to replace an expired one, and that will be usable for as long as the end-user remains online. |
### Scopes evaluation
Apps request scopes by calling the token endpoint or authorize endpoint. Your app’s scope request must pass the following checks to determine whether each scope within the request is granted:
* Is the scope included in the scope parameter of the request?
* Is the scope approved for your app’s OAuth client credentials?
* If the scope requires end user consent (for 3-legged OAuth only), did the user grant that consent when prompted?
All scopes included in the request must pass the first two checks or the request will fail. If all requested scopes pass the first two checks and end user consent is required for one or more of those scopes, then the user’s consent decision will determine the outcome of the request:
1. If the user denies all requested scopes when prompted, then the request will fail.
2. If the user grants one or more requested scopes, then the request will succeed. However, any scope the user denies will be omitted from the access token obtained through that request, preventing the app from accessing API endpoints requiring that scope. You can check which scopes were granted from your app’s request using token introspection.
### Expanding wildcard scopes
* How Elation EMR FHIR APIs expands wildcard `*` scope
* `patient/*.read` expands to:
- `patient/Patient.read`
- `patient/AllergyIntolerance.read`
- `patient/CarePlan.read`
- `patient/CareTeam.read`
- `patient/Condition.read`
- `patient/Device.read`
- `patient/DiagnosticReport.read`
- `patient/DocumentReference.read`
- `patient/Goal.read`
- `patient/Encounter.read`
- `patient/Immunization.read`
- `patient/MedicationRequest.read`
- `patient/Observation.read`
- `patient/Procedure.read`
- `patient/Provenance.read`
- `patient/Practitioner.read`
- `patient/PractitionerRole.read`
- `patient/ServiceRequest.read`
- `patient/QuestionnaireResponse.read`
- `patient/RelatedPerson.read`
- `patient/Organization.read`
- `patient/Location.read`
* `user/*.read` expands to:
- `user/Patient.read`
- `user/AllergyIntolerance.read`
- `user/CarePlan.read`
- `user/CareTeam.read`
- `user/Condition.read`
- `user/Device.read`
- `user/DiagnosticReport.read`
- `user/DocumentReference.read`
- `user/Goal.read`
- `user/Group.read`
- `user/Encounter.read`
- `user/Immunization.read`
- `user/MedicationRequest.read`
- `user/Observation.read`
- `user/Procedure.read`
- `user/Provenance.read`
- `user/Practitioner.read`
- `user/PractitionerRole.read`
- `user/ServiceRequest.read`
- `user/QuestionnaireResponse.read`
- `user/RelatedPerson.read`
- `user/Organization.read`
- `user/Location.read`
* `system/*.read` expands to:
- `system/AllergyIntolerance.read`
- `system/Binary.read`
- `system/CarePlan.read`
- `system/CareTeam.read`
- `system/Condition.read`
- `system/Device.read`
- `system/DiagnosticReport.read`
- `system/DocumentReference.read`
- `system/Encounter.read`
- `system/Goal.read`
- `system/Group.read`
- `system/Immunization.read`
- `system/Location.read`
- `system/Medication.read`
- `system/MedicationRequest.read`
- `system/Observation.read`
- `system/Organization.read`
- `system/Patient.read`
- `system/Practitioner.read`
- `system/PractitionerRole.read`
- `system/Procedure.read`
- `system/Provenance.read`
- `system/ServiceRequest.read`
- `system/QuestionnaireResponse.read`
- `system/RelatedPerson.read`
## SMART on FHIR Authorization flow
### Overview
Developer's App (client) can launch from within EHR (if supported) or Patient Portal session; this is known as an EHR launch. Alternatively, it can launch as a standalone application.
Once an App (client) receives a launch request, it requests authorization to access a FHIR resource by causing the browser to navigate to the Elation EMR FHIR API authorization endpoint.
On receiving the launch notification, the app would query the issuer’s `/metadata` [endpoint](/articles/fhir/service-base-urls) or `.well-known/smart-configuration` endpoint which contains the identifying the OAuth authorize and token endpoint URLs for use in requesting authorization to access FHIR resources.
Based on registered client rules and possibly end-user authorization, the Elation EMR FHIR API authorization server either grants the request (as described above in Scopes evaluation) by returning an authorization code to the app’s redirect URL, or denies the request. The app then exchanges the authorization code for an access token, which the app presents to the Elation EMR FHIR API to access requested FHIR resources. If a refresh token is returned along with the access token, the app may use this to request a new access token, with the same scope, once the access token expires.
**Implementation notes:**
* Before a SMART app can run against an Elation EMR FHIR API, the app must be registered with the authorization service.
* Proof Key for Code Exchange (PKCE) is required for public clients not using a client secret.
* The Refresh token is valid not more than 90 days.
**Optionally Registering for JWKS (key-pair) Authentication**\
As per [SMART ON FHIR Client Confidental Asymmetric](https://build.fhir.org/ig/HL7/smart-app-launch/client-confidential-asymmetric.html#registering-a-client-communicating-public-keys), in addition to standard API Key/Secret authentication, Elation supports JWKS authentication. If you would like to register your application for JWKS authentication, please contact support for instructions on how to register your key-pair.
### Authorization request
**Step 1.** The developer's App (client) asks for authorization
At launch time, the app constructs a request for authorization by supplying the following parameters to the Elation EMR FHIR API “authorize” endpoint.
The app **SHALL** use an unpredictable value for the state parameter with at least 122 bits of entropy (e.g., a properly configured random uuid is suitable). The app **SHALL** validate the value of the state parameter upon return to the redirect URL and **SHALL** ensure that the state value is securely tied to the user’s current session (e.g., by relating the state value to a session identifier issued by the app). The app SHOULD limit the grants, scope, and period of time requested to the minimum necessary.
If the app needs to authenticate the identity of the end-user, it should include two OpenID Connect scopes: `openid` and `fhirUser`. When these scopes are requested, and the request is granted, the app will receive an `id_token` along with the access token.
**Parameters**:
* `response_type` - Fixed value: `code` (*required*).
* `client_id` - The client's identifier (*required*).
* `redirect_uri` - Must match one of the client's pre-registered redirect URIs (*required*).
* `scope` - Must describe the access that the app needs, including clinical data scopes like `patient/*.read`, `openid` and `fhirUser` (*optional*).
* `state` - An opaque value used by the client to maintain state between the request and callback. The authorization server includes this value when redirecting the user-agent back to the client. The parameter **SHALL** be used for preventing cross-site request forgery or session fixation attacks (*required*).
* `aud` - URL of the Elation EMR FHIR API server from which the app wishes to retrieve FHIR data [Service Base urls](/articles/fhir/service-base-urls). This parameter prevents leaking a genuine bearer token to a counterfeit resource server (*Note*: in the case of an EHR launch flow, this aud value is the same as the launch's iss value) (*required*).\
`code_challenge` - PKCE code challenge generated from a cryptographically-random code verifier value. (*required for public clients only*)\
`code_challenge_method` - Method used to generate the PKCE code challenge. The only supported value is `S256`. (*required for public clients only*)
**Step 2.** Elation EMR FHIR API authorization server evaluates authorization request, asking for end-user input
The authorization decision is up to the authorization server, which may request consent from the end-user. The authorization server will enforce access rules based on local policies and optionally direct end-user input.
The Elation EMR decides whether to grant or deny access. This decision is communicated to the app (client) when the authorization server returns an authorization code (or, if denying access, an error response). Authorization codes are short-lived, usually expiring within around one minute. The code is sent when the authorization server causes the browser to navigate to the app’s redirect\_uri, with the following URL parameters:
**Parameters**:
* `code` - The authorization code generated by the authorization server. The authorization code *must* expire shortly after it is issued to mitigate the risk of leaks (*required*).\
`state` - The exact value received from the client (*required*).
**Step 3.** App exchanges authorization code for access token
After obtaining an authorization code, the app trades the code for an access token via **HTTP POST** to the authorization server’s token endpoint URL, using content-type `application/x-www-form-urlencoded`, as described in section [4.1.3 of RFC6749](https://tools.ietf.org/html/rfc6749#section-4.1.3).
* If a client has registered for Client Password authentication (i.e., it possesses a `client_secret` that is also known to the EHR), the client authenticates using an Authorization header with HTTP Basic authentication, where the `username` is the app’s `client_id` and the `password` is the app’s `client_secret`.
* If a client has registered for JWT assertion-based authentication (i.e., it possesses a public/private key-pair whose public key is known to the EHR), the client authenticates using two parameters: `client_assertion_type` and `client_assertion`, as profiled in [SMART Backend Services Protocol Details](https://hl7.org/fhir/uv/bulkdata/authorization/index.html#protocol-details).
**Parameters**:
* `grant_type` - Fixed value: authorization\_code (*required*).
* `code` - Code that the app received from the authorization server (*required*).
* `redirect_uri` - The same redirect\_uri used in the initial authorization request (*required*).
* `client_id` - Required for public apps. Omit for confidential apps (*conditional*).
* `code_verifier` - the PKCE cryptographically-random code generated previously and used for obtaining the `code_challenge` authorization endpoint value (*required for public clients only*).
The authorization server SHALL return a JSON object that includes an access token or a message indicating that the authorization request has been denied. The JSON structure includes the following parameters:
**Parameters**:
* `access_token` - The access token issued by the authorization server (*required*).
* `token_type` - Fixed value: Bearer (*required*).
* `expires_in` - Lifetime in seconds of the access token, after which the token **SHALL NOT** be accepted by the FHIR resource server (*recommended*).
* `scope` - Scope of access authorized. Note that this can be different from the scopes requested by the app (*required*).
* `id_token` - Authenticated user identity and user details, if requested (*optional*).
* `refresh_token` - Token that can be used to obtain a new access token, using the same or a subset of the original authorization grants (*optional*).
In addition, if the app was launched from within a patient context, parameters to communicate the context values **MAY BE** included. For example, a parameter like "patient": "123" would indicate the FHIR resource https\://\[fhir-base]/Patient/123. Other context parameters may also be available.
The parameters are included in the entity-body of the HTTP response, as described in section 5.1 of [RFC6749](https://tools.ietf.org/html/rfc6749).
The access token is a string of characters as defined in [RFC6749](https://tools.ietf.org/html/rfc6749) and [RFC6750](http://tools.ietf.org/html/rfc6750). The token is essentially a private message that the authorization server passes to the FHIR Resource Server, telling the FHIR server that the “message bearer” has been authorized to access the specified resources.\
Defining the format and content of the access token is left up to the organization that issues the access token and holds the requested resource.
The authorization server’s response SHALL include the HTTP “Cache-Control” response header field with a value of “no-store,” as well as the “Pragma” response header field with a value of “no-cache.”
The authorization server decides what expires\_in value to assign to an access token and whether to issue a refresh token, as defined in section 1.5 of [RFC6749](https://tools.ietf.org/html/rfc6749#page-10), along with the access token. If the app receives a refresh token along with the access token, it can exchange this refresh token for a new access token when the current access token expires (see step 5 below). A refresh token **SHALL BE** bound to the same `client_id` and **SHALL** contain the same, or a subset of, the set of claims authorized for the access token with which it is associated.
Apps **SHOULD** store tokens in app-specific storage locations only, not in system-wide-discoverable locations. Access tokens **SHOULD** have a valid lifetime no greater than one hour. Confidential clients may be issued longer-lived tokens than public clients.
At this point, the authorization flow is complete. Follow steps below to work with data and refresh access tokens
**Step 4.** App accesses clinical data via Elation EMR FHIR API
With a valid access token, the app (client) can access protected FHIR data by issuing a FHIR API call to the [FHIR endpoint](/articles/fhir/service-base-urls) on the Elation EMR FHIR resource server. The request includes an Authorization header that presents the `access_token` as a “Bearer” token:
```
Authorization: Bearer {{access_token}}
```
***Example***:
```
GET https://sandbox.fhir.elationemr.com/fhir/Patient/123
Authorization: Bearer eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.OTkgW2VudGFjdCBpcyB0aGUgbWVzc2FnZSBvZiA1MCBjaGFyYWN0ZXJzIHN0b3JlZCB0byBkZWFsIGVtYWlsIHZpYSBNSU1FLgo.MTU5IFt0aGVyZSBpcyBhIG5lZWQgZm9yIGVtYWlsIHZpYSBNSU1FLCB3aXRob3V0IG1vZGlmaWNhdGlvbiBpcyBjb21wbGV0ZWx5IHN0b3JlZCB0byBkZWFsIGVtYWlsIHZpYSBNSU1FLgo
```
The Elation EMR FHIR API **SHALL** validate the access token and ensure that it has not expired and that its scope covers the requested resource.
**Step 5.** App uses a refresh token to obtain a new access token
Refresh tokens are issued to enable sessions to last longer than the validity period of an access token. The app can use the `expires_in` field from the token response to determine when its access token will expire.
The [Token Introspection Protocol](https://tools.ietf.org/html/rfc7662) (OAuth 2.0) uses to provide an introspection endpoint that clients can use to examine the validity and meaning of tokens. An app with “online access” can continue to get new access tokens as long as the end-user remains online. Apps with “offline access” can continue to get new access tokens without the user being interactively engaged for cases where an application should have long-term access extending beyond the time when a user is still interacting with the client.
The app requests a refresh token in its authorization request via the `online_access` or `offline_access` scope. If granted, the authorization server supplies a refresh\_token in the token response. After an access token expires, the app requests a new access token by providing its refresh token to the token endpoint. An HTTP POST transaction is made to the authorization server’s token URL, with content-type `application/x-www-form-urlencoded`. The decision about how long the refresh token lasts is determined by a mechanism that the server chooses. For clients with online access, the goal is to ensure that the user is still online.
**Parameters**:
* `grant_type` - Fixed value: refresh\_token (*required*).
* `refresh_token` - The refresh token from a prior authorization response (*required*).
* `scope` - The scopes of access requested. If present, this value must be a strict sub-set of the scopes granted in the original launch (no new permissions can be obtained at refresh time). A missing value indicates a request for the same scopes granted in the original launch (*optional*).
The response is a JSON object containing a new access token, with the following claims:
**JSON Object property name**:
* `access_token` - New access token issued by the authorization server (*required*).
* `token_type` - Fixed value: bearer (*required*).
* `expires_in` - The lifetime in seconds of the access token. For example, the value 3600 denotes that the access token will expire in one hour from the time the response was generated (*required*).
* `scope` - Scope of access authorized. Note that this will be the same as the scope of the original access token, and it can be different from the scopes requested by the app (*required*).
* `refresh_token` - The refresh token issued by the authorization server. If present, the app should discard any previous refresh\_token associated with this launch, replacing it with this new value (*optional*).
*Note:* An app may be able to replace an expired access token automatically, without user interaction.
# Supported software and frameworks versions
Source: https://help.elationhealth.com/articles/fhir/software-versions
Elation EMR Standardized API for Patient and population services supports next versions of APIs, frameworks and standards:
* [x] [FHIR R4 version 4.0.1](http://hl7.org/fhir/R4)
* [x] [SMART-ON-FHIR 1.0.0](http://hl7.org/fhir/smart-app-launch/1.0.0/)
* [x] [US Core Data for Interoperability v2](https://www.healthit.gov/isa/united-states-core-data-interoperability-uscdi#uscdi-v2)
* [x] [US Core profiles 5.0.1](http://hl7.org/fhir/us/core)
* [x] [Bulk data export 2.0.0](http://hl7.org/fhir/uv/bulkdata/)
* [x] [Authorization Framework oAuth 2.0](https://www.rfc-editor.org/rfc/rfc6749)
# Standardized API for patient and population services
Source: https://help.elationhealth.com/articles/fhir/standardized-api-g10
§170.315(g)(10) Standardized API for Patient and Population Services conforms to the following documents and specifications:
* [HL7® FHIR® API R4 v4.0.1](http://hl7.org/fhir/R4)
* [US Core Data for Interoperability v2](https://www.healthit.gov/isa/united-states-core-data-interoperability-uscdi#uscdi-v2)
* [US Core Implementation Guide v5.0.1](http://hl7.org/fhir/us/core)
* [FHIR® Bulk Data Access v2.0.0](http://build.fhir.org/ig/HL7/bulk-data)
* [HL7 SMART App Launch Framework v1.0.0](https://hl7.org/fhir/smart-app-launch/1.0.0)
* [OAuth 2.0 & OpenID Connect](https://openid.net/specs/openid-connect-core-1_0.html)
Base urls for API calls published [here](/articles/fhir/service-base-urls).
Full Documentation published [here](/articles/fhir/getting-started-with-standardized-api).
API syntax, function names, required and optional parameters and their data types, return variables and their types/structures, exceptions and exception handling methods and their returns:
| Category | API Endpoint |
| ------------------------------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Allergies & Intolerances | `GET` [fhir/AllergyIntolerance/\[id\]](/articles/fhir/uscdi-allergy-intolerance)
`GET` [fhir/AllergyIntolerance](/articles/fhir/uscdi-allergy-intolerance)
`POST` [fhir/AllergyIntolerance/\_search](/articles/fhir/uscdi-allergy-intolerance) |
| Assessment & Plan of Treatment | `GET` [fhir/CarePlan/\[id\]](/articles/fhir/uscdi-care-plan)
`GET` [fhir/CarePlan](/articles/fhir/uscdi-care-plan)
`POST` [fhir/CarePlan/\_search](/articles/fhir/uscdi-care-plan)
*SDOH Assessment profile:*
`GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-observation-sdoh-assessment)
`GET` [fhir/Observation](/articles/fhir/uscdi-observation-sdoh-assessment)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-observation-sdoh-assessment)
*Survey profile:*
`GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-observation-survey)
`GET` [fhir/Observation](/articles/fhir/uscdi-observation-survey)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-observation-survey)
*Social history profile:*
`GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-observation-social-history)
`GET` [fhir/Observation](/articles/fhir/uscdi-observation-social-history)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-observation-social-history)
`GET` [fhir/QuestionnaireResponse/\[id\]](/articles/fhir/uscdi-questionnaire-response)
`GET` [fhir/QuestionnaireResponse](/articles/fhir/uscdi-questionnaire-response)
`POST` [fhir/QuestionnaireResponse/\_search](/articles/fhir/uscdi-questionnaire-response) |
| Care Team members | `GET` [fhir/CareTeam/\[id\]](/articles/fhir/uscdi-care-team)
`GET` [fhir/CareTeam](/articles/fhir/uscdi-care-team)
`POST` [fhir/CareTeam/\_search](/articles/fhir/uscdi-care-team)
`GET` [fhir/RelatedPerson/\[id\]](/articles/fhir/uscdi-care-team-related-person)
`GET` [fhir/RelatedPerson](/articles/fhir/uscdi-care-team-related-person)
`POST` [fhir/RelatedPerson/\_search](/articles/fhir/uscdi-care-team-related-person) |
| Clinical Notes | `GET` [fhir/DocumentReference/\[id\]](/articles/fhir/uscdi-clinical-notes-document-reference)
`GET` [fhir/DocumentReference](/articles/fhir/uscdi-clinical-notes-document-reference)
`POST` [fhir/DocumentReference/\_search](/articles/fhir/uscdi-clinical-notes-document-reference)
`GET` [fhir/DiagnosticReport/\[id\]](/articles/fhir/uscdi-clinical-tests-diagnostic-report)
`GET` [fhir/DiagnosticReport](/articles/fhir/uscdi-clinical-tests-diagnostic-report)
`POST` [fhir/DiagnosticReport/\_search](/articles/fhir/uscdi-clinical-tests-diagnostic-report) |
| Clinical Tests | `GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-clinical-tests-observation)
`GET` [fhir/Observation](/articles/fhir/uscdi-clinical-tests-observation)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-clinical-tests-observation)
`GET` [fhir/DiagnosticReport/\[id\]](/articles/fhir/uscdi-clinical-tests-diagnostic-report)
`GET` [fhir/DiagnosticReport](/articles/fhir/uscdi-clinical-tests-diagnostic-report)
`POST` [fhir/DiagnosticReport/\_search](/articles/fhir/uscdi-clinical-tests-diagnostic-report) |
| Diagnostic imaging | `GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-observation-imaging-result)
`GET` [fhir/Observation](/articles/fhir/uscdi-observation-imaging-result)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-observation-imaging-result)
`GET` [fhir/DiagnosticReport/\[id\]](/articles/fhir/uscdi-clinical-tests-diagnostic-report)
`GET` [fhir/DiagnosticReport](/articles/fhir/uscdi-clinical-tests-diagnostic-report)
`POST` [fhir/DiagnosticReport/\_search](/articles/fhir/uscdi-clinical-tests-diagnostic-report) |
| Encounters | `GET` [fhir/Encounter/\[id\]](/articles/fhir/uscdi-encounter-information)
`GET` [fhir/Encounter](/articles/fhir/uscdi-encounter-information)
`POST` [fhir/Encounter/\_search](/articles/fhir/uscdi-encounter-information)
`GET` [fhir/Condition/\[id\]](/articles/fhir/uscdi-encounter-diagnosis-condition)
`GET` [fhir/Condition](/articles/fhir/uscdi-encounter-diagnosis-condition)
`POST` [fhir/Condition/\_search](/articles/fhir/uscdi-encounter-diagnosis-condition) |
| Goals | `GET` [fhir/Goal/\[id\]](/articles/fhir/uscdi-goal)
`GET` [fhir/Goal](/articles/fhir/uscdi-goal)
`POST` [fhir/Goal/\_search](/articles/fhir/uscdi-goal) |
| Health Concerns | `GET` [fhir/Condition/\[id\]](/articles/fhir/uscdi-health-concerns-condition)
`GET` [fhir/Condition](/articles/fhir/uscdi-health-concerns-condition)
`POST` [fhir/Condition/\_search](/articles/fhir/uscdi-health-concerns-condition) |
| Immunizations | `GET` [fhir/Immunization/\[id\]](/articles/fhir/uscdi-immunization)
`GET` [fhir/Immunization](/articles/fhir/uscdi-immunization)
`POST` [fhir/Immunization/\_search](/articles/fhir/uscdi-immunization) |
| Laboratory Results | `GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-laboratory-results-observation)
`GET` [fhir/Observation](/articles/fhir/uscdi-laboratory-results-observation)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-laboratory-results-observation)
`GET` [fhir/DiagnosticReport/\[id\]](/articles/fhir/uscdi-laboratory-results-diagnostic-report)
`GET` [fhir/DiagnosticReport](/articles/fhir/uscdi-laboratory-results-diagnostic-report)
`POST` [fhir/DiagnosticReport/\_search](/articles/fhir/uscdi-laboratory-results-diagnostic-report) |
| Medications | `GET` [fhir/Medication/\[id\]](/articles/fhir/uscdi-medication)
`GET` [fhir/Medication](/articles/fhir/uscdi-medication)
`POST` [fhir/Medication/\_search](/articles/fhir/uscdi-medication)
`GET` [fhir/MedicationRequest/\[id\]](/articles/fhir/uscdi-medication-request)
`GET` [fhir/MedicationRequest](/articles/fhir/uscdi-medication-request)
`POST` [fhir/MedicationRequest/\_search](/articles/fhir/uscdi-medication-request) |
| Patient Demographics | `GET` [fhir/Patient/\[id\]](/articles/fhir/uscdi-patient)
`GET` [fhir/Patient](/articles/fhir/uscdi-patient)
`POST` [fhir/Patient/\_search](/articles/fhir/uscdi-patient) |
| Problems | `GET` [fhir/Condition/\[id\]](/articles/fhir/uscdi-health-concerns-condition)
`GET` [fhir/Condition](/articles/fhir/uscdi-health-concerns-condition)
`POST` [fhir/Condition/\_search](/articles/fhir/uscdi-health-concerns-condition) |
| Procedures | `GET` [fhir/Procedure/\[id\]](/articles/fhir/uscdi-procedure)
`GET` [fhir/Procedure](/articles/fhir/uscdi-procedure)
`POST` [fhir/Procedure/\_search](/articles/fhir/uscdi-procedure)
`GET` [fhir/ServiceRequest/\[id\]](/articles/fhir/uscdi-procedure-service-request)
`GET` [fhir/ServiceRequest](/articles/fhir/uscdi-procedure-service-request)
`POST` [fhir/ServiceRequest/\_search](/articles/fhir/uscdi-procedure-service-request) |
| Provenance | `GET` [fhir/Provenance/\[id\]](/articles/fhir/uscdi-provenance)
`GET` [fhir/Provenance](/articles/fhir/uscdi-provenance)
`POST` [fhir/Provenance/\_search](/articles/fhir/uscdi-provenance) |
| Smoking Status | `GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-smoking-status)
`GET` [fhir/Observation](/articles/fhir/uscdi-smoking-status)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-smoking-status) |
| Vital Signs | `GET` [fhir/Observation/\[id\]](/articles/fhir/uscdi-vital-signs)
`GET` [fhir/Observation](/articles/fhir/uscdi-vital-signs)
`POST` [fhir/Observation/\_search](/articles/fhir/uscdi-vital-signs) |
| Unique Device Identifiers | `GET` [fhir/Device/\[id\]](/articles/fhir/uscdi-device)
`GET` [fhir/Device](/articles/fhir/uscdi-device)
`POST` [fhir/Device/\_search](/articles/fhir/uscdi-device) |
| Others | `GET` [fhir/Binary/\[id\]](/articles/fhir/hl7-fhir-binary)
`GET` [fhir/Location/\[id\]](/articles/fhir/us-core-location)
`GET` [fhir/Location](/articles/fhir/us-core-location)
`POST` [fhir/Location/\_search](/articles/fhir/us-core-location)
`GET` [fhir/Practitioner/\[id\]](/articles/fhir/us-core-practitioner)
`GET` [fhir/Practitioner](/articles/fhir/us-core-practitioner)
`POST` [fhir/Practitioner/\_search](/articles/fhir/us-core-practitioner)
`GET` [fhir/PractitionerRole/\[id\]](/articles/fhir/us-core-practitioner-role)
`GET` [fhir/PractitionerRole](/articles/fhir/us-core-practitioner-role)
`POST` [fhir/PractitionerRole/\_search](/articles/fhir/us-core-practitioner-role) |
| Bulk export | `GET` [fhir/Group/\[id\]/\$export](/articles/fhir/bulk-data-export) |
# Simple Observation Information
Source: https://help.elationhealth.com/articles/fhir/ucsdi-simple-observation
## Overview
Simple Observation Information addresses:
* Observation HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-simple-observation.html)
The Simple Observation profile is used to record observations that are not covered by other specific US Core Observation profiles (such as Laboratory, Vital Signs, Smoking Status, etc.). This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Clinical Tests and Observations.
Simple Observations can include clinical observations, assessments, survey results, and other measurements or assertions about a patient that don't fit into more specialized observation categories. Examples include visual acuity tests, hearing tests, developmental milestones, functional assessments, and non-laboratory test results.
**Each Simple Observation Must Have:**
* a status
* a category code
* a code
* a patient
**Each Simple Observation Must Support:**
* a time indicating when the observation was made
* who answered the questions
* a value
This resource conforms to [USCDI v3](https://www.healthit.gov/isp/uscdi-data-class/clinical-tests) for Clinical Tests \* refers to [US Core Simple Observation Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-simple-observation.html). Simple Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Simple Observation **must support** these elements:*
* `status`
* `category`
* `category:us-core`
* `code`
* `subject`
* `effective[x]`
* `performer`
* `value[x]`
*Each Simple Observation Must Have (Mandatory):*
* `status`
* `category`
* `code`
* `subject`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
* including support for OR search on category (e.g.category=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: `gt`, `lt`, `ge`, `le`
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]`
*The following search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
* including support for these date comparators: `gt`, `lt`, `ge`, `le`
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]&date={gt|lt|ge|le}[date]`
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on category (e.g.category=\{system|}\[code],\{system|}\[code],...)
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]&status={code}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Simple Observation by Patient and Category
Search for Simple Observation using combination of `patient` and `category` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Category system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://terminology.hl7.org/CodeSystem/observation-category|`
\[code] - Category code. *Example:* `exam` (Exam) or `survey` (Survey)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&category=http://terminology.hl7.org/CodeSystem/observation-category|exam' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Simple Observation by Patient and Code
Search for Simple Observation using combination of `patient` and `code` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Observation code system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://loinc.org|`
\[code] - Observation code. *Example:* `28615-3` (Audiology study)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&code=http://loinc.org|28615-3' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Simple Observation by Patient, Category, and Date
Search for Simple Observation using combination of `patient`, `category`, and `date` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Category system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://terminology.hl7.org/CodeSystem/observation-category|`
\[code] - Category code. *Example:* `exam` (Exam)
\{gt|lt|ge|le} - Date comparison operator. *Example:* `ge` (greater than or equal to)
\[date] - Date in YYYY-MM-DD format. *Example:* `2024-01-01`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&category=http://terminology.hl7.org/CodeSystem/observation-category|exam&date=ge2024-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Simple Observation by Patient, Code, and Date
Search for Simple Observation using combination of `patient`, `code`, and `date` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]&date={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Observation code system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://loinc.org|`
\[code] - Observation code. *Example:* `28615-3` (Audiology study)
\{gt|lt|ge|le} - Date comparison operator. *Example:* `ge` (greater than or equal to)
\[date] - Date in YYYY-MM-DD format. *Example:* `2024-01-01`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&code=http://loinc.org|28615-3&date=ge2024-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Simple Observation by Patient, Category, and Status
Search for Simple Observation using combination of `patient`, `category`, and `status` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]&status={code}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Category system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://terminology.hl7.org/CodeSystem/observation-category|`
\[code] - Category code. *Example:* `exam` (Exam)
\{code} - Status code. *Example:* `final` or `preliminary`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&category=http://terminology.hl7.org/CodeSystem/observation-category|exam&status=final' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# General Guidance
Source: https://help.elationhealth.com/articles/fhir/us-core-guidance
This article describes the general syntax for API interactions.
## Using UCUM codes in the Quantity datatype
Both the [US Core Vital Signs Profile](/articles/fhir/uscdi-vital-signs) and [US Core Laboratory Result Observation Profile](/articles/fhir/uscdi-laboratory-results-observation) bind the `valueQuantity` data types to the [UCUM](http://unitsofmeasure.org/) code system. A FHIR UCUM Codes value set that defines all UCUM codes is in the FHIR specification. This guidance specifies how to represent the Quantity datatype when the correct UCUM units are missing or the units are missing altogether which will likely occur in the real world.
**UCUM code provided:**
```
"valueQuantity": {
"value": 26.0,
"unit": "g/mL",
"system": "http://unitsofmeasure.org",
"code": "g/mL"
}
```
**free text units only:**
* If UCUM units are not available then represent units in the unit element.
```
"valueQuantity": {
"value": 26.0,
"unit": "RR",
}
```
**no units:**
```
"valueQuantity": {
"value": 26.0
}
```
## Read (Fetch) Syntax
For fetching a resource, interactions on documentation pages are defined with the following syntax:
`GET [base url]/[Resource-type]/[id] {parameters}`
* `GET` is the `HTTP` verb used for fetching a resource
* Content surrounded by \[] is mandatory for the client to supply, and will be replaced by the string literal identified.
* `base url`: The Service Root URL (e.g. `https://sandbox.fhir.elationemr.com/fhir`)
* `Resource-type`: The name of a resource type (e.g. `Patient`)
* `id`: The Logical Id of a resource(e.g. `24342`)
* Content surrounded by `{}` is optional for the client to supply, and will be replaced by the string literal identified.
* parameters: URL parameters as defined for the particular interaction (e.g.`?_format=xml`)
For more information see the [FHIR RESTful API](/articles/fhir/kodjin-restful-api)
**Example**:
```
`https://sandbox.fhir.elationemr.com/fhir/Patient/24342`
```
## Search Syntax
This section defines the rules for servers and clients that support the RESTful interactions defined in this documentation.
All search interactions in this guide use the GET command with the following syntax:
```
GET [base url]/[Resource-type]?[parameter1]{:m1|m2|...}={c1|c2|...}[value1{,value2,...}]{&[parameter2]{:m1|m2|...}={c1|c2|...}[value1{,value2,...}]&...}
```
* `GET` is the `HTTP` verb used for fetching a resource
* Variables surrounded by “\[]” are mandatory for the client to supply, and will be replaced by the string literal identified.
* Variables surrounded by “\{}” are optional for the client to supply, and will be replaced by the string literal identified.
* base url: The Service Root URL (e.g. `https://sandbox.fhir.elationemr.com/fhir`)
* Resource-type: The name of a resource type (e.g. `Patient`)
* parameter: the search parameters as defined for the particular interaction (e.g.`?patient=Patient/123`)
* value: the search parameter value for a particular search
* When searching using the token type search parameter [how to search by token](http://hl7.org/fhir/R4/search.html#token), the syntax `{system|}[code]` means that the system value is optional for the client to supply.
* When searching using the reference type search parameter [how to search by reference](http://hl7.org/fhir/R4/search.html#reference), the syntax `{Type/}[id]` means that the `Type` value is optional for the client to supply.
* When searching using the `date` search parameter [how to search by date](https://hl7.org/fhir/search.html#date), the syntax `date={gt|lt|ge|le}[date]` means the date comparators “*gt*”, “*lt*”, “*ge*”, and “*le*” are optional. Date type searches without a comparator prefix are equivalent to searches with the “*eq*” comparator even if a server does not support the comparator.
* \{:m1 m2 …}: The list of supported search parameter modifiers
* \{c1 c2 …}: The list of supported search parameter comparators
* \{,value2,…}: Optional multiple ‘OR’ Values
* **Additional AND parameters:** In the GET line above, the portion starting with `&[parameter2]` shows how to chain more search parameters using `&`. Each chained segment repeats the same `[parameter]{:modifiers}={comparators}[values]` shape as the first parameter block.
In the simplest case, a search is executed by performing a GET operation in the RESTful framework:
`GET [base]/[Resource-type]?name=value&...`
For this RESTful search, the parameters are a series of name=\[value] pairs encoded in the URL. The search parameter names are defined for each resource. For example, for the Observation resource, the name “code” is used to search on the LOINC code.
### SMART-ON-FHIR
For the SMART on FHIR implementation with `patient` scopes (for example, `patient/Observation.read`; see [SMART App Launch 1.0.0](https://hl7.org/fhir/smart-app-launch/1.0.0)), the server evaluates searches in the **authorized patient context**: explicit search parameters are applied **within** that patient binding, consistent with the SMART rules for `patient/` scopes.
# Location
Source: https://help.elationhealth.com/articles/fhir/us-core-location
## Overview
Location Information addresses:
* Location HL7® FHIR® resource with [US Core Profile 6.1.0](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-location.html)
Details and position information for a physical place where services are provided and resources and participants may be stored, found, contained, or accommodated. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Location Information.
A Location includes both incidental locations (a place which is used for healthcare without prior designation or authorization) and dedicated, formally appointed locations. Locations may be private, public, mobile or fixed and scale from small freezers to full hospital buildings or parking garages.
**Each Location has next elements:**
* a name
**Each Location supports next elements:**
* Location.status
* Location.name
* Location.telecom
* Location.address
* managingOrganization
Location response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
This resource refers to [US Core Location Profile 6.1.0](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-location.html).
### Must support elements, mandatory and optional search parameters
*Location **must support** these elements:*
* `status`
* `name`
* `telecom`
* `address`
* `line`
* `city`
* `state`
* `postalCode`
* `managingOrganization`
*Each Location Must Have (Mandatory):*
* `name`
Location response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
*The following search parameters and search parameter combinations SHALL be supported (**mandatory**):*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching by location `name` using the name search parameter:
`GET [base url]/Location?name=[string]`
**SHALL** support searching location based on text `address` using the address search parameter:
`GET [base url]/Location?address=[string]`
*The following search parameter combinations **SHOULD** be supported (**optional**):*
**SHOULD** support searching using the `address-city` search parameter:
`GET [base url]/Location?address-city=[string]`
**SHOULD** support searching using the `address-state` search parameter:
`GET [base url]/Location?address-state=[string]`
**SHOULD** support searching using the `address-postalcode` search parameter:
`GET [base url]/Location?address-postalcode=[string]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Location By Name
Search for Location by location's name.
**METHOD** *GET*
```
GET [base url]/Location?name=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - Location's name
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Location?name=Health' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Location By Address
Search for Location by address string.
**METHOD** *GET*
```
GET [base url]/Location?address=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - Address string
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Location?address=Arbor' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Location by Address-City
Search for Locations by city name.
**METHOD** *GET*
```
GET [base url]/Location?address-city=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - City name
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Location?address-city=Ann%20Arbor' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Location by Address-State
Search for Locations by state.
**METHOD** *GET*
```
GET [base url]/Location?address-state=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - State name or abbreviation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Location?address-state=MI' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Location by Postal Code
Search for Locations by postal code.
**METHOD** *GET*
```
GET [base url]/Location?address-postalcode=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - Postal code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Location?address-postalcode=48104' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Organization
Source: https://help.elationhealth.com/articles/fhir/us-core-organization
## Overview
Organization Information addresses:
* Organization HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-organization.html)
A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Organization Information.
Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.
**Example Usage Scenarios**:
The following are example usage scenarios for the this profile:
* Query by organization name or NPI
**Each Organization has next elements:**
* A status of the organization (i.e., whether is still active )
* A name
**Each Organization supports next elements:**
* An identifier
* A list of contact information
* An address
Organization response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
This resource refers to [US Core Organization Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-organization.html).
**Profile specific implementation guidance:**
Systems **SHALL** support National Provider Identifier (NPI) for organizations and **SHOULD** support Clinical Laboratory Improvement Amendments (CLIA) for laboratories.
### Must support elements, mandatory and optional search parameters
*Organization**must support** these elements:*
* `identifier`
* `identifier:NPI`
* `identifier:CLIA`
* `identifier:NAIC`
* `system`
* `value`
* `active`
* `name`
* `telecom`
* `system`
* `value`
* `address`
* `line`
* `city`
* `state`
* `postalCode`
* `country`
*Each Organization Must Have (Mandatory):*
* `active`
* `name`
*Identifier Validation Rules:*
* **NPI**: Must be 10 digits with valid Luhn algorithm check digit
* **CLIA**: Must be 10 digits with letter "D" in third position (format: ##D#######)
* **NAIC**: Must be exactly 5 digitsgi
Organization response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
*The following search parameters and search parameter combinations SHALL be supported (**mandatory**):*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching by organization `name` using the name search parameter:\
`GET [base url]/Organization?name=[string]`
**SHALL** support searching organization based on text `address` using the address search parameter:\
`GET [base url]/Organization?address=[string]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Organization By Name
Search for Organization by name.
**METHOD** *GET*
```
GET [base url]/Organization?name=[string]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[string] - Organization's name
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Organization?name=Health' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Organization By Address
Get Organizations by address string.
**METHOD** *GET*
```
GET [base url]/Organization?address=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[string] - Address string
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Organization?address=Arbor' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Practitioner
Source: https://help.elationhealth.com/articles/fhir/us-core-practitioner
## Overview
Practitioner Information addresses:
* Practitioner HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-practitioner.html)
Practitioner is a person who is directly or indirectly involved in the provisioning of healthcare. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Care Team Member and Practitioner Information.
Practitioner covers all individuals who are engaged in the healthcare process and healthcare-related services as part of their formal responsibilities and this Resource is used for attribution of activities and responsibilities to these individuals.
**Example Usage Scenarios**:
The following are example usage scenarios for the this profile:
* Query for an practitioner by name or NPI
* Reference from other Resources
**Each Practitioner has next elements:**
* an identifier which must support an NPI if available.
* a name
**Each Practitioner supports next elements:**
* Contact information
* An address
Practitioner response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
This resource refers to [US Core Practitioner Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-practitioner.html).
### Must support elements, mandatory and optional search parameters
*Practitioner**must support** these elements:*
* `Slices for identifier`
* `identifier: all slices`
* `system`
* `value`
* `identifier: NPI`
* `active`
* `name`
* `family`
* `telecom`
* `system`
* `value`
* `address`
* `line`
* `city`
* `state`
* `postalCode`
* `country`
*Each Practitioner Must Have (Mandatory):*
* `identifier`
* `system`
* `value`
* `name`
* `family`
Practitioner response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for a practitioner by a string match of any part of `name` using the name search parameter:
`GET [base url]/Practitioner?name=[string]`
**SHALL** support searching a practitioner by an identifier such as an NPI using the `identifier` search parameter:
`GET [base url]/Practitioner?identifier={system|}[code]`
*The following search parameters and search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the `_id` search parameter:
`GET [base url]/Practitioner?_id=[id]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Practitioner By Name
Search for Practitioner by name using string match.
**METHOD** *GET*
```
GET [base url]/Practitioner?name=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - Practitioner's name (any portion - given, family, prefix, suffix)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Practitioner?name=Smith' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Practitioner By Identifier
Search for Practitioner by identifier (such as NPI).
**METHOD** *GET*
```
GET [base url]/Practitioner?identifier={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - The system for the identifier. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://hl7.org/fhir/sid/us-npi|`
\[code] - Identifier code. *Example:* NPI number `1234567890`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|1234567890' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Practitioner By Id
Fetch a single Practitioner by internal resource id.
**METHOD** *GET*
```
GET [base url]/Practitioner/{id}
```
or
```
GET [base url]/Practitioner?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Practitioner's internal resource id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Practitioner/97860456' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Practitioner Role
Source: https://help.elationhealth.com/articles/fhir/us-core-practitioner-role
## Overview
PractitionerRole Information addresses:
* PractitionerRole HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-practitionerrole.html)
PractitionerRole covers the recording of the location and types of services that Practitioners are able to provide for an organization. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Care Team Member and Practitioner Information.
The role, specialty, Location telecom and HealthcareService properties can be repeated if required in other instances of the PractitionerRole. Some systems record a collection of service values for a single location, others record the single service and the list of locations it is available. Both are acceptable options for representing this data. Where availability, telecom, or other details are not the same across all healthcare services, or locations a separate PractitionerRole instance should be created.
**Each Practitioner supports next elements:**
* an associated organization
* an associated practitioner
* a role
* a specialty
* an associated location
* contact information
* a communication endpoint
**Profile specific implementation guidance:**
* At least one of the following elements must be present:
* PractitionerRole.practitioner
* PractitionerRole.organization
* PractitionerRole.healthcareService
* PractitionerRole.location
* The PractitionerRole.endpoint is where a [Direct](https://www.healthit.gov/sites/default/files/directbasicsforprovidersqa_05092014.pdf) address may be represented.
* Clients can request servers return the Practitioner resource and Endpoint resources by using `_include`.
PractitionerRole response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
This resource refers to [US Core PractitionerRole Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-practitionerrole.html).
### Must support elements, mandatory and optional search parameters
*Practitioner**must support** these elements:*
* `practitioner`
* `organization`
* `code`
* `specialty`
* `location`
* `telecom`
* `system`
* `value`
* `endpoint`
*The following search parameters and search parameter combinations SHALL be supported (**mandatory**):*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching practitioner role by specialty using the `specialty` search parameter:
* including optional support for these `_include` parameters: `PractitionerRole:endpoint`, `PractitionerRole:practitioner`
`GET [base url]/PractitionerRole?specialty={system|}[code]`
**SHALL** support searching practitioner role by practitioner using the `practitioner` search parameter:
* including support for chained parameters: `practitioner.identifier`, `practitioner.name`
* including optional support for these `_include` parameters: `PractitionerRole:endpoint`, `PractitionerRole:practitioner`
`GET [base url]/PractitionerRole?practitioner={Type/}[id]`
**SHALL** support searching using chained parameter for practitioner name:
`GET [base url]/PractitionerRole?practitioner.name=[string]`
**SHALL** support searching using chained parameter for practitioner identifier:
`GET [base url]/PractitionerRole?practitioner.identifier={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## PractitionerRole By Specialty
Search for PractitionerRole by specialty.
**METHOD** *GET*
```
GET [base url]/PractitionerRole?specialty={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - The system for the specialty. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://nucc.org/provider-taxonomy|`
\[code] - Specialty code in the system. *Example:* `208D0000X` (General Practice)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/PractitionerRole?specialty=http://nucc.org/provider-taxonomy|208D0000X' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## PractitionerRole By Practitioner
Search for PractitionerRole by practitioner reference.
**METHOD** *GET*
```
GET [base url]/PractitionerRole?practitioner={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Practitioner/`
\[id] - Id for Practitioner resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/PractitionerRole?practitioner=Practitioner/example' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## PractitionerRole By Practitioner Name (Chained)
Search for PractitionerRole using chained search on practitioner name.
**METHOD** *GET*
```
GET [base url]/PractitionerRole?practitioner.name=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - Practitioner's name (any portion)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/PractitionerRole?practitioner.name=Smith' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## PractitionerRole By Practitioner Identifier (Chained)
Search for PractitionerRole using chained search on practitioner identifier.
**METHOD** *GET*
```
GET [base url]/PractitionerRole?practitioner.identifier={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - Identifier system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://hl7.org/fhir/sid/us-npi|`
\[code] - Identifier code (e.g., NPI number)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/PractitionerRole?practitioner.identifier=http://hl7.org/fhir/sid/us-npi|1234567890' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## PractitionerRole with Include Parameters
Search for PractitionerRole with included resources using \_include parameters.
**METHOD** *GET*
```
GET [base url]/PractitionerRole?specialty={system|}[code]&_include=PractitionerRole:practitioner&_include=PractitionerRole:endpoint
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - The system for the specialty
\[code] - Specialty code
\_include - Include related resources in the response bundle
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/PractitionerRole?specialty=http://nucc.org/provider-taxonomy|208D0000X&_include=PractitionerRole:practitioner&_include=PractitionerRole:endpoint' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# US Core 6.1.0 profiles and USCDI v3 data elements
Source: https://help.elationhealth.com/articles/fhir/us-core-to-uscdi
The [US Core Profiles 6.1.0](http://hl7.org/fhir/us/core/STU6.1/) are designed to meet the requirements of the U.S. Core Data for Interoperability [(USCDI) v3](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi#uscdi-v3). They support ASTP Health IT Certification Program requirements and provide the foundation for interoperable health data exchange in the United States.
The US Core 6.1.0 profiles were created to align with USCDI v3, which expanded from 52 data elements in 16 data classes (USCDI v1) to 94 data elements in 19 data classes. USCDI v3 adds significant new capabilities focused on promoting health equity, reducing disparities, and supporting public health data interoperability.
# Corresponding Objects
The table below lists the US Core 6.1.0 Profiles and FHIR Resources used for the corresponding USCDI v3 Data elements:
| USCDI v3 Data Class | USCDI v3 Data Elements | US Core 6.1.0 Profiles |
| ----------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Allergies and Intolerances | - Substance (Medication)
- Substance (Drug class)
- Reaction | [US Core AllergyIntolerance Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-allergyintolerance.html) |
| Assessment and Plan of Treatment | - Assessment and Plan of Treatment
- SDOH Assessment | [US Core CarePlan Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-careplan.html)
[US Core Observation Screening Assessment Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-screening-assessment.html) |
| Care Team Members | - Care Team Member Name
- Care Team Member Identifier
- Care Team Member Role
- Care Team Member Location
- Care Team Member Telecom | [US Core CareTeam Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-careteam.html)
[US Core Practitioner Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-practitioner.html)
[US Core PractitionerRole Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-practitionerrole.html)
[US Core RelatedPerson Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-relatedperson.html) |
| Clinical Notes | - Consultation Note
- Discharge Summary Note
- History & Physical
- Procedure Note
- Progress Note Narrative | [US Core DocumentReference Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-documentreference.html)
[US Core DiagnosticReport Profile for Report and Note Exchange](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-diagnosticreport-note.html) |
| Clinical Tests | - Clinical Test
- Clinical Test Result/Report | [US Core Observation Clinical Result Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-clinical-result.html)
[US Core DiagnosticReport Profile for Report and Note Exchange](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-diagnosticreport-note.html)
[US Core ServiceRequest Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-servicerequest.html) |
| Diagnostic Imaging | - Diagnostic Imaging Test
- Diagnostic Imaging Report | [US Core DiagnosticReport Profile for Report and Note Exchange](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-diagnosticreport-note.html)
[US Core ServiceRequest Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-servicerequest.html) |
| Encounter Information | - Encounter Type
- Encounter Diagnosis
- Encounter Time
- Encounter Location
- Encounter Disposition | [US Core Encounter Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-encounter.html)
[US Core Condition Encounter Diagnosis Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-condition-encounter-diagnosis.html) |
| Goals | - Patient Goals
- SDOH Goals | [US Core Goal Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-goal.html) |
| Health Status Assessments | - Health Concerns
- Disability Status
- Mental/Cognitive Status
- Functional Status
- Pregnancy Status
- Smoking Status | [US Core Condition Problems and Health Concerns Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-condition-problems-health-concerns.html)
[US Core Observation Screening Assessment Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-screening-assessment.html)
[US Core Observation Pregnancy Status Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-pregnancystatus.html)
[US Core Simple Observation Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-simple-observation.html) |
| Health Insurance Information | - Coverage Status
- Relationship to Subscriber
- Member Identifier
- Subscriber Identifier
- Payer Identifier
- Group Identifier
- Coverage Type | [US Core Coverage Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-coverage.html) |
| Immunizations | - Immunization | [US Core Immunization Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-immunization.html) |
| Laboratory | - Tests
- Values/Results
- Specimen Type
- Result Status | [US Core Observation Laboratory Result Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-lab.html)
[US Core DiagnosticReport Profile for Laboratory Results Reporting](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-diagnosticreport-lab.html)
[US Core Specimen Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-specimen.html) |
| Medications | - Medication
- Dose
- Dose Unit of Measure
- Indication
- Fill Status | [US Core MedicationRequest Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-medicationrequest.html)
[US Core Medication Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-medication.html)
[US Core MedicationDispense Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-medicationdispense.html) |
| Patient Demographics/Information | - First Name
- Last Name
- Middle Name (Including middle initial)
- Name Suffix
- Previous Name
- Date of Birth
- Date of Death
- Sex
- Race
- Ethnicity
- Tribal Affiliation
- Sexual Orientation
- Gender Identity
- Preferred Language
- Current Address
- Previous Address
- Phone Number
- Phone Number Type
- Email Address
- Related Person's Name
- Related Person's Relationship
- Occupation
- Occupation Industry | [US Core Patient Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html)
[US Core RelatedPerson Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-relatedperson.html) |
| Problems | - Problem
- SDOH Problems/Health Concerns
- Date of Diagnosis
- Date of Resolution | [US Core Condition Problems and Health Concerns Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-condition-problems-health-concerns.html) |
| Procedures | - Procedure
- SDOH Interventions
- Reason for Referral | [US Core Procedure Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-procedure.html) |
| Provenance | - Author Timestamp
- Author Organization | [US Core Provenance Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-provenance.html) |
| Unique Device Identifier(s) for a Patient's Implantable Device(s) | - Unique Device Identifier(s) for a patient's implantable device(s) | [US Core Implantable Device Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-implantable-device.html) |
| Vital Signs | - Diastolic Blood Pressure
- Systolic Blood Pressure
- Body Height
- Body Weight
- Heart Rate
- Respiratory Rate
- Body Temperature
- Pulse Oximetry
- Inhaled Oxygen Concentration
- BMI Percentile (2-20 years)
- Weight-for-length Percentile (0-24 months)
- Head Occipital-frontal Circumference Percentile (Birth - 36 Months) | [US Core Vital Signs Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-vital-signs.html)
[US Core Blood Pressure Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-blood-pressure.html)
[US Core BMI Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-bmi.html)
[US Core Head Circumference Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-head-circumference.html) |
# Allergies and Intolerances
Source: https://help.elationhealth.com/articles/fhir/uscdi-allergy-intolerance
## Overview
Allergies and Intolerances Information addresses:
* AllergyIntolerance HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-allergyintolerance.html)
The AllergyIntolerance resource defines clinical information about a patient's allergic response to a substance or class of substance including information about the adverse reaction. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Allergies and Intolerances, including enhanced support for non-medication substances.
Substances include, but are not limited to, medications, foods, environment (such as plants and animals), and insect bites. It defines the substance that elicited the response, as well as when the reaction occurred, the severity, and the type of reaction noted. The AllergyIntolerance resource can also accommodate search by ID and by patient, allowing it to return a list of allergies.
If a patient has not been asked about their allergies, this would be represented as:
* `AllergyIntolerance.code = "1631000175102" (Patient not asked (contextual qualifier) (qualifier value))`
* `AllergyIntolerance.verificationStatus = "unconfirmed"` or empty (element omitted)
If a patient has been asked, but has indicated they have no known allergies, this would be represented as:
* `AllergyIntolerance.code = "716186003" (No known allergy (situation))`
* `AllergyIntolerance.verificationStatus = "confirmed"`
Each AllergyIntolerance has next elements:
* a clinical status of the allergy (e.g., active or resolved)
* a code which tells you what the patient is allergic to
* a patient
Each AllergyIntolerance must support:
* a verification status
* a reaction manifestation
This resource conforms to [USCDI v3](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi#uscdi-v3) for Allergies and Intolerances - refer to [US Core AllergyIntolerance Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-allergyintolerance.html). AllergyIntolerance response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| --------------------- | ---------------------------------- |
| Substance(Drug class) | AllergyIntolerance.code(Snomed CT) |
| Substance(Medication) | AllergyIntolerance.code (RxNorm) |
| Reaction | AllergyIntolerance.reaction |
### Must support elements, mandatory and optional search parameters
*Allergy Intolerance**must support** these elements:*
* `clinicalStatus`
* `verificationStatus`
* `code`
* `patient`
* `reaction`
* `manifestation`
*Each AllergyIntolerance Must Have (Mandatory):*
* `code`
* `patient`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all allergies for a patient using the patient search parameter:
`GET [base url]/AllergyIntolerance?patient={Type/}[id]`
*The following search parameter combinations SHOULD be supported (**optional**):*
**SHOULD** support searching using the combination of the `patient` and `clinical-status` search parameters:
`GET [base url]/AllergyIntolerance?patient={Type/}[id]&clinical-status={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Allergies By Patient Id
Search for allergies by patient.
**METHOD** *GET*
```
GET [base url]/AllergyIntolerance?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type. *Example:* `Patient/`
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/AllergyIntolerance?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Allergies By Patient and Clinical Status
Search for allergies using the combination of the patient and clinical-status search parameters.
**METHOD** *GET*
```
GET [base url]/AllergyIntolerance?patient={Type/}[id]&clinical-status={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type. *Example:* `Patient/`
\[id] - Reference to the patient
\{system|} - Terminology system for allergy intolerance clinical status. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical|`
\[code] - Clinical status code. *Example:* `active`, `inactive`, `resolved`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**Implementation Notes:** This search will not return any "entered-in-error" resources because of the conditional presence of the clinicalStatus element.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/AllergyIntolerance?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&clinical-status=http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical|active' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Assessment and Plan of Treatment
Source: https://help.elationhealth.com/articles/fhir/uscdi-care-plan
## Overview
Assessment and Plan of Treatment Information addresses:
* CarePlan HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-careplan.html)
The CarePlan resource describes the intentions of how one or more practitioners plan to deliver care to a specific patient. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Assessment and Plan of Treatment Information.
This resource is designed for stating specific activities related to a single patient, rather than generic protocols for condition treatment. CarePlan can represent both proposed plans (for example, recommendations from a decision support engine or returned as part of a consult report) as well as active plans.
Each CarePlan has next elements:
* `status`
* `intent`
* `category` with code "assess-plan"
* `subject` (patient)
Each CarePlan must support:
* a narrative summary of the patient assessment and plan of treatment
This resource conforms to [USCDI v3](https://www.healthit.gov/isp/uscdi-data-class/assessment-and-plan-treatment#uscdi-v3) for Assessment and Plan of Treatment - refers to [US Core CarePlan Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-careplan.html). CarePlan response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------- | ------------------- |
| Narrative summary | CarePlan.text |
| Status | CarePlan.status |
| Intent | CarePlan.intent |
| Category | CarePlan.category |
| Patient | CarePlan.subject |
### Must support elements, mandatory and optional search parameters
*CarePlan **must support** these elements:*
* `text` (narrative summary)
* `status`
* `div`
* `status`
* `intent`
* `category`
* `category:AssessPlan`
* `subject`
*Each CarePlan Must Have (Mandatory):*
* `intent`
* `category`
* `category:AssessPlan`
* `subject`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan`
*The following search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `category` and `status` and `date` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## CarePlan By Patient and Category
Search for CarePlan using combination of the `patient` and `category` parameters.
**METHOD** *GET*
```
GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Id for Patient resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/CarePlan?patient=Patient/aa74fca2-2c68-47a8-98b6-3857d3df75c4&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## CarePlan By Patient, Category, and Date
Search for CarePlan using combination of the `patient`, `category`, and `date` parameters.
**METHOD** *GET*
```
GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Id for Patient resource
\{gt|lt|ge|le} - Date search modifiers. See [Search specification](https://www.hl7.org/fhir/search.html#date) for more information.
\[date] - Date for the period search
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/CarePlan?patient=Patient/aa74fca2-2c68-47a8-98b6-3857d3df75c4&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&date=ge2023-01-01&date=le2023-12-31' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## CarePlan By Patient, Category, and Status
Search for CarePlan using combination of the `patient`, `category`, and `status` parameters.
**METHOD** *GET*
```
GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Id for Patient resource
\{system|} - Status system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Status code. *Example:* `active`, `draft`, `completed`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/CarePlan?patient=Patient/aa74fca2-2c68-47a8-98b6-3857d3df75c4&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status=active' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## CarePlan By Patient, Category, Status, and Date
Search for CarePlan using combination of the `patient`, `category`, `status`, and `date` parameters.
**METHOD** *GET*
```
GET [base url]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Id for Patient resource
\{system|} - Status system. FHIR search token parameter.
\[code] - Status code. *Example:* `active`, `draft`, `completed`
\{gt|lt|ge|le} - Date search modifiers. See [Search specification](https://www.hl7.org/fhir/search.html#date) for more information.
\[date] - Date for the period search
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/CarePlan?patient=Patient/aa74fca2-2c68-47a8-98b6-3857d3df75c4&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status=active&date=ge2023-01-01T00:00:00Z&date=le2023-12-31T23:59:59Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Care Team Members
Source: https://help.elationhealth.com/articles/fhir/uscdi-care-team
## Overview
Care Team Members Information addresses:
* CareTeam HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-careteam.html)
The CareTeam includes all the people, teams, and organizations who plan to participate in the coordination and delivery of care for a single patient or a group. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Care Team Member Information.
Care team members or participants include practitioners (physicians, nurses, technicians, etc.), family members, friends, guardians, and the patient. The care team can be specific to an encounter or to the patient across all encounters (longitudinal).
Each CareTeam has next elements:
* a patient
* a participant role for each careteam members
* a reference to each careteam member which can be:
* a practitioner or practitioner type (doctor, nurse, therapist)
* a relative or friend or guardian
Each CareTeam must support:
* a status code
**Profile specific implementation guidance:**
In order to access care team member’s names, identifiers, locations, and contact information, the CareTeam profile supports several types of care team participants. They are represented as references to other profiles and include the following four profiles which are marked as must support:
* US Core Practitioner Profile
* US Core PractitionerRole Profile
* US Core RelatedPerson Profile
Although both `US Core Practitioner Profile` and `US Core PractitionerRole` are must support, the server system is not required to support both types of references (and \_include search parameters), but **SHALL** support at least one of them.
The client application **SHALL** support all three profile references.
Because the `US Core PractitionerRole` Profile supplies the provider’s location and contact information and a reference to the `Practitioner`, server systems **SHOULD** reference it instead of the `US Core Practitioner Profile`. An example of how to access the practitioner name and identifier is shown in the quick start section below.
Servers that support only `US Core Practitioner Profile` **SHALL** provide implementation specific guidance how to access a provider’s location and contact information using only the Practitioner resource.
This resource conforms to [USCDI v3](https://www.healthit.gov/isp/uscdi-data-class/care-team-members#uscdi-v3) for Care Team Members - refers to [US Core CareTeam Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-careteam.html). CareTeam response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCDI | USCore Data Element | FHIR Resource Field |
| --------------------------- | ---------------------------- | -------------------------------------- |
| Care Team Member Name | US Core Practitioner Profile | CarePlan.participant.member.name |
| Care Team Member Identifier | US Core Practitioner Profile | CarePlan.participant.member.identifier |
| Care Team Member Location | US Core Practitioner Profile | CarePlan.participant.member.address |
| Care Team Member Telecom | US Core Practitioner Profile | CareTeam.participant.member.telecom |
| Care Team Member Role | US Core Practitioner Profile | CareTeam.participant.role |
### Must support elements, mandatory and optional search parameters
*CareTeam**must support** these elements:*
* `status`
* `subject`
* `participant`
* `role`
* `member`
*Each CareTeam Must Have (Mandatory):*
* `subject`
* `participant`
* `role`
* `member`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching using the combination of the `patient` and `status` search parameters:
* including optional support for these `_include` parameters:
* `CareTeam:participant:PractitionerRole`
* `CareTeam:participant:Practitioner`
* `CareTeam:participant:Patient`
* `CareTeam:participant:RelatedPerson`
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/CareTeam?patient={Type/}[id]&status=active`
*The following search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `role` search parameters:
* including optional support for these `_include` parameters:
* `CareTeam:participant:PractitionerRole`
* `CareTeam:participant:Practitioner`
* `CareTeam:participant:Patient`
* `CareTeam:participant:RelatedPerson`
`GET [base url]/CareTeam?patient={Type/}[id]&role={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## CareTeam by Patient and Status
Search for CareTeam using combination of `patient` and `status` parameters.
**METHOD** *GET*
```
GET [base url]/CareTeam?patient={Type/}[id]&status=active
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/CareTeam?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&status=active' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## CareTeam by Patient and Status with Include Parameters
Search for CareTeam with included participant resources.
**METHOD** *GET*
```
GET [base url]/CareTeam?patient={Type/}[id]&status=active&_include=CareTeam:participant:PractitionerRole&_include=CareTeam:participant:Practitioner&_include=CareTeam:participant:Patient&_include=CareTeam:participant:RelatedPerson
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\_include - Include related participant resources in the response bundle
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/CareTeam?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&status=active&_include=CareTeam:participant:PractitionerRole&_include=CareTeam:participant:RelatedPerson' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## CareTeam by Patient and Role
Search for CareTeam using combination of `patient` and `role` parameters.
**METHOD** *GET*
```
GET [base url]/CareTeam?patient={Type/}[id]&role={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Role system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://snomed.info/sct|`
\[code] - Role code. *Example:* `223366009` (Healthcare professional)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/CareTeam?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&role=http://snomed.info/sct|223366009' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Related Person
Source: https://help.elationhealth.com/articles/fhir/uscdi-care-team-related-person
## Overview
RelatedPersons typically have a personal or non-healthcare-specific professional relationship to the patient. A RelatedPerson resource is primarily used for attribution of information, since RelatedPersons are often a source of information about the patient. For keeping information about people for contact purposes for a patient, use a Patient's Contact element.
**Each Related Person has next elements:**
* a status
* a patient
**Each Related Person supports next elements:**
* the relationship to the patient
* the name of the related person
* the telecom of the related person
* the address of the related person
**Profile specific implementation guidance:**
* Supports caretakers as part of CareTeam USCDI requirements
This resource conforms to [US Core Related Person Profile](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-relatedperson.html). RelatedPerson response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
## Must support elements, mandatory and optional search parameters
*RelatedPerson **must support** these elements:*
* `active`
* `patient`
* `relationship`
* `name`
* `telecom`
* `address`
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support fetching a RelatedPerson using the \_id search parameter:\
`GET [base url]/RelatedPerson[id]`
*The following search parameter combinations **SHOULD** be supported (**optional**):*
**SHOULD** support searching using the patient search parameter:\
`GET [base url]/RelatedPerson?patient={Type/}[id]`
**SHOULD** support searching using the combination of the `patient` and `name` search parameters:\
`GET [base url]/RelatedPerson?patient={Type/}[id]&name=[string]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Related Person By Id
Get RelatedPerson by ID.
**METHOD** *GET*
```
[base url]/RelatedPerson/{id}
```
or
```
[base url]/Patient?_id={id}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
`{id}` - Id for RelatedPerson resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/RelatedPerson/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Related Person by patient
Get RelatedPerson by a specific patient
**METHOD** *GET*
```
GET [base url]/RelatedPerson?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
`{Type/}` - optional reference type. *Example:* `Patient/`\
\[id] - patient id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/RelatedPerson=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Related Person by patient and name
Get RelatedPerson by a specific patient and name
**METHOD** *GET*
```
GET [base url]/RelatedPerson?patient={Type/}[id]&name=[string]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
`{Type/}` - optional reference type. *Example:* `Patient/`\
\[id] - patient id\
\[string] - name search string
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/RelatedPerson?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&name=Smith' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Clinical Notes
Source: https://help.elationhealth.com/articles/fhir/uscdi-clinical-notes-document-reference
## Overview
Clinical Notes Information addresses:
* Clinical Notes HL7® FHIR® description [US Core 6.1.0](http://hl7.org/fhir/us/core/STU6.1/clinical-notes.html)
Clinical notes are a key component in communicating a patient’s current status. In the context of this implementation the term “clinical notes” refers to the wide variety of documents generated on behalf of a patient in many care activities. They include notes to support transitions of care, care planning, quality reporting, billing, and even handwritten notes by providers.
This implementation defines how systems exchange eight “Common Clinical Notes” and three DiagnosticReport categories.
This implementation SHALL support, at minimum, these eight “Common Clinical Notes”:
1. Consultation Note (11488-4)
2. Discharge Summary (18842-5)
3. History & Physical Note (34117-2)
4. Procedures Note (28570-0)
5. Progress Note (11506-3)
6. Imaging Narrative (18748-4)
7. Laboratory Report Narrative (11502-2)
8. Pathology Report Narrative (11526-1)
**Example Usage Scenarios:**
The following are example usage scenarios for the US Core DocumentReference profile. See the Clinical Notes section for additional detail on using this profile for Clinical Notes:
* Query for all documents belonging to a Patient
* Query for a specific Clinical Note type (e.g. Discharge Summary or Continuity of Care Document (CCD))
* Query for all Clinical Notes belonging to a Patient
* Write a new Note to a Patient’s Chart
**Each DocumentReference has next elements:**
* a status
* a code describing the type of document
* a document category
* a patient
* an address (e.g. url) where the document can be retrieved or the content as inline base64 encoded data
* the MIME type (i.e. contentType) of the document
**Each DocumentReference must support:**
* a business identifier for the DocumentReference (possibly generated by the transcription system or EHR)
* date and time the reference was created
* an author
* a code identifying the specific details about the format of the document — over and above the content’s MIME type
* the patient encounter that is being referenced
* clinically relevant date
**Profile specific implementation guidance:**
* See [Clinical Notes](http://hl7.org/fhir/us/core/clinical-notes.html)
* The DocumentReference.type binding must support at a minimum the [5 Common Clinical Notes](http://hl7.org/fhir/us/core/ValueSet-us-core-clinical-note-type.html) and may extend to the full [US Core DocumentReference Type Value Set](http://hl7.org/fhir/us/core/ValueSet-us-core-documentreference-type.html)
* For a C-CDA Clinical Summary of Care (CCD):
* The document type code is the LOINC code 34133-9 *Summary of episode note*.
* The format code is `urn:hl7-org:sdwg:ccda-structuredBody:2.1`
* The DocumentReference resources can represent the referenced content using either an address where the document can be retrieved using `DocumentReference.attachment.url` or the content as inline base64 encoded data using `DocumentReference.attachment.data`.
* Although both are marked as must support, the server system is not required to support both an address and inline base64 encoded data, but SHALL support at least one of these elements.
* The client application **SHALL** support both elements.
* The `content.url` may refer to a FHIR Binary Resource (i.e. \[base]/Binary/\[id]), FHIR Document Bundle (i.e \[base]/Bundle/\[id] or other endpoint.
* If the endpoint is outside of the FHIR base URL, it **SHOULD NOT** require additional authorization to access.
* The organization responsible for the DocumentReference **SHALL** be present either in DocumentReference.custodian or accessible in the Provenance resource targeting the DocumentReference using `Provenance.agent.who` or `Provenance.agent.onBehalfOf`.
* Some system may also expose the same organization in referenced Encounter in `Encounter.serviceProvider`.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isp/uscdi-data-class/clinical-notes#uscdi-v3)
For DocumentReference - refers to [StructureDefinition US Core DocumentReference](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-documentreference.html).
DocumentReference response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*DocumentReference**must support** these elements:*
* `identifier`
* `status`
* `type`
* `category`
* `subject`
* `date`
* `author`
* `content`
* `attachment`
* `contentType`
* `data`
* `url`
* `format`
* `context`
* `encounter`
* `period`
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
*The following search parameters and search parameter combinations SHALL be supported (**mandatory**):*
**SHALL** support fetching a DocumentReference using the `_id` search parameter:
`GET [base url]/DocumentReference?_id=[id]`
**SHALL** support searching for all DocumentReference for a patient using the `patient` search parameter:
`GET [base url]/DocumentReference?patient={Type/}[id]`
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/DocumentReference?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on date (e.g. `date=[date]&date=[date]]&...`)
`GET [base url]/DocumentReference?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
**SHALL** support searching using the combination of the `patient` and `type` search parameters:
`GET [base url]/DocumentReference?patient={Type/}[id]&type={system|}[code]`
*The following search parameters and search parameter combinations SHOULD be supported (**optional**):*
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for *OR* search on `status` (e.g. `status={system|}[code],{system|}[code],...`)
`GET [base url]/DocumentReference?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `type` and `period` search parameters:
* including support for these period comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `period` (e.g. `period=[date]&period=[date]]&...`)
`GET [base url]/DocumentReference?patient={Type/}[id]&type={system|}[code]&period={gt|lt|ge|le}[date]{&period={gt|lt|ge|le}[date]&...}`
## DocumentReference By Id
Search for DocumentReference by id.
**METHOD** *GET*
```
GET [base url]/DocumentReference/[id]
```
or
```
GET [base url]/DocumentReference?_id=[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the DocumentReference
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DocumentReference/a11b21f6-1ac7-ca23-1ba2-a021f6532a5d' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DocumentReference By patient
Search for All DocumentReference by a specific patient.
**METHOD** *GET*
```
GET [base url]/DocumentReference?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DocumentReference?patient=Patient/1137192' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DocumentReference By patient and category
Fetches a bundle of all DocumentReference resources for the specified patient and category = `clinical-note`
**METHOD** *GET*
```
GET [base url]/DocumentReference?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DocumentReference?patient=Patient/1137192&category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DocumentReference By patient and category and date
Fetches a bundle of all DocumentReference resources for the specified patient and category = clinical=note and date
**METHOD** *GET*
```
GET [base url]/DocumentReference?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
\{gt|lt|ge|le} - Search modifiers for the date. See [Search specification](https://www.hl7.org/fhir/search.html#date) for more information.
\[date] - Beginning and/or ending for a period
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DocumentReference?patient=Patient/1235541&category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note&date=ge2020-01-01T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DocumentReference By patient and type
Fetches a bundle of all DocumentReference resources for the specified patient and type
**METHOD** *GET*
```
GET [base url]/DocumentReference?patient={Type/}[id]&type={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
\{system|} - Type system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Type code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DocumentReference?patient=Patient/1316024&type=http://loinc.org|18842-5' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DocumentReference By patient and status
Fetches a bundle of all DocumentReference resources for the specified patient and status
**METHOD** *GET*
```
GET [base url]/DocumentReference?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
\{system|} - Status system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Status code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DocumentReference?patient=Patient/1316024&status=superseded' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DocumentReference By patient and type and period
Fetches a bundle of all DocumentReference resources for the specified patient and type and period.
**METHOD** *GET*
```
GET [base]/DocumentReference?patient={Type/}[id]&type={system|}[code]&period={gt|lt|ge|le}[date]{&period={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
\{system|} - Type system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Type code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{gt|lt|ge|le} - Search modifiers for the date. See [Search specification](https://www.hl7.org/fhir/search.html#date) for more information.
\[date] - Beginning and/or ending for a period
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DocumentReference?patient=Patient/1316024&type=http://loinc.org |34133-9&period=ge2020-01-01T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Clinical Tests
Source: https://help.elationhealth.com/articles/fhir/uscdi-clinical-tests-diagnostic-report
## Overview
Clinical Tests addresses to the DiagnosticReport HL7® FHIR® resource.
The DiagnosticReport resource represents a resulted, patient-related, non-medication order and data associated with the order and the patient.
This resource returns textual results and discrete result components. It can return lab, imaging, and cardiology results. It can also return micro and EKG and pathology results that are not a scan. Scans filed into Epic are not returned by this resource.
This implementation SHALL support, at minimum, these three DiagnosticReport categories:
1. Cardiology (LP29708-2)
2. Pathology (LP7839-6)
3. Radiology (LP29684-5)
The following are example usage scenarios for the this profile:
* Query for a specific clinical test result such as electrocardiogram (ECG)
* Query for a specific imaging test result
* Query for a specific Radiology note (e.g., 84178-3 Interventional Radiology Note)
* Query for category of reports (e.g. all Cardiology reports)
Each Diagnostic Report has next elements:
* a status
* a category
* a code describing the type of report
* a patient
* the diagnostically relevant time (known as the “effective time” and typically the time of the procedure)
Each Diagnostic Report must support:
* the encounter the report occurred within
* an instant the report was released
* an author (actor) producing the report
* a reference to one or more test results
* a reference to one or more images
* a reference to the full report (presentedForm)
**Profile specific implementation guidance:**
* See [Clinical Notes Guidance](http://hl7.org/fhir/us/core/STU6.1/clinical-notes.html)
* The `DiagnosticReport.category` binding must support at a minimum the US Core DiagnosticReport Category Codes of Cardiology, Radiology, and Pathology. Other categories may be supported.
* A server will return how a customer has categorized their reports at a particular site. Categorization of reports is not consistent across sites. (e.g. a system may categorize an orthopedic note as cardiology.)
* For Diagnostic Imaging Reports systems **SHOULD** support using the subset of LOINC codes defined in CONF-DIR-19 in HL7 Implementation Guide for CDA Release 2: Imaging Integration, Levels 1, 2, and 3, Basic Imaging Reports in CDA and DICOM Diagnostic Imaging Reports (DIR) - Universal Realm, Release 1.0.
* Diagnostic imaging results in visual images requiring interpretation and clinical test results/reports may also reference images as part of the report. The DiagnosticReport resource links to both Media which represents a specific kind of Observation whose value is image data and ImagingStudy which represents the content in a DICOM imaging study.
* Only Media is marked as must support in this profile
* The imagingStudy element **MAY** be used by systems to reference ImagingStudy. However, it is not supported by the majority of systems and its inclusion would be an unnecessary barrier to adoption.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isp/uscdi-data-class/clinical-notes#uscdi-v3) for Diagnostic Report - refers to [StructureDefinition US Core DiagnosticReport Note](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-diagnosticreport-note.html). DiagnosticReport response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*DiagnosticReport**must support** these elements:*
* `status`
* `category`
* `code`
* `subject`
* `encounter`
* `effective[x]`
* `issued`
* `performer`
* `result`
* `media`
* `presentedForm`
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support searching for all DiagnosticReports for a patient using the `patient` search parameter:
`GET [base]/DiagnosticReport?patient={Type/}[id]`
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including optional support for OR search on code (e.g.`code={system|}[code],{system|}[code],...`)
`GET [base]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on date (e.g. `date=[date]&date=[date]]&...`)
`GET [base]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
*The following search parameters and search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for OR search on status (e.g. `status={system|}[code],{system|}[code],...`)
`GET [base]/DiagnosticReport?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including optional support for *OR* search on `code` (e.g. `code={system|}[code],{system|}[code],...`)
* including support for these date comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `date` (e.g. `date=[date]&date=[date]]&...`)
`GET [base]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Diagnostic Report by Patient id
Search for DiagnosticReports by patient.
**METHOD** *GET*
```
[base url]/DiagnosticReport?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Diagnostic Report by Patient and Category
Search for DiagnosticReports by combination patient and category.
**METHOD** *GET*
```
[base url]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - code for observation in the system, e.g. LP29684-5
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://loinc.org|LP29684-5' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Diagnostic Report by Patient and Code
Search for DiagnosticReports by combination patient and code.
**METHOD** *GET*
```
[base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - code for observation in the system, e.g. 24323-8
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|24323-8' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Diagnostic Report by Patient and Category and Date
Search for DiagnosticReports by combination patient and category and date.
**METHOD** *GET*
```
[base url]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - Code for observation in the system, e.g. 24323-8
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://loinc.org|LP29684-5&date=ge2010-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Diagnostic Report by Patient and Status
Search for DiagnosticReports by combination patient and status.
**METHOD** *GET*
```
[base url]/DiagnosticReport?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - code for observation in the system, e.g. 24323-8
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&status=completed' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Diagnostic Report by Patient and Code and Date
Search for DiagnosticReports by combination patient and code and date.
**METHOD** *GET*
```
[base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - code for observation in the system, e.g. 24323-8
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|24323-8&date=ge2019-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Clinical Tests
Source: https://help.elationhealth.com/articles/fhir/uscdi-clinical-tests-observation
## Overview
The US Core Observation Clinical Test Result Profile is based upon the core FHIR Observation Resource, and, along with the [US Core DiagnosticReport Profile for Report and Note exchange](/articles/fhir/uscdi-clinical-tests-diagnostic-report), meets the US Core Data for Interoperability (USCDI) v2 ‘Clinical Tests’ requirements. Clinical tests includes non-imaging and non-laboratory tests performed on a patient that results in structured or unstructured (narrative) findings specific to the patient, such as electrocardiogram (ECG), visual acuity exam, macular exam, or graded exercise testing (GXT), to facilitate the diagnosis and management of conditions.
The following are example usage scenarios for the this profile:
**Example Usage Scenarios:**
The following are example usage scenarios for the this profile:
* Query for non-imaging and non-laboratory tests results for a patient
* Record or update clinical tests results belonging to a Patient
**Each Observation has next elements:**
* a status
* a category code of `clinical-test`
* a LOINC code, if available, which tells you what is being measured
* a patient
**Each Observation supports next elements:**
* a time indicating when the measurement was taken
* a result value or a reason why the data is absent
* if the result value is a numeric quantity, a standard UCUM unit
**Profile specific implementation guidance:**
* This profile defines a Valueset based on a starter set of example clinical test LOINC codes identified in the [Appendix B in US Core Data for Interoperability (USCDI) Task Force 2021 HITAC Phase 3 Recommendations Report Letter](https://www.healthit.gov/sites/default/files/page/2021-10/2021-09-09_USCDI_TF_2021_HITAC_Phase%203_%20Recommendations%20Report_Signed_508.pdf). It is not intended to be complete and implementers are expected include other LOINC or other codes to meet their business needs.
* The `Observation.category` element provides an efficient way of restricting search on observations to “clinical-test” observations. However, clients need to understand that data categorization is somewhat subjective. The categorization applied by the source may not align with the client’s expectations. Clients may find it more useful to use queries based on a specific code or set of codes or to perform additional client side filtering of query results.
* Additional codes that translate or map to the Observation code or category codes are allowed. For example:
* providing both a local code and LOINC code
* providing a more specific code , a [SNOMED CT](http://hl7.org/fhir/R4/valueset-procedure-code.html) concept, or system specific codes in addition to the ‘clinical-test’ category code.
* Systems **SHOULD** support `Observation.effectivePeriod` to accurately represent procedure tests that are collected over a period of time .
* An Observation without a value, **SHALL** include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using `Observation.hasMember`.
* See the [General Guidance](/articles/fhir/us-core-guidance) Section for further guidance on using UCUM
* For imaging and laboratory tests the corresponding US Core Diagnostic Imaging Result Observation Profile and US Core Laboratory Result Observation Profile should be used instead.
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/uscdi-data-class/clinical-tests#uscdi-v2) for Observation - refers to [US Core Observation Profile for Report and Note Exchange](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-clinical-test.html). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `status`
* `Slices for category`\
-`category:clinical-test`
* `code`
* `subject`
* `effectiveDateTime`
* `valueQuantity`
* `valueCodeableConcept`
* `valueString`
* `dataAbsentReason`
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-test`
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including optional support for *OR* search on code (e.g.`code={system|}[code],{system|}[code],...`)
`GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on date (e.g. `date=[date]&date=[date]]&...`)
`GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
*The following search parameters and search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on status (e.g. `status={system|}[code],{system|}[code],...`)
`GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-test&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including optional support for *OR* search on `code` (e.g. `code={system|}[code],{system|}[code],...`)
* including support for these date comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `date` (e.g. `date=[date]&date=[date]]&...`)
`GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Diagnostic Report by Patient and Category
Search for ObservaDiagnosticReportstion by combination patient and category.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-test
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type\
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Code
Search for Observation by combination patient and code.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type\
\[id] - Id for the Patient\
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)\
\{code} - code for observation in the system, e.g. 44974-4
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|44974-4,http://loinc.org|44963-7,http://loinc.org|8601-7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Category and Date
Search for Observations by combination patient and category and date.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-test&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type\
\[id] - Id for the Patient\
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)\
\{code} - Code for observation in the system, e.g. 24323-8\
\[date] - Filter's date\
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-test&date=ge2010-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Category and Status
Search for Observations by combination patient and Category and Status.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-test&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type\
\[id] - Id for the Patient\
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)\
\{code} - code for observation in the system, e.g. final
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-test&status=final' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Code and Date
Search for Observations by combination patient and code and date.
**METHOD** *GET*
```
[base url]/ObsDiagnosticReportervation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type\
\[id] - Id for the Patient\
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)\
\{code} - code for observation in the system, e.g. 2339-0\
\[date] - Filter's date\
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|2339-0&date=ge2019-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Coverage
Source: https://help.elationhealth.com/articles/fhir/uscdi-coverage
## Overview
The Coverage resource describes an individual's insurance coverage or payment information for healthcare services. Coverage is a critical administrative resource that contains information about the individual's insurance plan, subscriber details, and relationship to the subscriber. At its minimum, Coverage contains a status, beneficiary reference, and payor information, but may also include data about the coverage period, policy details, and class/group information.
**Each Coverage Must Have:**
* health insurance member identifier or subscriber id
* a status
* the health insurance beneficiary (patient)
* beneficiary’s relationship to the subscriber
* the health insurance issuer (payer)
Each Coverage must support:
* health insurance coverage type (e.g., Medicare)
* coverage start and/or end date
* health insurance group and/or plan
## Profile specific implementation guidance:
* Coverage.status alone may not indicate whether an individual is covered. The Coverage.period needs to be considered as well. For example, the coverage may be expired with a status of “active”, or conversely, it may be “canceled” but still have covered claims.
* The hierarchical nature of the Coverage.type code system “Payer” (also known as the US Public Health Data Consortium Source of Payment Codes) may be unclear in the expansion, and some of the codes may be inappropriate for the use case. Implementers should refer to the PHDSC Payer Type Committee User’s Guide for the Source of Payment Typology when selecting codes.
* If Insurers issue unique member Ids for dependents, then the memberId Coverage.identifier should be used instead of Coverage.dependent to to uniquely refer to the dependent with respect to their insurance.
This resource conforms to **[USCDI v3 profile](https://www.healthit.gov/isa/uscdi-data-class/health-insurance-information)** for Coverage \* refer to [StructureDefinition US Core Coverage](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-coverage.html). Coverage response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Coverage **must support** these elements:*
* `identifier`
* `identifier:memberid`
* `type`
* `status`
* `type`
* `subscriberId`
* `beneficiary`
* `relationship`
* `period`
* `payor`
* `class`
* `class:group`
* `value`
* `name`
* `class:plan`
* `value`
* `name`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all coverages for a patient using the patient search parameter:
`GET [base url]/Coverage?patient={Type/}[id]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Coverage By Patient Id
Search for coverage by patient id.
**METHOD** *GET*
```
[base url]/Coverage?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Coverage?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Implantable Device
Source: https://help.elationhealth.com/articles/fhir/uscdi-device
## Overview
Implantable Device Information addresses:
* Device HL7® FHIR® resource with [US Core Implantable Device Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-implantable-device.html)
Unique Device Identifier(s) for a Patient's Implantable Device(s) are recorded in the system using the FHIR Device resource. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Unique Device Identifiers.
Device is a type of manufactured item that is used in the provision of healthcare without being substantially changed through that activity. The device may be a medical or non-medical device. This profile specifically focuses on implantable devices that have been placed in a patient's body.
**Each Device has next elements:**
* a code identifying the type of device
* a patient
**Each Implantable Device Must Support:**
* A Unique Device Identifier (UDI) numeric or alphanumeric code as the Human Readable Form (HRF) string representation of the barcode
* The Device Identifier (UDI-DI)
* the manufacture date
* the expiration date
* the lot number
* the serial number
* the distinct identifier (i.e., the distinct identification code)
**Profile specific implementation guidance:**
* This profile supports the requirement to retrieve an 170.315(a)(14) [Implantable device list](https://www.healthit.gov/test-method/implantable-device-list) and follows the [HL7 Cross Paradigm Implementation Guide: UDI Pattern](http://www.hl7.org/documentcenter/private/standards/HL7_IG_UDI_R2_2020JUN.pdf) guidelines for exchanging information about the use of and/or implantation of medical devices in patients.:
* The [AccessGUDID API](https://www.fda.gov/medical-devices/global-unique-device-identification-database-gudid/accessgudid-public) provides access to device records in GUDID including safety information and UDI. It includes APIs to query and download a complete list of implantable devices registered in GUDID.
* The Parse UDI API allows users to pass a UDI and return each part of the UDI in a structured format (specifically the serialNumber, lotNumber, expirationDate, distinctIdentifier (returned as donation\_id) or manufactureDate).
* Implantable medical devices that have UDI information SHALL represent this information in either carrierAIDC or carrierHRF. (Note that the UDI may not be present in all scenarios such as historical implantable devices, patient reported implant information, payer reported devices, or improperly documented implants.)
* For Implantable medical devices that have UDI information, at least one of the Production Identifiers (UDI-PI) SHALL be present.
* Servers SHOULD support query by Device.type to allow clients to request the patient’s devices by a specific type. Note: The Device.type is too granular to differentiate implantable vs. non-implantable devices.
* Records of implanted devices MAY be queried against UDI data including:
* UDI HRF string (udi-carrier)
* UDI Device Identifier (udi-di)
* Manufacturer (manufacturer)
* Model number (model)
Implementers MAY also adopt custom SearchParameters for searching by:
* lot numbers
* serial number
* expiration date
* manufacture date
* distinct identifier
This resource conforms to [USCDI v3](https://www.healthit.gov/isp/uscdi-data-class/unique-device-identifiers-a-patients-implantable-devices#uscdi-v3) for Unique Device Identifiers - refers to [US Core Implantable Device Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-implantable-device.html). Device response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| -------------------------- | ---------------------------------- |
| code | Device.type |
| patient | Device.patient |
| UDI (optional) | Device.udiCarrier.deviceIdentifier |
| manufacture date(optional) | Device.manufactureDate |
| expiration date (optional) | Device.expirationDate |
| lot number (optional) | Device.lotNumber |
| serial number (optional) | Device.serialNumber |
### Must support elements, mandatory and optional search parameters
*Device**must support** these elements:*
* `udiCarrier`
* `deviceIdentifier`
* `carrierHRF`
* `distinctIdentifier`
* `manufactureDate`
* `expirationDate`
* `lotNumber`
* `serialNumber`
* `type`
* `patient`
*Each CareTeam Must Have (Mandatory):*
* `type`
* `patient`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Devices for a patient using the `patient` search parameter:
`GET [base url]/Device?patient={Type/}[id]`
*The following search parameter combinations SHOULD be supported (**optional**):*
**SHOULD** support searching using the combination of the `patient` and `type` search parameters:
`GET [base url]/Device?patient={Type/}[id]&type={system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Device?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Device By Patient Id
Search for Device by patient.
**METHOD** *GET*
```
GET [base url]/Device?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Device?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Device By Id
Fetch a single Device by ID.
**METHOD** *GET*
```
GET [base url]/Device/{id}
```
or
```
GET [base url]/Device?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Device resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Device/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Device by Patient and Type
Search for Devices using combination of patient and type search parameters.
**METHOD** *GET*
```
GET [base url]/Device?patient={Type/}[id]&type={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient id
\{system|} - Terminology system for device type. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://snomed.info/sct|`
\[code] - Device type code. *Example:* `468063009` (Implantable cardioverter defibrillator)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Device?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&type=http://snomed.info/sct|468063009' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Device by Patient and Status
Search for Devices using combination of patient and status search parameters.
**METHOD** *GET*
```
GET [base url]/Device?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient id
\{system|} - Status system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Device status code. *Example:* `active`, `inactive`, `entered-in-error`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Device?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&status=active' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Encounter Diagnosis
Source: https://help.elationhealth.com/articles/fhir/uscdi-encounter-diagnosis-condition
## Overview
Encounter Diagnosis addresses to the Condition HL7® FHIR® resource. This is a part of [USCDI Encounter Information](https://www.healthit.gov/isa/taxonomy/term/1201/uscdi-v2). The US Core Condition Encounter Diagnosis Profile is based upon the core FHIR Condition Resource and meets the US Core Data for Interoperability (USCDI) v2 ‘Encounter Diagnosis’ requirements.
To promote interoperability and adoption through common implementation, this profile defines constraints and extensions on the Condition resource for the minimal set of data to record, search, and fetch information about a condition, diagnosis, or other event, situation, issue, or clinical concept that is documented and categorized as a problem or health concern including information about a Social Determinants of Health-related condition.
Each Condition has next elements:
* a category code of “encounter-diagnosis”
* a code that identifies the condition
* a patient
Each Condition must support:
* a clinical status of the condition (e.g., active or resolved)
* a verification status
* an encounter
* a date of diagnosis
* abatement date (in other words, date of resolution or remission)
* a date when recorded
**Profile specific implementation guidance:**
* For [Problems and Health Concerns](/articles/fhir/uscdi-health-concerns-condition) use the [US Core Condition Problems and Health Concerns Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html).
* USCDI v2 applicable vocabulary standards for Encounter Diagnosis are SNOMED CT and ICD-10-CM. For general guidance on extensible binding to coded data, review [this section](http://hl7.org/fhir/us/core/general-requirements.html#extensible-binding-for-codeableconcept-datatype) in the General Requirements page.
* The US Core Condition Codes supports ICD-9-CM for historical purposes only. ICD-10-CM is available and should be used as the primary code for current encounter diagnoses.
* The encounter **SHOULD** always be referenced in `Condition.encounter`.
* To search for an encounter diagnosis, query for Conditions that reference the Encounter of interest and have a category of `encounter-diagnosis`.
* There is no single element in Condition that represents the date of diagnosis. It may be the `assertedDate` Extension, `Condition.onsetDate`, or `Condition.recordedDate`.
* Although all three are marked as must support, the server is not required to support all.
* A server **SHALL** support Condition.recordedDate.
* A server **SHALL** support at least one of assertedDate Extension and Condition.onsetDate. A server may support both, which means they support all 3 dates.
* The client application **SHALL** support all three elements.
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/taxonomy/term/1201/uscdi-v2) for Condition - refers to [US Core Condition Encounter Diagnosis Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html). Condition response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------- | --------------------------------- |
| status | Condition.status |
| category | Condition.category (us-core) |
| code | Condition.code (ICD-10-CM/Snomed) |
| patient | Condition.subject |
### Must support elements, mandatory and optional search parameters
*Condition**must support** these elements:*
* `condition-assertedDate`
* `clinicalStatus`
* `verificationStatus`
* `category:us-core`
* `code`
* `subject`
* `onsetDateTime`
* `abatementDateTime`
* `recordedDate`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all conditions including problems, health concerns, and encounter diagnosis for a patient using the `patient` search parameter:
`GET [base]/Condition?patient={Type/}[id]`
*The following search parameter combinations SHOULD be supported:*\
**SHOULD** support searching using the combination of the `patient` and `clinical-status` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission`
**SHOULD** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `category` and `encounter` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id]`
**SHOULD** support searching using the combination of the patient and code search parameters:
`GET [base url]/Condition?patient={Type/}[id]&code={system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `onset-date` search parameters:
* including support for these `onset-date` comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `onset-date` (e.g.`onset-date=[date]&onset-date=[date]]&...`)
`GET [base url]/Condition?patient={Type/}[id]&onset-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `asserted-date` search parameters:
* including support for these `asserted-date` comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `asserted-date` (e.g.`asserted-date=[date]&asserted-date=[date]]&...`)
`GET [base url]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `recorded-date` search parameters:
* including support for these `recorded-date` comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `recorded-date` (e.g.`recorded-date=[date]&recorded-date=[date]]&...`)
`GET [base url]/Condition?patient={Type/}[id]&recorded-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `abatement-date` search parameters:
* including support for these `abatement-date` comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `abatement-date` (e.g.`abatement-date=[date]&abatement-date=[date]]&...`)
`GET [base]/Condition?patient={Type/}[id]&abatement-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Condition by Patient
Get Condition by `patient`
**METHOD** *GET*
```
GET [base url]/Condition?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLES:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&status=active' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and clinical-status
Get Condition by combination `patient` and `clinical-status`
**METHOD** *GET*
Notes: Fetches a bundle of all Condition resources for the specified patient and all “active” statuses (active,relapse,remission). This will exclude diagnoses and health concerns without a clinicalStatus specified.
```
GET [base url]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and category
Get Condition by combination `patient` and `category`
**METHOD** *GET*
```
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's id\
\{system|} - [http://hl7.org/fhir/us/core/CodeSystem/condition-category](http://hl7.org/fhir/us/core/CodeSystem/condition-category)\
\{code} - health-concern\
optionally: code could take a value from the list:\
\{code} - `problem-list-item`\
\{code} - `encounter-diagnosis`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and category and encounter
Get Condition by combination `patient` and `category` and `encounter`
**METHOD** *GET*
```
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Resource's id (Patient and/or Encounter)\
\{system|} - [http://hl7.org/fhir/us/core/CodeSystem/condition-category](http://hl7.org/fhir/us/core/CodeSystem/condition-category)\
\{code} - health-concern\
optionally: code could take a value from the list:\
\{code} - `problem-list-item`\
\{code} - `encounter-diagnosis`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|encounter-diagnosis?encounter=1036' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and code
Get Condition by combination `patient` and `code`
**METHOD** *GET*
```
GET [base url]/Condition?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's Id\
\{system|} - The system for the observation, e.g. [http://snomed.info/sct](http://snomed.info/sct)\
\{code} - code for observation in the system, e.g. 442311008
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&code=http://snomed.info/sct|442311008' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and asserted-date
Get Condition by combination `patient` and `asserted-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's Id\
\[date] - Filter's date\
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&asserted-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and onset-date
Get Condition by combination `patient` and `onset-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's Id\
\[date] - Filter's date\
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&onset-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and recorded-date
Get Condition by combination `patient` and `recorded-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's Id\
\[date] - Filter's date\
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&recorded-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and abatement-date
Get Condition by combination `patient` and `abatement-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional parameter for reference type\
\[id] - Patient's Id\
\[date] - Filter's date\
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&abatement-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Encounter Information
Source: https://help.elationhealth.com/articles/fhir/uscdi-encounter-information
## Overview
Encounter Information addresses:
* Encounter HL7® FHIR® resource with [US Core Profile 6.1.0](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-encounter.html)
Encounter contains information about an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Encounter Information.
An encounter has a class to distinguish between different health care settings such as inpatient, outpatient, emergency, etc. A patient may have one medical record number with multiple encounter numbers per facility or organization.
The Hospitalization component is intended to store the extended information relating to a hospitalization event. It is always expected to be the same period as the encounter itself. Where the period is different, another encounter instance should be used to capture this information as a partOf this encounter instance.
Each Encounter has next elements:
* a status
* a classification such as inpatient, outpatient or emergency
* an encounter type
* a patient
Each Encounter must support:
* an encounter identifier
* providers involved in the encounter
* when the encounter occurred
* reason for the visit
* the discharge disposition
* where the encounter occurred
**Profile specific implementation guidance:**
* To search for an [encounter diagnosis](/articles/fhir/uscdi-health-concerns-condition), query for Condition resources that reference the Encounter of interest and have a category of `encounter-diagnosis`.
* The Encounter resource can represent a reason using either a code with `Encounter.reasonCode`, or a reference with `Encounter.reasonReference` to Condition or other resource.
* Although both are marked as must support, servers are not required to support both a code and a reference, but they **SHALL** support at least one of these elements.
* The client application **SHALL** support both elements.
* If Encounter.reasonReference references an Observation, it **SHOULD** conform to a US Core Observation if applicable. For example, a laboratory result **SHOULD** conform to the US Core Laboratory Result Observation Profile.
* This profile supports where the encounter occurred. The location address can be represented by the Location referenced by `Encounter.location.location` or indirectly through the Organization referenced by `Encounter.serviceProvider`.
* Although both are marked as must support, servers are not required to support both `Encounter.location.location` and `Encounter.serviceProvider`, but they SHALL support at least one of these elements.
* The client application **SHALL** support both elements.
* If using `Encounter.location.location` it **SHOULD** conform to US Core Location. However, as a result of implementation feedback, it **MAY** reference the base FHIR Location resource. See this guidance on [Referencing US Core Profiles](https://www.hl7.org/fhir/us/core/general-guidance.html#referencing-us-core-profiles).
This resource refers to [US Core Encounter Profile 6.1.0](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-encounter.html). Encounter response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCDI | USCore Data Element | FHIR Resource Field |
| --------------------- | --------------------------------------------------------------- | ----------------------------------------------- |
| Encounter Diagnosis | [diagnosis](/articles/fhir/uscdi-encounter-diagnosis-condition) | Encounter.diagnosis |
| Encounter Time | When the encounter occurred | Encounter.period |
| Encounter Location | Where the encounter occurred | Encounter.location.location |
| Encounter Disposition | The discharge disposition | Encounter.hospitalization.dischargeDisposition |
| Encounter Type | An encounter type | Encounter.type |
| | A status | Encounter.status |
| | An classification such as inpatient, outpatient or emergency | Encounter.class |
| | A patient | Encounter.subject |
| | An encounter identifier | Encounter.identifier |
| | Providers involved in the encounter | Encounter.serviceProvider |
| | Reason for the visit | Encounter.reasonCode, Encounter.reasonReference |
### Must support elements, mandatory and optional search parameters
*Encounter **must support** these elements:*
* `identifier`
* `status`
* `class`
* `type`
* `subject`
* `participant`
* `period`
* `reasonCode`
* `reasonReference`
* `hospitalization`
* `dischargeDisposition`
* `location`
* `location`
* `serviceProvider`
*Each Encounter Must Have (Mandatory):*
* `status`
* `class`
* `type`
* `subject`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support fetching an encounter using the \_id search parameter:
`GET [base url]/Encounter/{id}`
or
`GET [base url]/Encounter?_id={id}`
**SHALL** support searching for all encounters for a patient using the `patient` search parameter:
`GET [base url]/Encounter?patient={Type/}[id]`
**SHALL** support searching using the combination of the `date` and `patient` search parameters:
including support for these date comparators: gt,lt,ge,le
including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Encounter?date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}&patient={Type/}[id]`
*The following search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the `identifier` search parameter:
`GET [base url]/Encounter?identifier={system|}[code]`
**SHOULD** support searching using the combination of the `class` and `patient` search parameters:
`GET [base url]/Encounter?class={system|}[code]&patient={Type/}[id]`
**SHOULD** support searching using the combination of the `patient` and `type` search parameters:
`GET [base url]/Encounter?patient={Type/}[id]&type={system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `location` search parameters:
`GET [base url]/Encounter?patient={Type/}[id]&location={Type/}[location_id]`
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
`GET [base]/Encounter?patient={Type/}[id]&status={system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `discharge-disposition` search parameters:
`GET [base]/Encounter?patient={Type/}[id]&discharge-disposition={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Encounter By Id
Get Encounter by id
**METHOD** *GET*
```
[base url]/Encounter/{id}
```
or
```
[base url]/Encounter?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Encounter resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter/b3117fc5-3116-b12a-cbbc-a0c3def361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter By Patient Id
Search all Encounter by the specified Patient
**METHOD** *GET*
```
[base url]/Encounter?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?patient=Patient/b3117fc5-3116-b12a-cbbc-a0c3def361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter for the Patient and for the period
Search all Encounters of the patient in a specific period defining period begin and/or period end
**METHOD** *GET*
```
[base url]/Encounter?date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}&patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{gt|lt|ge|le} - Search modifiers for the date. See [Search specification](https://www.hl7.org/fhir/search.html#date) for more information.
\[date] - Beginning and/or ending for a period
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for Patient resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?date=ge2021-01-01&date=le2021-12-31&patient=Patient/example' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter by Identifier
Search Encounter by the specified identifier
**METHOD** *GET*
```
[base url]/Encounter?identifier={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - Identifier system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Identifier code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?identifier=http://happyNation.io/visitId|00001' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter for the Patient by Class
Search all Encounters for the specific Patient by Encounter class.
**METHOD** *GET*
```
[base url]/Encounter?class={system|}[code]&patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - Class system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Class code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?class=http://terminology.hl7.org/CodeSystem/v3-ActCode|AMB&patient=Patient/example' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter for the Patient by Type
Search all Encounters for the specific Patient by Encounter type.
**METHOD** *GET*
```
[base url]/Encounter?patient={Type/}[id]&type={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for the Patient
\{system|} - Type system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Type code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?patient=Patient/example&type=http://snomed.info/sct|261665006' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter for the Patient by Encounter Location
Search all Encounters for the specific Patient by the specific Encounter Location. This API call supports searching using the combination of the patient and location search parameters.
**METHOD** *GET*
```
[base url]/Encounter?patient={Type/}[id]&location={locationType/}[locationId]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for the Patient
\{locationType/} - Type for the Location Reference. *Example:* `Location/`
\[locationId] - Id for the Location
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?patient=Patient/example&location=Location/ward_001' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter for the Patient by Encounter Status
Search all Encounters for the specific Patient by the specific Encounter status. This API call supports searching using the combination of the patient and status search parameters.
**METHOD** *GET*
```
[base url]/Encounter?patient={Type/}[id]&status={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for the Patient
\{system|} - Status system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Status code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?patient=Patient/aa74fca2-2c68-47a8-98b6-3857d3df75c4&status=finished' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Encounter for the Patient by Encounter Discharge disposition
Search all Encounters using the combination of the specific Patient and discharge-disposition search parameters.
**METHOD** *GET*
```
[base url]/Encounter?patient={Type/}[id]&discharge-disposition={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient/`
\[id] - Id for the Patient
\{system|} - Discharge disposition system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - Discharge disposition code. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Encounter?patient=Patient/aa74fca2-2c68-47a8-98b6-3857d3df75c4&discharge-disposition=http://www.nubc.org/patient-discharge|01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Goal
Source: https://help.elationhealth.com/articles/fhir/uscdi-goal
## Overview
The Goal resource describes the intended objective(s) for a patient, group or organization care, for example, weight loss, restoring an activity of daily living, obtaining herd immunity via immunization, meeting a process improvement objective, etc.
**Each Goal has next elements:**
* a status
* text description of the goal
* a patient
**Each Goal supports next elements:**
* target date(s)
* start date
* expressed by (who identified the goal)
**Profile specific implementation guidance:**
* Free text goals can be used in Goal.description.text when a concept isn’t available or a legacy goal is not mapped to a LOINC or SNOMED concept.
* See the [SDOH](https://www.hl7.org/fhir/us/core/sdoh.html) guidance page for more information when exchanging Social Determinants of Health (SDOH) Goals
This resource conforms to [USCDI v3 profile](https://www.healthit.gov/isa/uscdi-data-class/health-concerns#uscdi-v3) for Goal - refers to [StructureDefinition US Core Goal](https://build.fhir.org/ig/HL7/US-Core/StructureDefinition-us-core-goal.html). Goal response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------- | ---------------------- |
| status | Goal.achievementStatus |
| goal description | Goal.description |
| patient | Goal.subject |
### Must support elements, mandatory and optional search parameters
*Goal**must support** these elements:*
* `lifecycleStatus`
* `description`
* `subject`
* `target`
* `dueDate`
* `startDate`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all goals for a patient using the patient search parameter:
`GET [base url]/Goal?patient={Type/}[id]`
*The following search parameter combinations **SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the patient and lifecycle-status search parameters:
`GET [base url]/Goal?patient={Type/}[id]&lifecycle-status={system|}[code]`
**SHOULD** support searching using the combination of the patient and target-date search parameters:
* including support for these target-date comparators: gt,lt,ge,le
* including optional support for AND search on target-date (e.g.target-date=\{date}\&target-date=\{date}&...)
`GET [base url]/Goal?patient={Type/}[id]&target-date={gt|lt|ge|le}{date}`
**SHOULD** support searching using the combination of the patient and description search parameters:
`GET [base url]/Goal?patient={Type/}[id]&description={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Goal By Patient Id
Search for Goal by patient.
**METHOD** *GET*
```
[base url]/Goal?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Goal?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Goal By Id
Get Goal by ID.
**METHOD** *GET*
```
[base url]/Goal/{id}
```
or
```
[base url]/Goal?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Goal resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Goal/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Goal by patient and lifecycle-status
Get Goals using the combination of the patient and lifecycle-status search parameters
**METHOD** *GET*
```
GET [base url]/Goal?patient={Type/}[id]&lifecycle-status={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\{system|} - an identity of the terminology system, used to specify the state of the goal throughout its lifecycle
\[code] - the state of the goal throughout its lifecycle
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Goal?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&lifecycle-status=active' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Goal by patient and target-date search parameters
Get Goals using the combination of the patient and target-date search parameters
**METHOD** *GET*
```
GET [base url]/Goal?patient={Type/}[id]&target-date={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\[date] - indicates either the date or the duration after start by which the goal should be met
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Goal?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&target-date=ge2015-01-14&target-date=le2019-01-14' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Goal by patient and description search parameters
Get Goals using the combination of the patient and description search parameters
**METHOD** *GET*
```
GET [base url]/Goal?patient={Type/}[id]&description={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\{system|} - an identity of the terminology system for goal description codes
\[code] - a coded value for the goal description
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Goal?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&description=http://snomed.info/sct|289169006' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Health Concerns
Source: https://help.elationhealth.com/articles/fhir/uscdi-health-concerns-condition
## Overview
Health Concerns Information addresses:
* Health Concerns Condition HL7® FHIR® resource with [US Core Profile 6.1.0](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-condition-problems-health-concerns.html)
The US Core Condition Problems and Health Concerns Profile is based upon the core FHIR Condition Resource and meets the US Core Data for Interoperability (USCDI) v3 `SDOH Assessment`, `Health Status/Assessments` and `Problems` requirements.
To promote interoperability and adoption through common implementation, this profile defines constraints and extensions on the Condition resource for the minimal set of data to record, search, and fetch information about a condition, diagnosis, or other event, situation, issue, or clinical concept that is documented and categorized as a problem or health concern including information about a Social Determinants of Health-related condition.
Health concerns are also returned as part of the Condition resource and represent other concerns a patient may have such as financial or social risks.
Each Condition has next elements:
* a category code of “problem-list-item” or “health-concern”
* a code that identifies the condition
* a patient
Each Condition must support:
* a clinical status of the condition (e.g., active or resolved)
* a verification status
* additional health status/assessment categories
* a date of diagnosis
* abatement date (in other words, date of resolution or remission)
* a date when recorded
**Profile specific implementation guidance:**
* The [US Core Problem or Health Concern Codes](https://hl7.org/fhir/us/core/STU6.1/ValueSet-us-core-problem-or-health-concern.html) support the separate types of conditions so API consumers can separate health concerns, problems, and encounter diagnoses.
* The 2015 Certification rule requires the use of SNOMED CT for problem list entries. Following the rules for [extensible](http://hl7.org/fhir/R4/terminologies.html#extensible) binding to coded data types, ICD or other local codes can be used as translations to SNOMED CT.
* The [US Core Condition Code](https://hl7.org/fhir/us/core/STU6.1/ValueSet-us-core-condition-code.html) supports ICD-9-CM for historical purposes only. ICD-10-CM is available and may be used as the primary code for current encounter diagnoses.
* To search for an encounter diagnosis, query for Conditions that reference the Encounter of interest and have a category of encounter-diagnosis.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isp/uscdi-data-class/health-concerns) for Condition - refers to [US Core Condition Problems and Health Concerns Profile](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-condition-problems-health-concerns.html). Condition response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------- | --------------------------------- |
| status | Condition.status |
| category | Condition.category (us-core/sdoh) |
| code | Condition.code (ICD-10-CM/Snomed) |
| patient | Condition.subject |
### Must support elements, mandatory and optional search parameters
*Condition**must support** these elements:*
* `assertedDate`
* `clinicalStatus`
* `verificationStatus`
* `category`
* `category:us-core`
* `category:screening-assessment`
* `code`
* `subject`
* `onsetDateTime`
* `abatementDateTime`
* `recordedDate`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all conditions including problems, health concerns, and encounter diagnosis for a patient using the `patient` search parameter:
`GET [base]/Condition?patient={Type/}[id]`
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]`
*The following search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `clinical-status` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission`
**SHOULD** support searching using the combination of the `patient` and `category` and `clinical-status` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission`
**SHOULD** support searching using the combination of the `patient` and `category` and `encounter` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id]`
**SHOULD** support searching using the combination of the `patient` and `code` search parameters:
`GET [base url]/Condition?patient={Type/}[id]&code={system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `onset-date` search parameters:
* including support for these onset-date comparators: gt,lt,ge,le
* including optional support for AND search on onset-date (e.g.onset-date=\[date]\&onset-date=\[date]]&...)
`GET [base url]/Condition?patient={Type/}[id]&onset-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `asserted-date` search parameters:
* including support for these asserted-date comparators: gt,lt,ge,le
* including optional support for AND search on asserted-date (e.g.asserted-date=\[date]\&asserted-date=\[date]]&...)
`GET [base url]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `recorded-date` search parameters:
* including support for these recorded-date comparators: gt,lt,ge,le
* including optional support for AND search on recorded-date (e.g.recorded-date=\[date]\&recorded-date=\[date]]&...)
`GET [base url]/Condition?patient={Type/}[id]&recorded-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `abatement-date` search parameters:
* including support for these abatement-date comparators: gt,lt,ge,le
* including optional support for AND search on abatement-date (e.g.abatement-date=\[date]\&abatement-date=\[date]]&...)
`GET [base url]/Condition?patient={Type/}[id]&abatement-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Condition by Patient
Get Condition by `patient`
**METHOD** *GET*
```
GET [base url]/Condition?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLES:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&status=active' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and category
Get Condition by combination `patient` and `category`
**METHOD** *GET*
```
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's id
\{system|} - [http://hl7.org/fhir/us/core/CodeSystem/condition-category](http://hl7.org/fhir/us/core/CodeSystem/condition-category)
\[code] - health-concern
optionally: code could take a value from the list:
\[code] - problem-list-item
\[code] - encounter-diagnosis
\[code] - health-concern
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and clinical-status
Get Condition by combination `patient` and `clinical-status`
**METHOD** *GET*
Notes: Fetches a bundle of all Condition resources for the specified patient and all “active” statuses (active,relapse,remission). This will exclude diagnoses and health concerns without a clinicalStatus specified.
```
GET [base url]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient, category and clinical-status
Get Condition by combination `patient`, `category` and `clinical-status`
**METHOD** *GET*
Notes: Fetches a bundle of all Condition resources for the specified patient, category, and all "active" statuses (active, relapse, remission). This will exclude diagnoses and health concerns without a clinicalStatus specified.
```
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's id
\{system|} - [http://hl7.org/fhir/us/core/CodeSystem/condition-category](http://hl7.org/fhir/us/core/CodeSystem/condition-category)
\[code] - health-concern
optionally: code could take a value from the list:
\[code] - problem-list-item
\[code] - encounter-diagnosis
\[code] - health-concern
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient, category and encounter
Get Condition by combination `patient`, `category` and `encounter`
**METHOD** *GET*
Notes: Fetches a bundle of all Condition resources for the specified patient, category, and encounter. This is particularly useful for retrieving encounter-specific diagnoses.
```
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's id
\{system|} - [http://hl7.org/fhir/us/core/CodeSystem/condition-category](http://hl7.org/fhir/us/core/CodeSystem/condition-category)
\[code] - health-concern
optionally: code could take a value from the list:
\[code] - problem-list-item
\[code] - encounter-diagnosis
\[code] - health-concern
\[id] - Encounter's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|encounter-diagnosis&encounter=Encounter/12345' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and code
Get Condition by combination `patient` and `code`
**METHOD** *GET*
```
GET [base url]/Condition?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's Id
\{system|} - The system for the observation, e.g. [http://snomed.info/sct](http://snomed.info/sct)
\[code] - code for observation in the system, e.g. 442311008
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&code=http://snomed.info/sct|442311008' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and onset-date
Get Condition by combination `patient` and `onset-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&onset-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's Id
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&onset-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Condition by Patient and asserted-date
Get Condition by combination `patient` and `asserted-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's Id
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gt` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&asserted-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
***
## Condition by Patient and recorded-date
Get Condition by combination `patient` and `recorded-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&recorded-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's Id
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gt` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&recorded-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
***
## Condition by Patient and abatement-date
Get Condition by combination `patient` and `abatement-date`
**METHOD** *GET*
```
GET [base]/Condition?patient={Type/}[id]&abatement-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional parameter for reference type
\[id] - Patient's Id
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gt` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&abatement-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Immunization
Source: https://help.elationhealth.com/articles/fhir/uscdi-immunization
## Overview
The Immunization resource describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party. At its minimum, Immunization contains vaccine code, date, reference to the patient and status of the immunization, but may also contain data about the administered vaccine including the manufacturer, lot number and expiration date.
If an immunization was not given, this would be represented as:
* `Immunization.status = “not-done”`
Each Immunization has next elements:
* a status
* a vaccine code that identifies the kind of vaccine administered
* a date the vaccine was administered
* a patient
Each Immunization must support:
* a statusReason if the vaccine wasn't given
| USCore Data Element | FHIR Resource Field |
| ------------------- | ------------------------ |
| status | Immunization.status |
| vaccine | Immunization.vaccineCode |
| date | Immunization.occurrence |
| patient | Immunization.patient |
**Profile specific implementation guidance:**
* Use the status code: not-done to represent that an immunization was not given.
* NDC codes as a translational data element: Based upon the 2015 Edition Certification Requirements, [CVX vaccine codes](http://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx) are required and the NDC vaccine codes SHOULD be supported as translations to them. A [NDC to CVX ConceptMap](http://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_crosswalk.asp) is provided and is based upon the CDC's [CVX crosswalk table](http://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_crosswalk.asp). A translation is illustrated in the example below.
This resource conforms to **[USCDI v3 profile](https://www.healthit.gov/isa/uscdi-data-class/immunizations)** for Immunization - refer to [StructureDefinition US Core Immunization](http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-immunization.html). Immunization response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
Immunization **must support** these elements:
* `status`
* `statusReason`
* `vaccineCode`
* `patient`
* `occurrence[x]`
* `primarySource`
The following search parameters and search parameter combinations SHALL be supported:
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all immunizations for a patient using the patient search parameter:
`GET [base url]/Immunization?patient={Type/}[id]`
The following search parameters and search parameter combinations SHOULD be supported:
**SHOULD** support searching using the combination of the patient and date search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Immunization?patient={Type/}[id]&date=[date]`
**SHOULD** support searching using the combination of the patient and status search parameters:
`GET [base url]/Immunization?patient={Type/}[id]&status={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Immunization By Patient Id
Search for immunizations by patient id.
**METHOD** *GET*
```
[base url]/Immunization?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Immunization?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Immunization By Id
Get Immunization by ID.
**METHOD** *GET*
```
[base url]/Immunization/{id}
```
or
```
[base url]/Immunization?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id of Immunization resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Immunization/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Immunization By patient and date search parameters
Get Immunization by combination of the patient and date search parameters.
**METHOD** *GET*
```
[base url]/Immunization?patient=[reference]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\[date] - immunization date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Immunization?patient=1137192&date=ge2019-01-14' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Immunization by patient and status search parameters
Get Immunization by combination of the patient and status search parameters.
**METHOD** *GET*
```
[base url]/Immunization?patient=[reference]&status={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define immunization status code
\[code] - status of immunization
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Immunization?patient=1137192&status=completed' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Laboratory Results Reporting
Source: https://help.elationhealth.com/articles/fhir/uscdi-laboratory-results-diagnostic-report
## Overview
Laboratory Results Information addresses:
* Laboratory Results DiagnosticReport HL7® FHIR® resource with [US Core Profile 6.1.0](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-diagnosticreport-lab.html)
Laboratory Results are represented as an FHIR Diagnostic Report object. A diagnostic report is the set of information that is typically provided by a diagnostic service when investigations are complete. The information includes a mix of atomic results, text reports, images, and codes.
**Each DiagnosticReport has next elements:**
* a status
* a category code of ‘LAB’
* a code (preferably a LOINC code) which tells you what is being measured
* a patient
* the diagnostically relevant time (known as the “effective time” and typically the time of specimen collection)\*
* when the report was released
**Each DiagnosticReport supports next elements:**
* who issues the report
* a result
**Profile specific implementation guidance:**
* Additional codes that translate or map to the DiagnosticReport codes or category codes are allowed. For example:
* providing both a local system codes and a LOINC code that it map to
* providing a more specific category codes to the “LAB” category code, such as “CH” (chemistry), in an additional coding element.
* Results that are free text or report form are represented using the ‘presentedForm’ element in DiagnosticReport.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isp/uscdi-data-class/laboratory#uscdi-v3) for DiagnosticReport - refer to [StructureDefinition US Core DiagnosticReport Lab](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-diagnosticreport-lab.html). DiagnosticReport response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------- | -------------------- |
| status | Observation.status |
| category | Observation.category |
| LOINC code | Observation.code |
| patient | Observation.subject |
### Must support elements, mandatory and optional search parameters
*DiagnosticReport **must support** these elements:*
* `status`
* `Slices for category`
-`category:LaboratorySlice`
* `code`
* `subject`
* `effective[x]`
* `issued`
* `performer`
* `result`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all DiagnosticReports for a patient using the `patient` search parameter:
`GET [base url]/DiagnosticReport?patient={Type/}[id]`
**SHALL** support searching for all DiagnosticReports for a patient using the `patient` and `category` search parameters:
`GET [base url]/DiagnosticReport?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB`
**SHALL** support searching for all DiagnosticReports for a patient using the `patient` and `code` search parameters
* including optional support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code],{system|}[code]`
**SHALL** support searching for all DiagnosticReports for a `patient` and `category` and `date` search parameters
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date])
`GET [base url]/DiagnosticReport?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB&date={gt|lt|ge|le}[date]`
*The following search parameter combinations **SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code])
`GET [base url]/DiagnosticReport?patient={Type/}[id]&status={system|}[code],{system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including optional support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]&...)
`GET [base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## DiagnosticReport By Patient Id
Search for DiagnosticReport by patient.
**METHOD** *GET*
```
[base url]/DiagnosticReport?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DiagnosticReport By Id
Get DiagnosticReport by ID.
**METHOD** *GET*
```
[base url]/DiagnosticReport/{id}
```
or
```
[base url]/DiagnosticReport?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for DiagnosticReport resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## DiagnosticReport by patient and category
Get DiagnosticReports using the combination of the patient and category search parameters:
**METHOD** *GET*
```
`GET [base url]/DiagnosticReport?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## DiagnosticReport by patient and code
Get DiagnosticReports using the combination of the patient and code search parameters:
**METHOD** *GET*
```
`GET [base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code],{system|}[code]`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\{system|} - an identity of the terminology system, used to specify DiagnosticReport code
\[code] - DiagnosticReport code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|24323-8 \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## DiagnosticReport by patient and category and date
Get DiagnosticReports using the combination of the patient and category and date search parameters
**METHOD** *GET*
```
`GET [base url]/DiagnosticReport?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB&date={gt|lt|ge|le}[date]`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\[date] - DiagnosticReport effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB&date=ge2010-01-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## DiagnosticReport by patient and status
Get DiagnosticReports using the combination of the patient and status search parameters
**METHOD** *GET*
```
`GET [base url]/DiagnosticReport?patient={Type/}[id]&status={system|}[code],{system|}[code]`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\{system|} - an identity of the terminology system, used to specify status
\[code] - DiagnosticReport status
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&status=completed\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## DiagnosticReport by patient and code and date
Get DiagnosticReports using the combination of the patient and code and date search parameters
**METHOD** *GET*
```
`GET [base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\[date] - DiagnosticReport effective date
\{system|} - an identity of the terminology system, used to specify DiagnosticReport code
\[code] - DiagnosticReport code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|24323-8&date=ge2019-01-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Laboratory Results Observation
Source: https://help.elationhealth.com/articles/fhir/uscdi-laboratory-results-observation
## Overview
The US Core Laboratory Result Observation Profile is based upon the core FHIR Observation Resource, and, along with the [US Core DiagnosticReport Profile for Laboratory Results Reporting](/articles/fhir/uscdi-laboratory-results-diagnostic-report), meets the US Core Data for Interoperability (USCDI) v1 ‘Laboratory’ requirements. Laboratory results are grouped and summarized using the DiagnosticReport resource which reference Observation resources. Each Observation resource represents an individual laboratory test and result value, a “nested” panel (such as a microbial susceptibility panel) which references other observations, or rarely a laboratory test with component result values.
**Example Usage Scenarios:**
The following are example usage scenarios for the this profile:
* Query for lab results belonging to a Patient
* Record or update lab results belonging to a Patient
**Each Observation has next elements:**
* a category code of ‘laboratory’
* a laboratory LOINC code, if available, which tells you what is being measured
**Each Observation supports next elements:**
* a result value\*
* if the result value is a numeric quantity, a standard UCUM unit
* if the result value is a coded quantity, a standard SNOMED CT\*
* a specimen type (e.g., blood, serum, urine)
**Profile specific implementation guidance:**
* Additional codes that translate or map to the Observation code or category codes are allowed. For example:
* providing both a local code and LOINC code
* providing a more specific category codes such as ‘chemistry’, [SNOMED CT](http://hl7.org/fhir/R4/observation.html#obsgrouping) concept, or system specific codes in addition to the ‘laboratory’ category code.
* An Observation without a value, SHALL include a reason why the data is absent unless there are component observations, or references to other Observations that are grouped within it.
* For Further guidance see the [US Core Observation Grouping](http://hl7.org/fhir/R4/observation.html#obsgrouping) section in FHIR Specification.
* See the [General US Core Guidance Section](http://hl7.org/fhir/us/core/STU6.1/general-guidance.html) page for further guidance on using SNOMED and UCUM.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isp/uscdi-data-class/laboratory#uscdi-v3) for Observation \* refer to [StructureDefinition US Core Observation Lab](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-lab.html). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Observation **must support** these elements:*
* `status`
* `Slices for category`
-`category:us-core`
* `code`
* `subject`
* `effective[x]`
* `value[x]`
* `dataAbsentReason`
* `specimen`
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory`
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including optional support for *OR* search on code (e.g.`code={system|}[code],{system|}[code],...`)
`GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on date (e.g. `date=[date]&date=[date]]&...`)
`GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
*The following search parameters and search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on status (e.g. `status={system|}[code],{system|}[code],...`)
`GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including optional support for *OR* search on `code` (e.g. `code={system|}[code],{system|}[code],...`)
* including support for these date comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `date` (e.g. `date=[date]&date=[date]]&...`)
`GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation by Patient and Category
Search for Observation by combination patient and category.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Code
Search for Observation by combination patient and code.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - code for observation in the system, e.g. 44974-4
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|2339-0,http://loinc.org|25428-4,http://loinc.org|2514-8' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Category and Date
Search for Observations by combination patient and category and date.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - Code for observation in the system, e.g. 24323-8
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date=ge2010-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Category and Status
Search for Observations by combination patient and Category and Status.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - code for observation in the system, e.g. final
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&status=final' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by Patient and Code and Date
Search for Observations by combination patient and code and date.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - optional reference type
\[id] - Id for the Patient
\{system|} - The system for the category, e.g. [http://loinc.org](http://loinc.org)
\{code} - code for observation in the system, e.g. 2339-0
\[date] - Filter's date
\{gt|lt|ge|le} - Search modifier `gr` or `lt` or `ge` or `le`. Specification [how to search by date in FHIR](http://hl7.org/fhir/R4/search.html#date)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|2339-0&date=ge2019-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Medication
Source: https://help.elationhealth.com/articles/fhir/uscdi-medication
## Overview
The Medication resource is used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.
**Each Medication has next elements:**
* a medication code
**Profile specific implementation guidance:**
* RXNorm concepts are used and are defined as an extensible binding. USCDI V3+ recommends the National Drug Codes (NDC) as an optional terminology. They can be supplied as an additional coding element.
* Since the binding is extensible, when a code is unavailable just text is allowed.
* When the medication is compounded and is a list of ingredients, the code is still present and may contain only the text.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isa/uscdi-data-class/medications#uscdi-v3) for Medication - refer to [StructureDefinition US Core Medication](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-medication.html). Medication response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------- | ------------------- |
| medication code | medication.code |
### Must support elements, mandatory and optional search parameters
**Medication must support these elements:**
* `code`
No required search criteria for us-core-medication profile.
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Medication?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Medication By Id
Get Medication by ID.
**METHOD** *GET*
```
[base url]/Medication/`{id}`
```
or
```
[base url]/Medication?_id=`{id}`
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for Medication resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Medication/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# MedicationDispense
Source: https://help.elationhealth.com/articles/fhir/uscdi-medication-dispense
## Overview
Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.
**Each MedicationDispense has next elements:**
* a status
* a medication
* a patient
**Each MedicationDispense supports next elements:**
* who dispensed the medication
* the authorizing prescription
* type of dispense (e.g., partially dispensed)
* the quantity dispensed
* a date for when dispensed to the patient
* free text dosage instructions (the SIG)
* the dose and rate
**Profile specific implementation guidance:**
* The MedicationDispense resource is used to represent the USCDI v3 medication fill status.
* This Profile can represent a medication using a code or reference a Medication resource
* When using a code, RXNorm concepts are used. They are defined as an extensible binding to .medicationCodeableConcept. USCDI V3+ recommends the National Drug Codes (NDC) as an optional terminology. They can be supplied as an additional coding element.
* When referencing a Medication resource in .medicationReference, the resource may be contained or an external resource.
* The server systems are not required to support both a code and a reference, but SHALL support at least one of these methods.
* If an external reference to a Medication resource is used, the server SHALL support the \_include parameter for searching this element.
* The client application SHALL support all methods.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isa/uscdi-data-class/medications#uscdi-v3) for MedicationDispense \* refer to [StructureDefinition US Core MedicationDispense](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-medicationdispense.html). MedicationDispense response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*MedicationDispense **must support** these elements:*
* `status`
* `medication[x]`
* `subject`
* `performer`
* `actor`
* `authorizingPrescription`
* `type`
* `quantity`
* `whenHandedOver`
* `dosageInstruction`
* `text`
* `timing`
* `doseAndRate`
* `dose[x]`
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support searching using the `patient` search parameter:
* including optional support for these `_include` parameters: MedicationDispense:medication
`GET [base]/MedicationDispense?patient=14676`
*The following search parameter combinations **SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/MedicationDispense?patient={Type/}[id]&status={system|}[code]`
**SHOULD** support searching using the combination of the `patient` and `status` and `type` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/MedicationDispense?patient={Type/}[id]&status={system|}[code]&type={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## MedicationDispense By Patient Id
Search for MedicationDispense by patient.
**METHOD** *GET*
```
[base url]/MedicationDispense?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationDispense?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## MedicationDispense by patient and status search parameters
Get MedicationDispenses using the combination of the patient and status search parameters
**METHOD** *GET*
```
GET [base url]/MedicationDispense?patient={Type/}[id]&status={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\{system|} - terminology system used to identify medication dispense status
\[code] - status of the medication dispense
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationDispense?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&status=completed' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## MedicationDispense by patient and status and type search parameters
Get MedicationDispenses using the combination of the patient and status and type search parameters
**METHOD** *GET*
```
GET [base url]/MedicationDispense?patient={Type/}[id]&status={system|}[code]&type={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\{system|} - terminology system used to identify medication dispense status or type
\[code] - status or type of the medication dispense
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationDispense?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&status=completed&type=http://terminology.hl7.org/CodeSystem/v3-ActCode|EM' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Medication Request
Source: https://help.elationhealth.com/articles/fhir/uscdi-medication-request
## Overview
An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
**Each MedicationRequest has next elements:**
* a status
* an intent code
* a medication
* a patient
**Each MedicationRequest supports next elements:**
* the category (e.g., Discharge Medication)
* the reported flag or reference signaling that information is from a secondary source such as a patient
* the encounters
* a prescriber
* a date for when written
* the prescription Sig
* the amount dispensed and number of refills
* the dose and rate
**Profile specific implementation guidance:**
* See the [Medication List](https://www.hl7.org/fhir/us/core/medication-list.html) section for guidance on accessing a patient medications including over the counter (OTC) medication and other substances taken for medical and recreational use.
* \*The MedicationRequest resources can represent a medication using either a code, or reference a [Medication](http://hl7.org/fhir/R4/medication.html) resource.
* When referencing a Medication resource, the resource may be [contained](http://hl7.org/fhir/R4/references.html#contained) or an external resource.
* The server application MAY choose any combination of these methods, but if an external reference to Medication is used, the server SHALL support the \_include parameter for searching this element.
* The client application SHALL support both elements.
* Source EHR identifiers SHOULD be included to support deduplication across MedicationRequest resources. Exposing the EHR identifiers helps client applications identify duplicates.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isa/uscdi-data-class/medications#uscdi-v3) for MedicationRequest - refer to [StructureDefinition US Core MedicationRequest](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-medicationrequest.html). MedicationRequest response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------- | ---------------------------- |
| status | medicationRequest.status |
| intent code | medicationRequest.intent |
| medication | medicationRequest.medication |
| patient | medicationRequest.subject |
| date when written | medicationRequest.authoredOn |
| prescriber | medicationRequest.requester |
### Must support elements, mandatory and optional search parameters
*MedicationRequest**must support** these elements:*
* `status`
* `intent`
* `category`
* `category:us-core`
* `reported[x]`
* `medication[x]`
* `subject`
* `encounter`
* `authoredOn`
* `requester`
* `dosageInstruction`
* `text`
* `timing`
* `doseAndRate`
* `dose[x]`
* `dispenseRequest`
* `numberOfRepeatsAllowed`
* `quantity`
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support searching using the combination of the `patient` and `intent` search parameters:
* including support for OR search on intent (e.g.intent=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/MedicationRequest?patient={Type/}[id]&intent=order,plan`
**SHALL** support searching using the combination of the `patient` and `intent` and `status` search parameters:
* including support for OR search on intent (e.g.intent=\{system|}\[code],\{system|}\[code],...)
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/MedicationRequest?patient={Type/}[id]&intent=order,plan&status={system|}[code]`
*The following search parameter combinations **SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the patient and intent and encounter search parameters:
* including support for OR search on intent (e.g.intent=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/MedicationRequest?patient={Type/}[id]&intent=order,plan&encounter={Type/}[encounter_id]`
**SHOULD** support searching using the combination of the `patient` and `intent` and `authoredon` search parameters:
* including support for OR search on intent (e.g.intent=\{system|}\[code],\{system|}\[code],...)
* including support for these authoredon comparators: gt,lt,ge,le
* including optional support for AND search on authoredon (e.g.authoredon=\[date]\&authoredon=\[date]&...)
`GET [base url]/MedicationRequest?patient={Type/}[id]&intent=order,plan&authoredon={gt|lt|ge|le}[date]&authoredon={gt|lt|ge|le}[date]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## MedicationRequest By Patient Id
Search for MedicationRequest by patient.
**METHOD** *GET*
```
[base url]/MedicationRequest?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationRequest?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## MedicationRequest By Id
Get MedicationRequest by ID.
**METHOD** *GET*
```
[base url]/MedicationRequest/{id}
```
or
```
[base url]/MedicationRequest?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for MedicationRequest resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationRequest/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## MedicationRequest by patient and intent search parameters
Get MedicationRequests using the combination of the patient and intent search parameters
**METHOD** *GET*
```
GET [base url]/MedicationRequest?patient={Type/}[id]&intent=order,plan&status={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\{system|} - terminology system used to identify medication request status
\[code] - status of the medication request
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&intent=order,plan&status=active' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## MedicationRequest by patient and intent and encounter search parameters:
Get MedicationRequests using the combination of the patient and intent and encounter search parameters
**METHOD** *GET*
```
GET [base url]/MedicationRequest?patient=Patient/[id]&intent=order,plan&encounter=[reference]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - patient id
\[reference] - reference to Encounter
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&intent=order,plan&encounter=Encounter/example123' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## MedicationRequest by patient and intent and authoredon search parameters
Get MedicationRequests using the combination of the patient and intent and authoredon search parameters
**METHOD** *GET*
```
GET [base url]/MedicationRequest?patient=Patient/[id]&intent=order,plan&authoredon={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Type for the Reference. *Example:* `Patient`
\[id] - patient id
\[date] -date when medication request was authored on
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/MedicationRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&intent=order,plan&authoredon=ge2019-01-01T00:00:00Z' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Observation Clinical Result
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-clinical-result
## Overview
The Observation Clinical Result resource represents clinical observations and measurements about a patient, including findings from diagnostic imaging, clinical procedures, and other non-laboratory tests. This resource captures results from various clinical assessments such as radiology findings, procedure observations, and examination results. For example, it records observations like the size of a polyp noted during a colonoscopy or findings from an imaging study. At its minimum, Observation contains a code identifying what was observed, a status, a reference to the patient, and the observed value or result, but may also contain data about the performer, timing, and interpretation of the observation. the observation.
**Each Observation Must Have:**
* a status
* a category code
* a LOINC code, if available, which tells you what is being measured
* a patient
**Each Observation Must Support:**
* a time indicating when the measurement was taken
* a result value
* a reason why the data is absent
This resource conforms to **[USCDI v3 profile](https://www.healthit.gov/isa/uscdi-data-class/clinical-tests)** for Observation Clinical Result - refer to [StructureDefinition US Core Observation Clinical Result](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-clinical-result.html). Observation Clinical Result response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Observation Clinical Result **must support** these elements:*
* `status`
* `category`
* `category:us-core`
* `code`
* `subject`
* `effective[x]`
* `value[x]`
* `dataAbsentReason`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including optional support for OR search on code
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]&date=[date]`
*The following search parameters and search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]&date=[date]`
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on status
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]&status={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation Clinical Result By patient and category search parameters
Get Observation Clinical Result by combination of the patient and category search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation category code
\[code] - category of observation (e.g., laboratory, vital-signs)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=laboratory' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Clinical Result By patient and code search parameters
Get Observation Clinical Result by combination of the patient and code search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation code (e.g., LOINC)
\[code] - code identifying what was observed
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&code=http://loinc.org|2339-0' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Clinical Result By patient, category and date search parameters
Get Observation Clinical Result by combination of the patient, category and date search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation category code
\[code] - category of observation
\[date] - effective date of observation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=laboratory&date=ge2023-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Clinical Result By patient, code and date search parameters
Get Observation Clinical Result by combination of the patient, code and date search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&code={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation code
\[code] - code identifying what was observed
\[date] - effective date of observation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&code=http://loinc.org|2339-0&date=ge2023-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Clinical Result By patient, category and status search parameters
Get Observation Clinical Result by combination of the patient, category and status search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={system|}[code]&status={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation category/status code
\[code] - category of observation and status code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=laboratory&status=final' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Observation Imaging Result
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-imaging-result
## Overview
Imaging Result are represented using Observation FHIR Resource. Observations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics, as well as capture results of tests performed on products and substances. Most observations are simple name/value pair assertions with some metadata, but some observations group other observations together logically, or even are multi-component observations.
**Each Observation has next elements:**
* a status
* a category code of ‘imaging’
* a LOINC code, if available, which tells you what is being measured
* a patient
**Each Observation supports next elements:**
* a time indicating when the measurement was taken
* a result value or a reason why the data is absent\*
* if the result value is a numeric quantity, a standard UCUM unit
**Profile specific implementation guidance:**
* The Observation.category element provides an efficient way of restricting search on observations to “imaging” observations. Example searches are shown in the Quick Start section below. However, clients need to understand that data categorization is somewhat subjective. The categorization applied by the source may not align with the client’s expectations. Clients may find it more useful to use queries based on a specific code or set of codes or to perform additional client side filtering of query results.
* Additional codes that translate or map to the Observation code or category codes are allowed. For example:
* providing both a local code and LOINC code
* providing a more specific code , a [SNOMED CT](http://hl7.org/fhir/R4/valueset-procedure-code.html) concept, or system specific codes in addition to the ‘imaging’ category code.
* Systems SHOULD support Observation.effectivePeriod to accurately represent procedure tests that are collected over a period of time .
* \*An Observation without a value, SHALL include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using Observation.hasMember.
* For further guidance see the [Observation Grouping](http://hl7.org/fhir/R4/observation.html#obsgrouping) section in FHIR Specification.
* Systems that never provide an observation without a value are not required to support Observation.dataAbsentReason.
* \*An Observation.component without a value, SHALL include a reason why the data is absent.
* Systems that never provide a component observation without a component value are not required to support Observation.component.dataAbsentReason.
* See the [General Guidance Section](http://hl7.org/fhir/us/core/general-guidance.html#using-ucum-codes-in-the-quantity-datatype) for further guidance on using UCUM
* See the [LOINC scale type to FHIR data type mapping](http://hl7.org/fhir/R4/loinc.html#dataelements) for guidance on which Observation.value\[x] data type to use based on the LOINC Type of Scale.
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/uscdi-data-class/assessment-and-plan-treatment#uscdi-v2) for Observation - refer to [US Core Observation Imaging Result Profile ](https://www.healthit.gov/isa/uscdi-data-class/diagnostic-imaging#uscdi-v2). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ---------------------------------------------------------------- | ------------------------- |
| status | Observation.status |
| category code of ‘imaging’ | Observation.category |
| LOINC code, if available, which tells you what is being measured | Observation.code |
| patient | Observation.subject |
| time indicating when the measurement was taken | Observation.effective\[x] |
| a result value or a reason why the data is absent | Observation.value\[x] |
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `status`
* `Slices for category`
* `category:imaging`
* `code`
* `subject`
* `effectiveDateTime`
* `value[x]`
* `valueQuantity`
* `valueCodeableConcept`
* `valueString`
* ` dataAbsentReason`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Observations for a patient and category search parameters:\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging`
**SHALL** support searching for all Observations for a patient and code search parameters:
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}`
**SHALL** support searching for all Observations for a patient and category and date search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}&...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
*The following search parameter combinations**SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the patient and category and status search parameters:
* including support for OR search on status (e.g.status=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging&status={system|}|{code}{,{system|}|{code},...}`
**SHOULD** support searching using the combination of the patient and code and date search parameters:
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}&...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation By Patient Id
Search for Observation by patient.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation By Id
Get Observation by ID.
**METHOD** *GET*
```
[base url]/Observation/{id}
```
or
```
[base url]/Observation?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{id} - Id for Observation resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by patient and category search parameters
Get Observations using the combination of the patient and category search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code search parameters
Get Observations using the combination of the patient and code search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - terminology system used to identify observation code\
\{code} - observation code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|18782-3,http://loinc.org|18834-2,http://loinc.org|19005-8\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and date search parameters
Get Observations using the combination of the patient and category and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{date} - observation effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and status search parameters
Get Observations using the combination of the patient and category and status search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging&status={system|}|{code}{,{system|}|{code},...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - terminology system used to identify observation status\
\{code} - observation status code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging&status=final\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code and date search parameters
Get Observations using the combination of the patient and code and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - terminology system used to identify observation code\
\{code} - observation code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|18782-3&date=ge2019-01-01T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Observation Occupation
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-occupation
## Overview
The Observation Occupation resource represents a patient's occupation. Occupation refers to the type of work a person does to earn a living or the principal activity that a person does for pay or profit. This resource captures patient-reported or clinically documented occupation information as part of comprehensive social history and social determinants of health data. At its minimum, Observation contains a specific LOINC code for occupation (11341-5), a status, a reference to the patient, and the occupation value, but may also contain data about the occupation period, industry, and related employment details.
**Each Observation Occupation has next elements:**
* a status
* a code for job history
* a patient
* the job code or text
**Each Observation Occupation must support:**
* a category code of “social-history”
* when the job occurred
* a code for the job history industry
* the industry code or text
This resource conforms to **[USCDI v3 profile](https://www.healthit.gov/isa/uscdi-data-element/occupation)** for Occupation - refer to [StructureDefinition US Core Observation Occupation Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-occupation.html). Observation Occupation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Observation Occupation **must support** these elements:*
* `status`
* `category`
* `category:socialhistory`
* `code`
* `subject`
* `effective[x]:effectivePeriod`
* `value[x]:valueCodeableConcept`
* `component`
* `component:industry`
* `component.code`
* `component.value[x]`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including optional support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
*The following search parameters and search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including optional support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation Occupation By patient and code search parameters
Get Observation Occupation by combination of the patient and code search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system (LOINC)
\[code] - LOINC code 11341-5 or 21843-8 for Occupation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&code=http://loinc.org|11341-5' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Occupation By patient and category search parameters
Get Observation Occupation by combination of the patient and category search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation category code
\[code] - category code (social-history)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=social-history' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Occupation By patient, category and date search parameters
Get Observation Occupation by combination of the patient, category and date search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system ([http://terminology.hl7.org/CodeSystem/observation-category](http://terminology.hl7.org/CodeSystem/observation-category))
\[code] - category code (social-history)
\[date] - effective date of observation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date=ge2023-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Occupation By patient, category and status search parameters
Get Observation Occupation by combination of the patient, category and status search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation category/status code
\[code] - category code (social-history) and status code (supports OR search)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status=final' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Occupation By patient, code and date search parameters
Get Observation Occupation by combination of the patient, code and date search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system (LOINC)
\[code] - observation code (supports OR search)
\[date] - effective date of observation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&code=http://loinc.org|11341-5&date=ge2023-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Observation Screening Assessment Information
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-screening-assessment
## Overview
The US Core Observation Screening Assessment Profile is based upon the core FHIR Observation Resource and meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Assessments. This profile sets minimum expectations for the Observation resource to record, search, and fetch observations representing screening and assessment results for a patient. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used.
**Each Observation Screening Assessment Must Have:**
* a status
* a category code of "survey"
* a code describing the type of assessment or screening
* a patient
**Each Observation Screening Assessment Must Support:**
* additional categories that further specify the assessment or screening
* a time indicating when the survey was taken
* the answer or a reason why the data is absent
* if the result value is a numeric quantity and coded quantity units are used, UCUM is required.
* who answered the questions
* related questionnaire responses or observations that this observation is made from
* reference to observations that make up this observation
This resource conforms to [USCDI v3](https://www.healthit.gov/isp/uscdi-data-class/assessments#uscdi-v3) for Assessments - refers to [US Core Observation Screening Assessment Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-screening-assessment.html). Observation Screening Assessment response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Observation Screening Assessment **must support** these elements:*
* `status`
* `category`
* `category:survey`
* `category:screening-assessment`
* `code`
* `subject`
* `effective[x]`
* `effectiveDateTime`
* `performer`
* `value[x]`
* `valueQuantity`
* `valueCodeableConcept`
* `valueString`
* `dataAbsentReason`
* `hasMember`
* `derivedFrom`
*Each Observation Screening Assessment Must Have (Mandatory):*
* `status`
* `category` (with at least one category code of "survey")
* `code`
* `subject`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
* including support for OR search on category (e.g. category=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&category=survey`
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including support for OR search on code (e.g. code=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these `date` comparators: gt, lt, ge, le
* including optional support for AND search on date (e.g. date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&category=survey&date={gt|lt|ge|le}[date]`
*The following search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on category (e.g. category=\{system|}\[code],\{system|}\[code],...)
* including support for OR search on status (e.g. status=\[code],\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&category=survey&status={code}`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including support for these `date` comparators: gt, lt, ge, le
* including optional support for AND search on date (e.g. date=\[date]\&date=\[date]]&...)
* including support for OR search on code (e.g. code=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]&date={gt|lt|ge|le}[date]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation Screening Assessment by Patient and Category
Search for Observation Screening Assessment using combination of `patient` and `category` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=survey
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&category=survey' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Screening Assessment by Patient and Code
Search for Observation Screening Assessment using combination of `patient` and `code` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Code system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://loinc.org|`
\[code] - Assessment code. *Example:* `44261-6` (Patient Health Questionnaire 9 item (PHQ-9) total score \[Reported])
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&code=http://loinc.org|44261-6' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Screening Assessment by Patient, Category and Date
Search for Observation Screening Assessment using combination of `patient`, `category`, and `date` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=survey&date={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{gt|lt|ge|le} - Date comparator. *Example:* `ge` (greater than or equal to)
\[date] - Date value. *Example:* `2024-01-01`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&category=survey&date=ge2024-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Screening Assessment by Patient, Category and Status
Search for Observation Screening Assessment using combination of `patient`, `category`, and `status` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=survey&status={code}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{code} - Status code. *Example:* `final`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&category=survey&status=final' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Screening Assessment by Patient, Code and Date
Search for Observation Screening Assessment using combination of `patient`, `code`, and `date` parameters.
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]&date={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
\{system|} - Code system. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information. *Example:* `http://loinc.org|`
\[code] - Assessment code. *Example:* `44261-6` (Patient Health Questionnaire 9 item (PHQ-9) total score \[Reported])
\{gt|lt|ge|le} - Date comparator. *Example:* `ge` (greater than or equal to)
\[date] - Date value. *Example:* `2024-01-01`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&code=http://loinc.org|44261-6&date=ge2024-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Observation SDOH Assessment
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-sdoh-assessment
## Overview
Observation SDOH Assessment Survey is represented using Observation FHIR Resource. Observations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics, as well as capture results of tests performed on products and substances. Most observations are simple name/value pair assertions with some metadata, but some observations group other observations together logically, or even are multi-component observations.
**Each Observation supports next elements:**
* a category code of `sdoh`
* an SDOH LOINC code, if available
* references to other US Core SDOH assessments
**Profile specific implementation guidance:**
* This profile defines a Valueset based on a starter set of example survey LOINC codes made up of commonly asked social questions as identified by [FindHelp.org](https://company.findhelp.com/) and the PRAPARE, Hunger Vital Sign, AHC-HRSN screening tools referenced in USCDI v2. It is not intended to be complete and implementers are expected include other LOINC or other codes to meet their business needs.
* See the [US Core Observation Survey Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-survey.html) page for how to represent individual responses, panels of multi-question surveys, and multi-select responses to “check all that apply” questions, and other implementation guidance.
* See the SDOH guidance page for how this profile along with other Observation Profiles or alternatively QuestionnaireResponse to is used represent [SDOH](http://hl7.org/fhir/us/core/sdoh.html) assessments.
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/uscdi-data-class/assessment-and-plan-treatment#uscdi-v2) for Observation - refer to [US Core Observation SDOH Assessment Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-sdoh-assessment.html). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| -------------------------------------------- | --------------------- |
| a category code of “sdoh” | Observation.category |
| an SDOH LOINC code, if available | Observation.code |
| references to other US Core SDOH assessments | Observation.hasMember |
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `category:sdoh`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Observations for a patient and category search parameters:\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey`
**SHALL** support searching for all Observations for a patient and code search parameters:
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}}`
**SHALL** support searching for all Observations for a patient and category and date search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}&...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
*The following search parameter combinations**SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the patient and category and status search parameters:
* including support for OR search on status (e.g.status=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status={system|}|{code}{,{system|}|{code},...}`
**SHOULD** support searching using the combination of the patient and code and date search parameters
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}}&...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation By Patient Id
Search for Observation by patient.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation By Id
Get Observation by ID.
**METHOD** *GET*
```
[base url]/Observation/{id}
```
or
```
[base url]/Observation?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{id} - Id for Observation resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by patient and category search parameters
Get Observations using the combination of the patient and category search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and date search parameters
Get Observations using the combination of the patient and category and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{date} - observation effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code search parameters
Get Observations using the combination of the patient and code search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - system used to identify observation code\
\{code} - observation code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7 \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code and date search parameters
Get Observations using the combination of the patient and code and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - terminology system used to identify observation code\
\{code} - observation code\
\{date} - observation effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and status search parameters
Get Observations using the combination of the patient and category and status search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status={status_system}|{status}{,{status_system}|{status},...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{status\_system} - terminology system used to identify observation status\
\{status} - observation status
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status=final\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Observation Sexual Orientation
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-sexual-orientation
## Overview
The Observation Sexual Orientation resource represents a patient's self-identified sexual orientation. Sexual orientation is a person's identity in relation to the gender or genders to which they are romantically or sexually attracted. This resource captures patient-reported sexual orientation information as part of comprehensive patient demographics and social history. At its minimum, Observation contains a specific LOINC code for sexual orientation (76690-7), a status, a reference to the patient, and the sexual orientation value, but may also contain data about when the information was recorded and who recorded it.
**Each Observation has next elements:**
* a status
* a fixed code for sexual orientation(76690-7)
* a patient
**Each Observation supports next elements:**
* a time indicating when the observation was made
* a sexual orientation value
**Profile specific implementation guidance:**
* Additional codes that translate or map to the Observation code (e.g., local codes) are allowed.
This resource conforms to **[USCDI v3 profile](https://www.healthit.gov/isa/uscdi-data-element/sexual-orientation)** for Sexual Orientation - refer to [StructureDefinition US Core Observation Sexual Orientation Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-sexual-orientation.html). Observation Sexual Orientation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ----------------------------------------------- | ------------------------- |
| status | Observation.status |
| a fixed code for sexual orientation | Observation.code |
| patient | Observation.subject |
| a time indicating when the observation was made | Observation.effective\[x] |
| a sexual orientation value | Observation.value\[x] |
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `status`
* `code`
* `subject`
* `effective[x]`
* `value[x]:valueCodeableConcept`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Observations for a patient and code search parameters:\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}`
**SHALL** support searching for all Observations for a patient and code and date search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}}&...)\
`GET [base url]/Observation?patient={Type/}{id}&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including optional support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/Observation?patient={Type/}[id]&category={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` and `date` search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
*The following search parameters and search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the combination of the `patient` and `category` and `status` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/Observation?patient={Type/}[id]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including optional support for OR search on code (e.g.code=\{system|}\[code],\{system|}\[code],...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\[date]\&date=\[date]]&...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation Sexual Orientation By patient and code search parameters
Get Observation Sexual Orientation by combination of the patient and code search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system (LOINC)
\[code] - LOINC code 76690-7 for Sexual orientation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&code=http://loinc.org|76690-7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Sexual Orientation By patient and category search parameters
Get Observation Sexual Orientation by combination of the patient and category search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation category code
\[code] - category code (social-history)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=social-history' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Sexual Orientation By patient, category and date search parameters
Get Observation Sexual Orientation by combination of the patient, category and date search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system ([http://terminology.hl7.org/CodeSystem/observation-category](http://terminology.hl7.org/CodeSystem/observation-category))
\[code] - category code (social-history)
\[date] - effective date of observation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date=ge2023-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Sexual Orientation By patient, category and status search parameters
Get Observation Sexual Orientation by combination of the patient, category and status search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&category={http://terminology.hl7.org/CodeSystem/observation-category|}social-history&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system used to define observation category/status code
\[code] - category code (social-history) and status code (supports OR search)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status=final' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation Sexual Orientation By patient, code and date search parameters
Get Observation Sexual Orientation by combination of the patient, code and date search parameters.
**METHOD** *GET*
```
[base url]/Observation?patient=[reference]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[reference] - reference to the Patient
\{system|} - terminology system (LOINC)
\[code] - observation code (supports OR search)
\[date] - effective date of observation
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=1137192&code=http://loinc.org|76690-7&date=ge2023-01-01' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Observation Social History
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-social-history
## Overview
Social History is represented using Observation FHIR Resource. Observations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics, as well as capture results of tests performed on products and substances. Most observations are simple name/value pair assertions with some metadata, but some observations group other observations together logically, or even are multi-component observations.
**Each Observation has next elements:**
* a status
* a category code of “social-history”
* a code
* a patient
**Each Observation supports next elements:**
* a category code of ‘sdoh’
* a time indicating when observation was made
* who answered the questions
* a value
**Profile specific implementation guidance:**
* See the [SDOH](http://hl7.org/fhir/us/core/sdoh.html) guidance page for how this profile can used to represent SDOH assessments.1
* Observations that are formally derived from an assessment tool or survey should use the [US Core Observation Survey Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-survey.html). However, simple assertion may be derived from a screening tool assessments and can reference them using Observation.derivedFrom.
* The codes can be from LOINC or SNOMED CT.
* Often the pattern for these types of observations that the Observation.code indicates a statement about findings and the Observation.value is present and “qualifies” the finding typically confirming or refuting it. For example:
code: Transport too expensive (SNOMED CT: 160695008)\
value: true
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/uscdi-data-class/assessment-and-plan-treatment#uscdi-v2) for Observation - refer to [US Core Observation Social History Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-social-history.html). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------------------------------- | ------------------------- |
| status | Observation.status |
| a category code of “social-history” | Observation.category |
| a code | Observation.code |
| a patient | Observation.subject |
| a category code of ‘sdoh’ | Observation.category |
| a time indicating when observation was made | Observation.effective\[x] |
| who answered the questions | Observation.performer |
| a value | Observation.value\[x] |
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `status`
* `Slices for category`
* ` category:us-core/social-history`
* ` category:sdoh`
* `code`
* `subject`
* `effectiveDateTime`
* `performer`
* `value[x]`
* `valueQuantity`
* `valueString`
* `valueBoolean`
* `valueCodeableConcept`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Observations for a patient and category search parameters:\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history`
**SHALL** support searching for all Observations for a patient and code search parameters:
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}}`
**SHALL** support searching for all Observations for a patient and category and date search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}&...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
*The following search parameter combinations**SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the patient and category and status search parameters:
* including support for OR search on status (e.g.status=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status={system|}|{code}{,{system|}|{code},...}`
**SHOULD** support searching using the combination of the patient and code and date search parameters
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}}&...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation By Patient Id
Search for Observation by patient.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation By Id
Get Observation by ID.
**METHOD** *GET*
```
[base url]/Observation/{id}
```
or
```
[base url]/Observation?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Observation resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by patient and category search parameters
Get Observations using the combination of the patient and category search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and date search parameters
Get Observations using the combination of the patient and category and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{date} - observation effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code search parameters
Get Observations using the combination of the patient and code search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - system used to identify observation code\
\{code} - observation code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7 \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code and date search parameters
Get Observations using the combination of the patient and code and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - terminology system used to identify observation code\
\{code} - observation code\
\{date} - observation effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and status search parameters
Get Observations using the combination of the patient and category and status search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status={status_system}|{status}{,{status_system}|{status},...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{status\_system} - terminology system used to identify observation status\
\{status} - observation status
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status=final\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Observation Survey
Source: https://help.elationhealth.com/articles/fhir/uscdi-observation-survey
## Overview
Observation Survey is represented using Observation FHIR Resource. Observations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics, as well as capture results of tests performed on products and substances. Most observations are simple name/value pair assertions with some metadata, but some observations group other observations together logically, or even are multi-component observations.
**Each Observation has next elements:**
* a status
* a category code of “survey”
* a [LOINC](http://loinc.org/) code, if available, which tells you the survey question
* a patient
**Each Observation supports next elements:**
* a time indicating when survey was taken
* the answer or a reason why the data is absent
* if the result value is a numeric quantity and coded quantity units are used, UCUM is required.
* who answered the questions
* related questionnaire responses or observations that this observation is made from
* reference to observations that make up this observation
**Profile specific implementation guidance:**
* For responses to individual survey questions, the question is represented in Observation.code, and the answer in Observation.value.
* For responses to multi-select or “check all that apply” questions, each response is represented as individual US Core Survey Observations. For each response, the question is represented in Observation.code, and the answer in Observation.value.
* For multi-question surveys and assessments represented in Observation.code, the Observation.value element should be empty, and the individual survey questions represented as distinct US Core Survey Observations and referenced using Observation.hasMember.
* See the SDOH guidance page for how this profile along with other Observation Profiles or alternatively QuestionnaireResponse to is used represent [SDOH](http://hl7.org/fhir/us/core/sdoh.html) assessments.
* Individual clinical assessments made by an individual about a patient’s social history which array\_to\_sentence\_string not derived from an assessment tool or survey should use the [US Core Observation Social History Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-social-history.html) instead.
* The Observation.category element provides an efficient way of restricting search on observations to “survey” observations.However, clients need to understand that data categorization is somewhat subjective. The categorization applied by the source may not align with the client’s expectations. Clients may find it more useful to use queries based on a specific code or set of codes or to perform additional client side filtering of query results.
* An Observation without a value, SHALL include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using Observation.hasMember.
* For further guidance see the [Observation Grouping](http://hl7.org/fhir/R4/observation.html#obsgrouping) section in FHIR Specification.
* Systems that never provide an observation without a value are not required to support Observation.dataAbsentReason.
* An Observation.component without a value, SHALL include a reason why the data is absent.\
Systems that never provide a component observation without a component value are not required to support Observation.component.dataAbsentReason.
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/uscdi-data-class/assessment-and-plan-treatment#uscdi-v2) for Observation - refer to [US Core Observation Survey Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-survey.html). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------------------------------------------------------------------------ | ---------------------------- |
| status | Observation.status |
| a category code of “survey” | Observation.category |
| a [LOINC](http://loinc.org/) code, if available, which tells you the survey question | Observation.code |
| a patient | Observation.subject |
| a time indicating when survey was taken | Observation.effective\[x] |
| the answer or a reason why the data is absent | Observation.dataAbsentReason |
| who answered the questions | Observation.performer |
| related questionnaire responses or observations that this observation is made from | Observation.derivedFrom |
| reference to observations that make up this observation | Observation.value\[x] |
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `status`
* `Slices for category`
* `category:survey`
* `code`
* `subject`
* `effectiveDateTime`
* `performer`
* `value[x]`
* `valueQuantity`
* `valueString`
* `valueCodeableConcept`
* `dataAbsentReason`
* `hasMember`
* `derivedFrom`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Observations for a patient and category search parameters:\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey`
**SHALL** support searching for all Observations for a patient and code search parameters:
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}}`
**SHALL** support searching for all Observations for a patient and category and date search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}&...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
*The following search parameter combinations**SHOULD** be supported (**optional**):*
**SHOULD** support searching using the combination of the patient and category and status search parameters:
* including support for OR search on status (e.g.status=\{system|}|\{code},\{system|}|\{code},...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status={system|}|{code}{,{system|}|{code},...}`
**SHOULD** support searching using the combination of the patient and code and date search parameters
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}}&...)\
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation By Patient Id
Search for Observation by patient.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation By Id
Get Observation by ID.
**METHOD** *GET*
```
[base url]/Observation/{id}
```
or
```
[base url]/Observation?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{id} - Id for Observation resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by patient and category search parameters
Get Observations using the combination of the patient and category search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and date search parameters
Get Observations using the combination of the patient and category and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{date} - observation effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code search parameters
Get Observations using the combination of the patient and code search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - system used to identify observation code\
\{code} - observation code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7 \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code and date search parameters
Get Observations using the combination of the patient and code and date search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}&date={gt|lt|ge|le}{date}{&date={gt|lt|ge|le}{date}&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{system|} - terminology system used to identify observation code\
\{code} - observation code\
\{date} - observation effective date
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|76690-7&date=ge2018-03-14T00:00:00Z\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and status search parameters
Get Observations using the combination of the patient and category and status search parameters:
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&category=category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status={status_system}|{status}{,{status_system}|{status},...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type} - Type for the Reference. *Example:* `Patient`\
\[id] - patient id\
\{status\_system} - terminology system used to identify observation status\
\{status} - observation status
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status=final\
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Patient
Source: https://help.elationhealth.com/articles/fhir/uscdi-patient
## Overview
Demographics and other administrative information about an individual receiving care or other health-related services. This information is used to categorize individuals for identification, records matching, and other purposes.
**Each Patient has next elements:**
* a patient identifier (e.g. MRN)
* a patient name
* a gender\*
**Each Patient supports next elements:**
* contact detail (e.g. a telephone number or an email address)
* a birth date
* an address
* a communication language
* a race
* an ethnicity
* a birth sex\*
### Handling Previous Name, Suffix and Previous address
* Note that Previous Name, Suffix, and Previous address are listed in the USCDI.
* Suffix is represented using the Patient.name.suffix element.
* Previous name is represented by setting Patient.name.use to “old” and providing an end date in Patient.name.period element if known
* Previous address is represented by setting Patient.address.use to “old” and providing an end date in Patient.address.period element if known.
* The patient example below demonstrates the usage of both of these elements.
**Profile specific implementation guidance:**
* Note that Previous Name, Suffix, and Date of Death are listed in the U.S. Core Data for Interoperability.
* Suffix is represented using the Patient.name.suffix element.
* Previous name is represented by providing an end date in the Patient.name.period element for a previous name.
* Date of Death is communicated using the Patient.deceasedDateTime element.
* The patient example below demonstrates the usage of both of these elements.
* \*The FHIR Specification provides guidance and background for representing patient gender. The American Clinical Laboratory Association (ACLA) has published best practice guidelines for administrative and clinical gender related to laboratory testing and reporting which implementers may find helpful as well.
This resource conforms to **[USCDI v3 profile](https://www.healthit.gov/isa/uscdi-data-class/patient-demographicsinformation)** for Patient Demographics/Information - refer to [US Core Patient Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html). Patient response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ---------------------- | --------------------------------------------------------------------------------------------------------------------------------------------- |
| First Name/Middle Name | Patient.name.given |
| Patient description | Patient.description |
| Last Name | Patient.name.family |
| Previous Name | Patient.name |
| Suffix | Patient.name.suffix |
| Birth Sex | [US Core Birth Sex Extension](http://hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html) |
| Date of Birth | Patient.birthDate |
| Race | [US Core Race Extension](http://hl7.org/fhir/us/core/StructureDefinition-us-core-race.html) |
| Ethnicity | [US Core Ethnicity Extension](http://hl7.org/fhir/us/core/StructureDefinition-us-core-ethnicity.html) |
| Sexual Orientation | [Us Core Sexual Orientation Observation Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-sexual-orientation.html) |
| Gender Identity | [Us Core Gender Identity Extension](http://hl7.org/fhir/us/core/StructureDefinition-us-core-genderIdentity.html) |
| Preferred Language | Patient.communication |
| Address | Patient.address |
| Phone Number | Patient.telecom |
### Must support elements, mandatory and optional search parameters
*Patient**must support** these elements:*
* `us-core-race` *(Must support in USCDI v3)*
* `us-core-ethnicity` *(Must support in USCDI v3)*
* `us-core-tribal-affiliation` *(Must support in USCDI v3)*
* `us-core-sex` *(Must support in USCDI v3)*
* `us-core-genderIdentity` *(Must support in USCDI v3)*
* `identifier`
* `system`
* `value`
* `name`
* `family`
* `given`
* `suffix` *(Must support in USCDI v3)*
* `telecom`
* `system`
* `value`
* `use`
* `gender`
* `birthDate`
* `deceasedDateTime` *(Must support in USCDI v3)*
* `address`
* `line`
* `city`
* `state`
* `postalCode`
* `communication`
* `language`
**The following search parameters and search parameter combinations SHALL be supported:**
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Patients for a patient using \_id search parameter:
`GET [base url]/Patient/{id}` or `GET [base url]/Patient?_id={id}`
**SHALL** support searching patient by an identifier such as a MPI using the identifier search parameter:
`GET [base url]/Patient?identifier={system|}[code]`
**SHALL** support searching patient by a server defined search that matches any of the string fields in the HumanName, including family, given, prefix, suffix, and/or text using the name search parameter:
`GET [base url]/Patient?name=[string]`
**SHALL** support searching using the combination of the birthdate and name search parameters:
`GET [base url]/Patient?birthdate={date}&name=[string]`
**SHALL** support searching using the combination of the gender and name search parameters:
`GET [base url]/Patient?gender={system|}[code]&name=[string]`
**The following search parameter combinations SHOULD be supported (optional):**
**SHOULD** support searching using the combination of the birthdate and family search parameters:
`GET [base url]/Patient?birthdate={date}&family=[string]`
**SHOULD** support searching using the combination of the death-date and family search parameters:
`GET [base]/Patient?death-date=[date]&family=[string]`
**SHOULD** support searching using the combination of the family and gender search parameters:
`GET [base url]/Patient?family=[string]&gender={system|}[code]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Patient By Id
Get Patient by ID.
**METHOD** *GET*
```
[base url]/Patient/{id}
```
or
```
[base url]/Patient?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Patient resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Patient by an identifier
Get Patients using patient by an identifier such as a MPI using the identifier search parameter
**METHOD** *GET*
```
GET [base url]/Patient?identifier={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - The namespace for the identifier value
\{code} - patient unique identifier value
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?identifier=http://hospital.smarthealthit.org|1032702' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Patient by HumanName
Get Patients using matches any of the string fields in the HumanName, including family, given, prefix, suffix, and/or text using the name search parameter:
**METHOD** *GET*
```
GET [base url]/Patient?name=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - family or given name of the patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?name=Shaw' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Patient by birthdate and name search parameters
Get Patients using the combination of the birthdate and name search parameters
**METHOD** *GET*
```
GET [base url]/Patient?birthdate={date}&name=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - family or given name of the patient
\{date} - birthdate of the patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?birthdate=1995-09-24&name=Shaw' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Patient by gender and name search parameters
Get Patients using the combination of gender and name search parameters
**METHOD** *GET*
```
GET [base url]/Patient?gender={system|}[code]&name=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{system|} - terminology system used to identify patient's gender
\{code} - patient's gender
\[string] - family or given name of the patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?name=Shaw&gender=female' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Patient by birthdate and family search parameters
Get Patients using the combination of birthdate and family search parameters
**METHOD** *GET*
```
GET [base url]/Patient?birthdate={date}&family=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{date} - patient's birthdate
\[string] - patient's family name
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?family=Shaw&birthdate=2007-03-20' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Patient by death-date and family search parameters
Get Patients using the combination of death-date and family search parameters
**METHOD** *GET*
```
GET [base url]/Patient?death-date={date}&family=[string]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{date} - patient's death-date
\[string] - patient's family name
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?death-date=Shaw&birthdate=2007-03-20' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Patient by family and gender search parameters
Get Patients using the combination of family and gender search parameters
**METHOD** *GET*
```
GET [base url]/Patient?family=[string]&gender={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[string] - patient's family name
\{system|} - terminology system used to identify patient's gender
\{code} - patient's gender
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?family=Shaw&gender=female' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Procedure
Source: https://help.elationhealth.com/articles/fhir/uscdi-procedure
## Overview
The Procedure resource is used to record the details of current and historical procedures performed on or for a patient, such as surgical procedures, diagnostic procedures, endoscopic procedures, biopsies, counseling, physiotherapy, personal support services, adult day care services, non-emergency transportation, home modification, exercise, etc. Procedures may be performed by a healthcare professional, a service provider, a friend or relative or in some cases by the patient themselves.
If a procedure includes an implantable device , this would be represented as:
* `Procedure.focalDevice with a reference to the US Core Implantable Device Profile`\
Procedure codes can be taken from SNOMED-CT, CPT, HCPCS II, ICD-10-PCS, CDT. LOINC.\
Only LOINC concepts that reflect actual procedures SHOULD be used
Each Procedure has next elements:
* a status
* a code that identifies the type of procedure performed on the patient
* a patient
* when the procedure was performed
Profile specific implementation guidance:
* Procedure codes can be taken from SNOMED-CT, CPT, HCPCS II, ICD-10-PCS, CDT, or LOINC.
* Only LOINC concepts that reflect actual procedures SHOULD be used.
* A procedure including an implantable device SHOULD use Procedure.focalDevice with a reference to the US Core Implantable Device Profile.
* See the [Screening and Assessments](http://hl7.org/fhir/us/core/STU6.1/screening-and-assessments.html) guidance page for more information when exchanging Social Determinants of Health (SDOH) Procedures.
* The Reason or justification for a referral or consultation is communicated through the US Core ServiceRequest Profile which can be linked to the Procedure through the \`Procedure.basedOn’ element.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isa/united-states-core-data-interoperability-uscdi) for Procedure - refer to [StructureDefinition US Core Procedure](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-procedure.html). Procedure response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ------------------------ | ------------------- |
| status | Procedure.status |
| procedure code | Procedure.code |
| patient | Procedure.subject |
| procedure performed date | Procedure.performed |
### Must support elements, mandatory and optional search parameters
*Procedure**must support** these elements:*
* `status`
* `code`
* `subject`
* `performed[x]`
* `performedDateTime`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all Procedure for a patient using the patient search parameter:
`GET [base url]/Procedure?patient={Type/}[id]`
**SHALL** support searching using the combination of the `patient` and `date` search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date
`GET [base url]/Procedure?patient={Type/}[id]&date=[date]`
The following search parameter combinations **SHOULD** be supported (**optional**):
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for OR search on status
`GET [base url]/Procedure?patient={Type/}[id]&status={system|}[code],{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `code` and `date` search parameters:
* including optional support for OR search on code
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date
`GET [base url]/Procedure?patient={Type/}[id]&code={system|}[code]&date=[date]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Procedure By Patient Id
Search for Procedure by patient.
**METHOD** *GET*
```
[base url]/Procedure?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Procedure?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Procedure By Id
Get Procedure by ID.
**METHOD** *GET*
```
[base url]/Procedure/{id}
```
or
```
[base url]/Procedure?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Procedure resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Procedure/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Procedure by patient and date
Get Procedures for the specified patient and date
**METHOD** *GET*
```
GET [base url]/Procedure?patient={Type/}[id]&date={gt|lt|ge|le}[date]&date={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - patient id
\[date] - an estimated or actual date, when the procedure was performed
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Procedure?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&date=ge2019-01-14' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Procedure by patient and status
Get Procedure by patient id and procedure status
**METHOD** *GET*
```
`GET [base url]/Procedure?patient={Type/}[id]&status={system|}[code],{system|}[code],...}`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - a patient id
\{system|} - an identity of the terminology system, used to specify the state of the procedure . FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{code} - a code specifying the state of the procedure
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Procedure?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&status=completed' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Procedure of the patient and code and date search parameters
Fetches a bundle of all Procedure resources for the specified patient and date and procedure code(s)
**METHOD** *GET*
```
`GET [base url]/Procedure?patient={Type/}[id]&code={system|}[code]&date=[date]`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - patient id
\{system|} - an identity of the terminology system, used to specify the state of the procedure . FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{code} - a code specifying the state of the procedure
\[date] - an estimated or actual date, when the procedure was performed
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Procedure?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&date=ge2019-01-14T00:00:00Z&code=http://snomed.info/sct|35637008' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Service Request
Source: https://help.elationhealth.com/articles/fhir/uscdi-procedure-service-request
## Overview
ServiceRequest is a record of a request for a procedure or diagnostic or other service to be planned, proposed, or performed, as distinguished by the ServiceRequest.intent field value, with or on a patient. The procedure will lead to either a Procedure or DiagnosticReport, which in turn may reference one or more Observations, which summarize the performance of the procedures and associated documentation such as observations, images, findings that are relevant to the treatment/management of the subject
**Example Usage Scenarios:**
The following are example usage scenarios for the this profile:
Query for a specific procedure or test request such as an electrocardiogram (ECG) order or a referral to a support program.\
Query for a specific service offered to a patient such as a referral to a support program.\
Query for category of service request (e.g. all cardiology requests)
**Each Service Request has next elements:**
* a status
* an intent code indicating whether the request is a proposal, plan, or order.
* a code defining what is being requested
* a patient
## Profile specific implementation guidance
* The ServiceRequest.category binding Must Support, at a minimum, the US Core ServiceRequest Category Codes. However, this valueset can be treated as extensible, and other category codes can be used instead.
* The ServiceRequest.code valueset is broad to accommodate a wide variety of use cases andSHOULDbe constrained to a subset for a particular use case or domain. (for example, LOINC for laboratory orders.)
* The ServiceRequest resource can communicate the reason or indication for referral or consultation using either a code in ServiceRequest.reasonCode or a reference using ServiceRequest.reasonReference.
* As documented here, when using ServiceRequest.reasonReference, the referenced resources SHOULD be a US Core Profile.
* See the [Screening and Assessments](http://hl7.org/fhir/us/core/STU6.1/screening-and-assessments.html) guidance page for more information when exchanging Social Determinants of Health (SDOH) Service Requests.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isp/uscdi-data-class/procedures#uscdi-v3) for Procedure - refer to [StructureDefinition US Core ServiceRequest](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-servicerequest.html). ServiceRequest response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*ServiceRequest**must support** these elements:*
* `status`
* `intent`
* `category`
* `category:us-core`
* `code`
* `subject`
* `occurrence[x]`
* `authoredOn`
* `requester`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support both read ServiceRequest by id AND ServiceRequest search using the `_id` search parameter:
`GET [base url]/ServiceRequest/[id]` or `GET [base url]/ServiceRequest?_id=[id]`
**SHALL** support searching for all ServiceRequest for a patient using the `patient` search parameter:
`GET [base url]/ServiceRequest?patient={Type/}[id]`
**SHALL** support searching using the combination of the `patient` and `category` search parameters:
`GET [base url]/ServiceRequest?patient={Type/}[id]&category={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `code` search parameters:
* including optional support for OR search on code
`GET [base url]/ServiceRequest?patient={Type/}[id]&code={system|}[code]`
**SHALL** support searching using the combination of the `patient` and `category` and `authored` search parameters:
* including support for these authored comparators: gt,lt,ge,le
* including optional support for AND search on authored
`GET [base url]/ServiceRequest?patient={Type/}[id]&category={system|}[code]&authored=[date]`
The following search parameter combinations **SHOULD** be supported (**optional**):
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for OR search on status
`GET [base]/ServiceRequest?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `code` and `authored` search parameters:
* iincluding optional support for OR search on code
* including support for these authored comparators: gt,lt,ge,le
* including optional support for AND search on authored
`GET [base]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## ServiceRequest By Patient Id
Search for ServiceRequest by patient.
**METHOD** *GET*
```
[base url]/ServiceRequest?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## ServiceRequest By Id
Get ServiceRequest by ID.
**METHOD** *GET*
```
[base url]/ServiceRequest/{id}
```
or
```
[base url]/ServiceRequest?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for ServiceRequest resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest?_id=c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
**Implementation Notes:** This search allows searching by the logical id of the ServiceRequest resource using either the direct read operation or the `_id` search parameter.
## ServiceRequest by patient and category
Get ServiceRequests for the specified patient and category
**METHOD** *GET*
```
GET [base url]/ServiceRequest?patient={Type/}[id]&category={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - patient id
\{system|} - an identity of the terminology system used to specify the category of service request. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{code} - a code specifying the category of service request (e.g., laboratory, imaging, consult)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://snomed.info/sct|108252007' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## ServiceRequest by patient and code
Get ServiceRequests for the specified patient and service code
**METHOD** *GET*
```
GET [base url]/ServiceRequest?patient={Type/}[id]&code={system|}[code]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - patient id
\{system|} - an identity of the terminology system used to specify the requested service. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{code} - a code identifying the requested service
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://snomed.info/sct|76164006' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## ServiceRequest by patient and status
Get ServiceRequest by patient id and request status
**METHOD** *GET*
```
GET [base url]/ServiceRequest?patient={Type/}[id]&status={system|}[code],{system|}[code],...
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - a patient id
\{system|} - an identity of the terminology system used to specify the status of the service request. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{code} - a code specifying the status of the service request (e.g., draft, active, completed, cancelled)
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&status=active' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## ServiceRequest by patient, category, and authored date
Fetches a bundle of all ServiceRequest resources for the specified patient, category, and authored date
**METHOD** *GET*
```
GET [base url]/ServiceRequest?patient={Type/}[id]&category={system|}[code]&authored=[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - patient id
\{system|} - an identity of the terminology system used to specify the category of service request. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\{code} - a code specifying the category of service request
\[date] - the date when the service request was authored
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&authored=ge2019-01-14T00:00:00Z&category=http://snomed.info/sct|108252007' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## ServiceRequest by patient, code and authored date
Get ServiceRequests for the specified patient, code and authored date
**METHOD** *GET*
```
GET [base url]/ServiceRequest?patient={Type/}[id]&code={system|}[code]&authored={gt|lt|ge|le}[date]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - patient id
\{system|} - an identity of the terminology system used to specify the requested service. FHIR search token parameter. See [Search specification](https://www.hl7.org/fhir/search.html#token) for more information.
\[code] - a code identifying the requested service
\[date] - the date when the service request was authored
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/ServiceRequest?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://snomed.info/sct|76164006&authored=ge2019-01-14' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Provenance
Source: https://help.elationhealth.com/articles/fhir/uscdi-provenance
## Overview
Provenance of a resource is a record that describes entities and processes involved in producing and delivering or otherwise influencing that resource.
The Provenance resource tracks information about the activity that created, revised, deleted, or signed a version of a resource, describing the entities and agents involved. This information can be used to form assessments about its quality, reliability, trustworthiness, or to provide pointers for where to go to further investigate the origins of the resource and the information in it.
Each Provenance has next elements:
* a reference to the resource(s) the Provenance record is supporting (target)
* a date and time for the activity
Each Provenance must support:
* an author responsible for the update
* the author organization responsible for the information
* the transmitter that provided the information
* the transmitter organization responsible for the transmission (if the transmitter is a device the transmitter organization must also be valued).
**Profile specific implementation guidance:**
The US Core Provenance resource **SHALL** be supported for these US Core resources:
* AllergyIntolerance
* CarePlan
* CareTeam
* Condition
* Coverage
* Device
* DiagnosticReport
* DocumentReference
* Encounter
* Goal
* Immunization
* MedicationDispense
* MedicationRequest
* Observation
* Patient
* Procedure
* QuestionnaireResponse
* RelatedPerson
* ServiceRequest
* If a system receives a provider in Provenance.agent.who as free text they must capture who sent them the information as the organization. On request they SHALL provide this organization as the source and MAY include the free text provider.
* Systems that need to know the activity has occurred SHOULD populate the activity.
This resource conforms to [USCDI V3 profile](https://www.healthit.gov/isa/uscdi-data-class/provenance#uscdi-v3) for Provenance - refers to [StructureDefinition US Core Provenance](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-provenance.html). Provenance response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCDI | USCore Data Element | FHIR Resource Field |
| ------------------- | ------------------- | -------------------- |
| Author Time Stamp | recorded | Provenance.recorded |
| Author Organization | agent | Provenance.agent.who |
### Must support elements, mandatory and optional search parameters
*Provenance **must support** these elements:*
* `target`
* `reference`
* `recorded`
* `agent`
* `type`
* `agent:ProvenanceAuthor`
* `agent:ProvenanceTransmitter`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support searching for all US Core Profile resource types listed above for a patient and all the Provenance records for those resources using a combination of the `patient` and `[_revinclude]` search parameters:
`GET [base url]/[Resource]?patient=[id]&_revinclude=Provenance:target`
**SHALL** support searching for a particular instance of a US Core Profile resource type listed above and all its Provenance resources using combination of the `_id` and the \[\_revinclude] search parameters:
`GET [base url]/[Resource]?_id=[id]&_revinclude=Provenance:target`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Provenance By id
Get Provenance by id
**METHOD** *GET*
```
[base url]/Provenance/{id}
```
or
```
[base url]/Provenance?_id={id}
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{id} - Id for Provenance resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Provenance/a210cfa5-2116-c12a-fbbc-f2c323a3c1g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Resource By id and \_revinclude
Get any supported resource by `id` and corresponding provenance by usin `_revinclude` search parameter.
**METHOD** *GET*
```
[base url]/[Resource]?_id=[id]&_revinclude=Provenance:target
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[Resource] - Resource type
\[id] - Id for the resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Patient?_id=05b87542-b50e-4f19-8a87-2da2e6959bfb&_revinclude=Provenance:target' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Questionnaire Response
Source: https://help.elationhealth.com/articles/fhir/uscdi-questionnaire-response
## Overview
QuestionnaireResponse provides a complete or partial list of answers to a set of questions filled when responding to a questionnaire. This resource store to form/survey and assessment tools such as the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) Survey. This profile is based on the [Structured Data Capture (SDC) Questionnaire Response Profile](http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaireresponse.html).
QuestionnaireResponse along with the [US Core Care Plan Profile](/articles/fhir/uscdi-care-plan), [US Core Observation Survey Profile](/articles/fhir/uscdi-observation-survey), [US Core Observation SDOH Profile](/articles/fhir/uscdi-observation-sdoh-assessment) and [US Core Observation Social History Profile](/articles/fhir/uscdi-observation-social-history) meets the US Core Data for Interoperability (USCDI) v2 Assessment and Plan of Treatment requirements.
**Example Usage Scenarios:**
The following are example usage scenarios for this profile:
* Query for survey screening results for a patient.
* Record or update screening results results belonging to a Patient
Each QuestionnaireResponse has next elements:
* a reference back to the assessment upon which it is based
* a status
* a patient
* the date the answers were gathered
Each QuestionnaireResponse must support:
* a tag to indicate context like SDOH
* a practitioner who recorded the answers
* the questions and decimal, string, and coded type answers
* each question must have a identifier the pointing to question
**Profile specific implementation guidance:**
* The SDC profile (from which this profile is derived) focuses on the constraints appropriate to capturing the “answer(s)” to a [FHIR Questionnaire](http://hl7.org/fhir/R4/questionnaire.html) and demands that the Questionnaire’s canonical URL be specified. If the QuestionnaireResponse is based on a non-FHIR form:
1. Construct a FHIR Questionnaire which represents at least the relevant metadata (in other words, the actual questions may be omitted).
2. Communicates the identifier of the non-FHIR form instead of the canonical URI using the [US Core Extension Questionnaire URI](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-extension-questionnaire-uri.html) extension.
* See the [SDOH](https://www.hl7.org/fhir/us/core/sdoh.html) guidance page for how this profile or alternatively Observations can be used represent SDOH assessments.
* QuestionnaireResponse can be searched using the standard FHIR RESTful API search parameters.
* The basic workflow for the creation, discovery and retrieval and data-extraction of FHIR Questionnaire and QuestionnaireResponse is thoroughly documented in the [Structured Data Capture (SDC](http://hl7.org/fhir/uv/sdc) implementation guide.
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/uscdi-data-class/assessment-and-plan-treatment#uscdi-v2) for Assessment and Plan of Treatment - refers to [US Core QuestionnaireResponse Profile](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-questionnaireresponse.html). QuestionnaireResponse response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*QuestionnaireResponse**must support** these elements:*
* meta
* tag
* Slices:
* All slices
* :sdoh
* identifier
* questionnaire
* display
* us-core-extension-questionnaire-uri
* status
* subject
* authored
* author
* item
* linkId
* text
* answer
* value\[x]
* valueDecimal
* valueString
* valueCoding
* item
* item
*The following search parameters and search parameter combinations SHALL be supported (**mandatory**):*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support fetching a QuestionnaireResponse using the \_id search parameter:
`GET [base url]/QuestionnaireResponse[id]`
**SHALL** support searching for all QuestionnaireResponse for a patient using the patient search parameter:
`GET [base]/QuestionnaireResponse?patient={Type/}[id]`
*The following search parameters and search parameter combinations SHOULD be supported (**optional**):*
**SHOULD** support searching using the combination of the `patient` and `status` search parameters:
* including support for OR search on status (e.g.status=\{system|}\[code],\{system|}\[code],...)
`GET [base url]/QuestionnaireResponse?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}`
**SHOULD** support searching using the combination of the `patient` and `_tag` search parameters:
`GET [base url]/QuestionnaireResponse?patient={Type/}[id]&_tag=sdoh`
**SHOULD** support searching using the combination of the `patient` and `authored` search parameters:
* including support for these authored comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on authored (e.g.authored=\[date]\&authored=\[date]]&...)
`GET [base url]/QuestionnaireResponse?patient={Type/}[id]&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `_tag` and `authored` search parameters:
* including support for these authored comparators: `gt`,`lt`,`ge`,`le`
* including optional support for *AND* search on `authored` (e.g. `authored=[date]&authored=[date]]&...`)
`GET [base]/QuestionnaireResponse?patient={Type/}[id]&_tag=sdoh&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}`
**SHOULD** support searching using the combination of the `patient` and `questionnaire` search parameters:
`GET [base url]/QuestionnaireResponse?patient={Type/}[id]&questionnaire={Type/}[id]`
## QuestionnaireResponse by Id
Get a QuestionnaireResponse by id
**METHOD** *GET*
```
GET [base url]/QuestionnaireResponse/[id]
```
or
```
GET [base url]/QuestionnaireResponse?_id=[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - QuestionnaireResponse id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/QuestionnaireResponse/b110cfa5-ab16-b12a-fbbc-f22323a3c1g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## QuestionnaireResponse by patient
Fetches a bundle of all QuestionnaireResponse resources for the specified patient
**METHOD** *GET*
```
GET [base url]/QuestionnaireResponse?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type. *Example:* `Patient/`\
\[id] - patient id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/QuestionnaireResponse?patient=Patient/a210cfa5-2116-c12a-fbbc-f2c323a3c1g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## QuestionnaireResponse by patient and status
Fetches a bundle of all QuestionnaireResponse resources for the specified patient and status
**METHOD** *GET*
```
GET [base url]/QuestionnaireResponse?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type. *Example:* `Patient/`\
\[id] - patient id\
\{system|} - The system for the category\
\[code] - code in the system, e.g. `completed`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/QuestionnaireResponse?patient=Patient/a210cfa5-2116-c12a-fbbc-f2c323a3c1g7&status=completed' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## QuestionnaireResponse by patient and \_tag
Fetches a bundle of all QuestionnaireResponse resources for the specified patient and \_tag= 'sdoh'
**METHOD** *GET*
```
GET [base url]/QuestionnaireResponse?patient={Type/}[id]&_tag=sdoh
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type. *Example:* `Patient/`\
\[id] - patient id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/QuestionnaireResponse?patient=Patient/a210cfa5-2116-c12a-fbbc-f2c323a3c1g7&_tag=sdoh' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## QuestionnaireResponse by patient and authored
Fetches a bundle of all QuestionnaireResponse resources for the specified patient and date
**METHOD** *GET*
```
GET [base url]/QuestionnaireResponse?patient={Type/}[id]&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type. *Example:* `Patient/`\
\[id] - patient id\
\[date] - an estimated or actual date, when the QuestionnaireResponse signed\
\{gt|lt|ge|le} - search modifiers for date parameter. See [Search specification](https://www.hl7.org/fhir/search.html#date) for more information
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/QuestionnaireResponse?patient=Patient/a210cfa5-2116-c12a-fbbc-f2c323a3c1g7&date=ge2022' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## QuestionnaireResponse by patient and \_tag and authored
Fetches a bundle of all QuestionnaireResponse resources tagged as 'sdoh' for the specified patient and date
**METHOD** *GET*
```
GET [base url]/QuestionnaireResponse?patient={Type/}[id]&_tag=sdoh&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type. *Example:* `Patient/`\
\[id] - patient id\
\[date] - an estimated or actual date, when the QuestionnaireResponse signed\
\{gt|lt|ge|le} - search modifiers for date parameter. See [Search specification](https://www.hl7.org/fhir/search.html#date) for more information
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/QuestionnaireResponse?patient=Patient/a210cfa5-2116-c12a-fbbc-f2c323a3c1g7&_tag=sdoh&date=ge2022' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## QuestionnaireResponse by patient and questionnaire
Fetches a bundle of all QuestionnaireResponse resources for the specified patient that have been completed against a specified form
**METHOD** *GET*
```
GET [base]/QuestionnaireResponse?patient={Type/}[id]&questionnaire={Type/}[questionnaire_id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{Type/} - optional reference type. *Example:* `Patient/`\
\[id] - patient id\
\[questionnaire\_id] - questionnaire id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/QuestionnaireResponse?patient=Patient/a210cfa5-2116-c12a-fbbc-f2c323a3c1g7&questionnaire=http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnaireHungerVitalSign' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Smoking Status
Source: https://help.elationhealth.com/articles/fhir/uscdi-smoking-status
## Overview
Representing a patient’s smoking behavior through the core FHIR Observation Resource.
The profile restricts observation code to be set in 72166-2 Tobacco smoking status NHIS (LOINC).
Each Observation has next elements:
* a status
* a category code of ‘social-history’
* a code for smoking observation
* a patient
* a date representing when the smoking status was recorded
* a result value code for smoking status
**Profile specific implementation guidance:**
This resource conforms to [USCDI V2 profile](https://www.healthit.gov/isa/united-states-core-data-interoperability-uscdi#uscdi-v2) for Observation - refer to [US Core Observation Profile](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-smokingstatus.html). Observation response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
| USCore Data Element | FHIR Resource Field |
| ---------------------------- | --------------------- |
| status | Observation.status |
| code | Observation.code |
| patient | Observation.subject |
| smoking status recorded date | Observation.effective |
| value | Observation.value |
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `status`
* `Slices for category`
* ` category:SocialHistory`
* `code`
* `subject`
* `effectiveDateTime`
* `valueCodeableConcept`
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support searching for all Observation for a patient using the patient and code search parameters:
* including optional support for OR search on code (e.g.code=\{system|}`[code]`,\{system|}`[code]`)
`GET [base url]/Observation?patient={Type/}`\[id]`&code=http://loinc.org|72166-2`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation By Patient Id
Search for Observation by patient.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation By Id
Get Observation by ID.
**METHOD** *GET*
```
[base url]/Observation/{id}
```
or
```
[base url]/Observation?_id={id}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
`{id}` - Id for Observation resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by patient and code
Get Observations for the specified patient and code search parameters
**METHOD** *GET*
```
GET [base url]/Observation?patient={Type/}[id]&code=http://loinc.org|72166-2
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - patient id\
`{Type/}` - Type for the Reference. *Example:* `Patient`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|72166-2' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Specimen Information
Source: https://help.elationhealth.com/articles/fhir/uscdi-specimen
## Overview
Specimen Information addresses:
* Specimen HL7® FHIR® resource with [US Core Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-specimen.html)
The Specimen resource describes a sample of a physical substance collected from a patient for laboratory analysis, diagnostic testing, or other purposes. This profile meets the U.S. Core Data for Interoperability (USCDI) v3 requirements for Specimen Information.
Specimens can include blood, urine, tissue samples, swabs, and other biological materials collected for testing. The Specimen resource provides information about what was collected, how it was collected, when it was collected, and its current status.
**Each Specimen Must Have:**
* a specimen code
**Each Specimen Must Support:**
* a patient
**Profile Specific Implementation Guidance:**
* Since the binding is extensible when a code is unavailable, just text is allowed.
* in addition to Specimen search criteria, clients may request Specimen resources be included with Observation or DiagnosticReport resource query. An example query is provided in the Notes section below.
This resource conforms to [USCDI v3](https://www.healthit.gov/isp/uscdi-data-class/clinical-tests#uscdi-v3) for Specimen - refers to [US Core Specimen Profile 6.1.0](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-specimen.html). Specimen response will be provided in JSON (refers to Capability Statement) format as per [FHIR](https://hl7.org/fhir) standard R4 version.
### Must support elements, mandatory and optional search parameters
*Specimen **must support** these elements:*
* `type`
* `subject`
*Each Specimen Must Have (Mandatory):*
* `type`
*The following search parameters and search parameter combinations SHALL be supported:*
The syntax used to describe the interactions is described [here](/articles/fhir/us-core-guidance).
**SHALL** support both read Specimen by `id` **AND** Specimen search using the `_id` search parameter:
`GET [base url]/Specimen/[id]`
`GET [base url]/Specimen?_id=[id]`
*The following search parameter combinations SHOULD be supported:*
**SHOULD** support searching using the `patient` search parameter:
`GET [base url]/Specimen?patient={Type/}[id]`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
*The following search parameter combinations MAY be supported:*
**MAY** support searching for Observation resources that reference a Specimen using the `_include` parameter:
`GET [base url]/[Resource-type]?_id=[id]&_include=Observation:specimen`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Specimen by ID
Read a single Specimen resource by its ID.
**METHOD** *GET*
```
GET [base url]/Specimen/[id]
```
**PARAMS**
\[base url] \* [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Specimen's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Specimen/specimen-123' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Specimen Search by ID
Search for Specimen using the `_id` search parameter.
**METHOD** *GET*
```
GET [base url]/Specimen?_id=[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Specimen's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Specimen?_id=specimen-123' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Specimen by Patient
Search for Specimen using the `patient` parameter.
**METHOD** *GET*
```
GET [base url]/Specimen?patient={Type/}[id]
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\{Type/} - Reference type for the patient resource. *Example:* `Patient/`
\[id] - Patient's id
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Specimen?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation with Included Specimen
Search for Observation resources with included Specimen references.
**METHOD** *GET*
```
GET [base url]/Observation?_id=[id]&_include=Observation:specimen
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)
\[id] - Observation's id
\_include - Include related Specimen resources in the response bundle
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?_id=9163726&_include=Observation:specimen' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
# Vital Signs
Source: https://help.elationhealth.com/articles/fhir/uscdi-vital-signs
## Overview
Vital Signs are represented as an FHIR Observation resources, restricted by [US Core Vital Signs Profile](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-vital-signs.html). Each specific vital sign should also conform to its own profile as it is listed below:
**Supported Profiles**
| Vital Sign | US Core Profile | Observation LOINC code |
| ------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------- |
| Systolic\Diastolic blood pressure | [Blood pressure systolic and diastolic (FHIR Core Profile)](http://hl7.org/fhir/R4/bp.html) | 85354-9 |
| Heart Rate | [Heart rate (FHIR Core Profile)](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-heart-rate.html) | 8867-4 |
| Respiratory rate | [Respiratory rate (FHIR Core Profile)](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-respiratory-rate.html) | 9279-1 |
| Body temperature | [Body temperature (FHIR Core Profile)](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-body-temperature.html) | 8310-5 |
| Body height | [ Body height (FHIR Core Profile)](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-body-height.html) | 8302-2 |
| Body weight | [Body weight (FHIR Core Profile)](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-body-weight.html) | 29463-7 |
| Pulse oximetry | [US Core Pulse Oximetry Profile ](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-pulse-oximetry.html) | 59408-5 and 3151-8 (flow rate) and 3150-0 (concentration) |
| Inhaled oxygen concentration | [US Core Pulse Oximetry Profile ](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-pulse-oximetry.html) | 2708-6 |
| BMI Percentile (2-20 years old) | [US Core Pediatric BMI for Age Observation Profile](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-pediatric-bmi-for-age.html) | 59576-9 |
| Weight-for-length Percentile (Birth - 36 months) | [US Core Pediatric Weight for Height Observation Profile ](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-pediatric-weight-for-height.html) | 77606-2 |
| Occipital Frontal Head Circumference Percentile (Birth - 36 months) | [US Core Pediatric Head Occipital Frontal Circumference Percentile Profile](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-head-occipital-frontal-circumference-percentile.html) | 8289-1 |
Each Observation has next elements:
* a status
* a category code of “vital-signs”
* a LOINC code, if available, which tells you what is being measured
* a patient
* a clinically relevant time
Each Observation must support:
* a result value
* if the result value is a numeric quantity, a standard UCUM unit
* a reason if the value is absent\*
* component results
### Must support elements, mandatory and optional search parameters
*Observation**must support** these elements:*
* `status`
* `Slices for category`
* `category:VSCat`
* `coding`\
-`system`\
-`code`
* `code`
* `subject`
* `effectiveDateTime`
* `valueQuantity`
* `dataAbsentReason`
* `component`\
-`code`\
-`valueQuantity`\
-`dataAbsentReason`
*The following search parameters and search parameter combinations SHALL be supported:*
**SHALL** support searching for all Observation for a patient using the patient and category search parameters:
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs`
**SHALL** support searching using the combination of the patient and code search parameters:
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}`
**SHALL** support searching using the combination of the patient and category and date search parameters:
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}...)\
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date={gt|lt|ge|le}{date}}`
*The following search parameters and search parameter combinations SHOULD be supported:*\
**SHOULD** support searching using the combination of the patient and category and status search parameters:
* including support for OR search on status (e.g.status=\{system|}|\{code},\{system|}|\{code},...)
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status={system|}|{code}`
**SHOULD** support searching using the combination of the patient and code and date search parameters:
* including optional support for OR search on code (e.g.code=\{system|}|\{code},\{system|}|\{code},...)
* including support for these date comparators: gt,lt,ge,le
* including optional support for AND search on date (e.g.date=\{date}\&date=\{date}...)
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code},{system|}|{code},...}&date={gt|lt|ge|le}{date}`
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
## Observation By Patient Id
Search for Observation by patient.
**METHOD** *GET*
```
[base url]/Observation?patient={Type/}[id]
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - Id for the Patient
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation By Id
Get Observation by ID.
**METHOD** *GET*
```
[base url]/Observation/{id}
```
or
```
[base url]/Observation?_id={id}
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\{id} - Id for Observation resource
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'
```
## Observation by patient and category
Get Observations for the specified patient and category search parameters:
**METHOD** *GET*
```
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs`
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - patient id\
\{Type/} - Type for the Reference. *Example:* `Patient`
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code
Get Observations for the specified patient and code search parameters:
**METHOD** *GET*
```
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code}{,{system|}|{code},...}`
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - patient id\
\{Type/} - Type for the Reference. *Example:* `Patient`\
\{code} - observation code\
\{system|} - terminology system used to represend observation code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|8867-4,http://loinc.org|9279-1,http://loinc.org|85354-9' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and date search parameters
Get Observations for the specified patient and category and date search parameters:
**METHOD** *GET*
```
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date={gt|lt|ge|le}{date}`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - patient id\
\{Type/} - Type for the Reference. *Example:* `Patient`\
\{date} - observation effective date\
\{gt|lt|ge|le} - prefix for date value
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date=ge2020-01-01T00:00:00Z' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and category and status search parameters
Get Observations for the specified patient and category and status search parameters::
**METHOD** *GET*
```
`GET [base url]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status={system|}|{code}`
```
**PARAMS**
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - patient id\
\{Type/} - Type for the Reference. *Example:* `Patient`\
\{date} - observation effective date\
\{gt|lt|ge|le} - prefix for date value
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status=final' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
## Observation by patient and code and date search parameters
Get Observations for the specified patient and code and date search parameters:
**METHOD** *GET*
```
`GET [base url]/Observation?patient={Type/}[id]&code={system|}|{code},{system|}|{code},...}&date={gt|lt|ge|le}{date}`
```
**PARAMS**\
\[base url] - [FHIR base url](/articles/fhir/service-base-urls)\
\[id] - patient id\
\{Type/} - Type for the Reference. *Example:* `Patient`\
\{date} - observation effective date\
\{gt|lt|ge|le} - prefix for date value\
\{code} - observation code\
\{system|} - terminology system used to represend observation code
**HEADERS**
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to [Authentication and Authorization](/articles/fhir/authentication-authorization) for further details.
| Header | Type | Required/Optional | Value |
| ------------- | ---------- | ----------------- | ---------------- |
| Authorization | **string** | required | `Bearer ` |
**RESPONSES**
| Code | Description | Comment |
| ---- | ---------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------- |
| 200 | OK | The request was processed successfully |
| 400 | Bad request | Invalid request parameters or FHIR operation outcome resource returned |
| 401 | Unauthorized | This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource |
| 404 | No route matched with those values | The request was able to communicate with a given server, but the server could not find what was requested |
| 500 | Internal Server Error | The server has encountered a situation it doesn't know how to handle |
**EXAMPLE:**
```
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Observation?patient=Patient/fe1cd986-1ac7-4c26-b8b3-d632a48408fd&code=http://loinc.org|8867-4,http://loinc.org|9279-1,http://loinc.org|85354-9&date=ge2020-01-01T00:00:00Z' \
--header 'Authorization: Bearer 1239b275-909e-4754-8f73-1e411fd6769e'
```
# Filing a Claim
Source: https://help.elationhealth.com/articles/filing-a-claim
Learn how to create and file claims in Elation Billing
This article provides step-by-step instructions on how to set up a superbill, file a claim, submit a claim, and change fees in Elation Billing.
## Overview
### What is Filing a Claim?
Filing a claim is the process of creating and submitting a superbill in Elation Billing to request reimbursement from insurance payers or patients for services rendered.
### Why is Filing a Claim important?
Properly filing claims ensures that your practice receives timely and accurate reimbursement for the healthcare services you provide. It also maintains accurate billing records and supports efficient revenue cycle management.
## Workflow Instructions
### Integrated/AiO Claims Creation
Typically\*, AiO claims will be created in Elation Billing once the Visit Note with Billing Information has been Signed in the EHR. If you have Delayed Billing activated in the EHR, you can scrub and transmit the signed notes via Billing Home.
Any edits made to a Note in the EHR after it has been sent to the Billing Software must also be manually updated within the Billing Software.
Once the claim has been created and reviewed in Elation Billing, proceed to Step 8 - Lightning Bill of these instructions.
\*For claims that need billing and are not tracked in the EHR, follow the steps below!
### Creating a Superbill in Elation Billing
1. **Navigate** - Hover over the **Billing** tab and select **+ New Superbill**.
2. **Add the Patient** - Under **NEW SUPERBILL**, click the blue **Add Patient** button.
At this point, you can either Select an existing patient, or Add a New Patient.
To quickly find an existing patient, you can use the Search bar and search by First Name, Last Name, or DOB (YYYY-MM-DD), and then click **SELECT** on the patient required.
Once you have Selected the patient, you have three new options - (L to R) **Copy Claims**, **Edit**, and **Swap Patient**
* **Copy Claims** - Select this to view previous claims for this patient. Select the **Charges** tab for the opportunity to select a previous claim for this patient and copy ALL of its attributes to this new Superbill.
* **Edit** - Update the Patient Details stored within the Billing Software.
* **Swap Patient** - Select a different patient to apply to this Superbill. Note: this option will disappear once you Add a Claim Line to the Superbill.
3. **Insurance Coverage** - Once you have selected the patient, their Insurance Coverage will populate in the middle of your screen. From here, you can view and edit the Patient's Insurance and Authorization information, as well as update the Eligibility. (To view Authorizations, select **Auths**, detailed in the next step)
For Elation EHR + Billing practices, insurance syncs from the patient's Demographics in the EHR into Elation Billing in one direction, and only at the moment a superbill is first created. If the patient's insurance was not entered (or not marked Active) in their Demographics before the superbill was generated, it will not populate automatically here. Use **Edit Insurance** below to add it directly to an existing superbill.
Buttons (L to R) - **Edit Insurance**, **Insurance Notes**, **Deactivate Insurance**
* **Edit Insurance** - Update the Payer, Priority, Member ID, and Group Number. Select **SEE MORE** to add Coverage Start and End Dates\*, Patient Relationship to Insured, Insured Info (if not Self), and Medicare Secondary Codes (only for use on Medicare policies in Secondary).
\*Please note that at this time the Coverage Start and End Dates only serve a clerical function - the billing software will always bill to whatever Active policy you've selected when you Bill, rather than automatically routing to a payer based on Start/End Dates.
* **Insurance Notes** - Add a Note for the Insurance selected. Remember that this is not patient specific - this note will be seen throughout the billing software when this Insurance is selected.
* **Deactivate Insurance** - Rather than Deleting the insurance, this moves it from Active to Inactive. This maintains a record of previous policies, while letting the billing software know which policies it can ignore when it comes to routing a claim.
4. **Authorizations** - To view Authorizations on file, select **Auths**. From here, you can add, view, and edit authorizations on file for the patient.
To add a stored Auth to a specific claim, select **Add Authorization** in the green Copayment Collected box (see step 5).
The billing software will automatically count down the amount of Authorizations that have been attached to claims to help let you know when it's time to request a new one!
5. **Rendering, Location, From/Thru Date, Copayment Collected** - This is also where you'll:
* Add a Supervising Provider
* Add a Referring Provider
* Add Authorizations already on file
If you'd like, you can establish a Default Provider and/or Location in the **Claim Defaults** tab of your **Practice Settings**. While establishing these rules will automatically populate the Rendering and/or Location, note that you can always change these on a claim-by-claim basis.
Use **Copayment Collected** to denote copayment taken at time of service - this will create a Payment in the billing software attributed to the Patient, to be applied at a later date.
6. **Add Claim Lines/CPTs** - Select **Add Claims** to start adding your Procedure Codes.
Selecting Add Claims will generate a Superbill ID number for this claim, which can be found above the Patient Name in the upper left of the Superbill. This is also when the Claim will begin to Auto-Save every change you make!
Within the pop-up, add as many CPTs as you need, making sure to press \[Tab] or \[Enter] after each code to register it to the Claim. If you add the wrong one, click the **x** next to the code to remove it. When you're all done, click **Save**.
Note that clicking on the CPT as shown below will display more information about the CPT. The same is true of DX codes.
7. **Add Modifiers & Diagnosis Codes** - Now that you've got your CPTs added, you can update the From/To dates on a Code by Code basis, add any needed Modifiers, update the Units and Charge, and add up to 4 Diagnosis Codes.
You can add Diagnosis Codes by either typing them in, selecting **SAME** to add the same Dx as appeared on the last Superbill, or by selecting them via **Add**. Using **Add** allows you to view recently used Diagnosis codes, as well as search for Diagnosis codes for more information.
You can add Modifiers by typing either the modifier number itself, or by searching for words relevant to the modifier needed.
**(Optional) Claim Notes, Correct Claim Info, Claim Narrative and More Fields**
**More Fields** is where you can enter additional information about specific claim types, such as workers' compensation claims. This includes details like the Date of Injury and Location of Injury.
8. **Lightning Bill, Save, Worklist, Delete**
**Lightning Bill**
Using the dropdown menu in the center of the pop-up, select where the claim will be routed (Primary, Secondary, Tertiary, or Patient) as well as the choice to either **Mark As Billed** or **Bill Now**.
* **Mark As Billed** is to be used when submitting this claim through means other than electronic submission through the billing software - it will add Mark As Billed to the Claim's History, along with a marker of which payer to which it was submitted.
* **Bill Now** will send it to the Claims Queue, where it will await your final approval.
**Save** - while the billing software automatically saves your progress as you edit a Superbill, Save offers peace of mind to those nervous about an auto-save.
**Worklist** - If you are not ready to bill off this claim, Worklist allows you to set the Worklist Status to **Yes**, and select the tag(s) you would like it stored under.
**Delete** - if this claim has yet to be billed off, it can be Deleted to scrub it from the system. If the claim has already been billed off, you will be unable to Delete the claim.
8a. **Billing Validation** - On selecting **Lightning Bill**, Elation Billing will conduct a preliminary check for required information. The following will be flagged if the fields are empty/missing:
* **Diagnosis Codes** - if any charge line has no Diagnoses Code present
* **Patient Address** - If the patient's street, city, state, and/or 5-digit Zip Code are missing
* **Patient Insurance Member ID** - if the patient's Member ID is completely missing
9. **Bill the Queue** - When you're ready to transmit your claims to the Payers, you'll need to Bill the Queue! From any page within Elation Billing, select **Bill Now** at the top of the page, confirming this choice in the pop-up that appears. If you would like to review the Queue before billing, you would instead select **See Queue**.
## Related Articles
* [Add a New Patient](/articles/add-a-new-patient)
* [Add/Update a Fee Schedule](/articles/add-update-a-fee-schedule)
* [Claims Queue](/articles/claims-queue)
# Filing a Claim (VIDEO)
Source: https://help.elationhealth.com/articles/filing-a-claim-video
Video tutorial for filing a claim in Elation Billing
This article provides video instructions for filing a claim in Elation Billing.
## Overview
These instructions do not address the creation of a claim in the EHR for All-in-One users. Instructions for EHR claim creation are forthcoming.
For step-by-step written instructions, see [Filing a Claim](/articles/filing-a-claim).
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Filing a Corrected Claim](/articles/filing-a-corrected-claim)
* [Claims Queue](/articles/claims-queue)
# Filing a Corrected Claim
Source: https://help.elationhealth.com/articles/filing-a-corrected-claim
Learn how to file a corrected claim in Elation Billing
This article provides step-by-step instructions on how to file a corrected claim in Elation Billing.
## Overview
### What is a Corrected Claim?
A corrected claim is a resubmission of a previously submitted claim with updated information. It includes a correction code and the original claim's ICN (Internal Control Number) to identify which claim is being corrected.
### Automatic Corrected Claims
Corrected claims have been partially automated! If the payer has provided an ERA in Elation Billing, simply update and resubmit the claim to file it as Corrected. Our clearinghouse will automatically add the ICN and file the claim as Corrected.
If the claim does not have an ERA in Elation Billing, you'll need to manually mark the claim as corrected and add the ICN by following the steps below.
## Workflow Instructions
### Filing a Corrected Claim Manually
1. **Navigate to the Claim** - Find the claim in your Worklist or locate it in the patient's chart by clicking **Claims**.
2. **Save the Payer ICN** - We suggest adding the ICN to a saved list for reuse:
* Click **Corrected Claim Info**
* Click **Add ICN to List**
* Select the Insurance Payer
* Enter the ICN
* Click **Save**
### Finding the ICN
1. Go to the Superbill
2. Click the **Claim History** button
3. Under the Clearinghouse History section, look for **ERA Received**
4. The ICN will be under the Messages column
You can also click **Open ERA** to see the ICN in the ERA.
![CA Blue Cross remittance advice showing the ICN field circled in red, displaying value TST702753235 in the GRP/RC-AMT column for claim reference.]()
3. **Attach the ICN and Correction Code** - From the Claim Corrections Screen:
* Select a **Correction Code**:
* **Original Claim** (Frequency Code 1)
* **Corrected Claim** (Frequency Code 7) - All resubmitted claims will have this code and ICN automatically included
* **Voided Claim** (Frequency Code 8)
* Enter an ICN OR select one from your list by clicking on it
* Click **Save**
The correction code will be attached to the claim for ONE SUBMISSION ONLY. This keeps correction codes from following the claim to subsequent secondary billing.
> 4. **Lightning Bill the Claim** - Bill the claim to the payer using the usual method.
>
> Once the Corrected Claim has been billed, the **Corrected** tag will automatically be added.
For information on the disposition of the claim after submitting, contact the payer (typically via their portal).
## Frequently Asked Questions
### If only one line item needs to be corrected, can I resubmit just that line instead of the whole claim?
No, there currently isn't a way to resubmit only a single line item. Correct the line that needs to change and Lightning Bill the whole claim again — the payer will typically deny any already-paid lines as duplicates and re-adjudicate the corrected line.
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Claim History](/articles/claim-history)
* [Claim Appeals](/articles/claim-appeals)
# Patient Chart Guide- Uploading documents directly within the patient's chart
Source: https://help.elationhealth.com/articles/filing-documents-to-a-patient-chart
This article describes the step-by-step instructions for uploading documents into a patient chart using the drag-and-drop feature.
## Overview
### How to add documents to a patient's chart
There are two ways to add documents to a patient's chart
1. File documents from the [Fax Inbox](/articles/Fax-Inbox-Introduction).
2. Upload documents (e.g. PDF, .JPEG, .PNG, .doc, .xls) directly within the patient's chart using the drag-and-drop feature.
### When to use the drag-and-drop feature
The drag-and-drop feature comes in handy when you have documents on your computer that you would like to upload to a patient's chart. You can only use the drag-and-drop feature to upload one document at a time. If you need to upload multiple documents, you will need to take the drag-and-drop steps multiple times.
Use the [Fax Inbox](/articles/Fax-Inbox-Introduction) if:
* If you need to combine multiple documents into one record in the chart
* If a single document contains records for more than one patient
## Workflow Instructions
### Uploading files to the patient's chart using the drag-and-drop feature
Find the document (e.g. PDF, .JPEG, .PNG, .doc, .xls) you want to file into your patient's chart on your computer.
Click on the file from the folder on your computer, hold down on your mouse cursor and drag the file anywhere over the patient's chart in Elation and release your mouse cursor to drop the file. ![Drag-and-drop upload: DNR.pdf selected from Desktop folder being dragged onto the patient chart, with a "Drop Here to Upload" target zone highlighted.]()
Fill out the reviewer's name, date of document, select the document type ( [Report Category](/articles/report-types) ) and add a title and/or report tags if desired. The **Reviewer** field only lists Provider Level Users, so select the provider you want associated with the document even if it doesn't require clinical review.
Click **Upload File** when you are ready to upload the document. !["File Document into Chart" dialog for DNR.pdf showing Reviewer: Karly Smith, MD, Date: 03/23/2022, document type: Legal Report, Title: DNR, with Upload File button.]()
Wait for the document to upload and process before moving or removing it from the original location on your computer or the upload will fail.
Once processed, the document will appear in the Chronological Record.
### Uploading files to a visit note draft using the drag-and-drop feature
Find the document (e.g. PDF, .JPEG, .PNG, .doc, .xls) you want to file into your patient's chart on your computer.
While a visit note draft is open, click on the file from the folder on your computer, hold down on your mouse cursor and drag the file anywhere over the visit note in Elation and release your mouse cursor to drop the file. ![Dragging HRA.pdf from a Mac Finder window onto an open visit note in Elation, which displays a dashed "Drop Here to Upload" target zone.]()
Wait for the document to upload and process before moving or removing it from the original location on your computer or the upload will fail.
Once the document is processed it will appear in a new **Attachment** section immediately below the **Follow Up** section of the visit note draft. ![PHQ-9 questionnaire displayed in the Attachments section of an open visit note draft, highlighted with a red border, located below the Follow Up section.]()
## Frequently Asked Questions
### The document I'm uploading doesn't need a provider's review. Can I leave the Reviewer field blank or enter a staff member's name?
No. The **Reviewer** field only lists Provider Level Users, so you must select a provider even for documents that don't require clinical review, such as administrative records. By default, the selected reviewer will still get a pending item in their **Requiring Action** queue for the document. To skip that and avoid creating unnecessary work for the reviewer, check **File on behalf of Reviewer** when uploading — this marks the document as already reviewed and files it directly into the Chronological Record without generating a sign-off task.
**Related Articles**
* [Fax Inbox Guide- Managing inbound electronic faxes and uploading documents](/articles/Fax-Inbox-Introduction)
* [Report Category Guide- Categorizing patient documents](/articles/report-types)
# Patient List Report Guide - Searching your patient panel
Source: https://help.elationhealth.com/articles/find-patients-with-elations-patient-list
The Patient List Report allows you to run complex searches and generate specific lists from your entire patient panel.
## Overview
### What is a Patient List Report?
Use the Patient List Report to find patients who match specific criteria based on structured data in their charts. You can create detailed searches—for example, patients with certain diagnoses, medications, or lab results. Once you've generated a list, you can export it as an Excel-compatible spreadsheet for further analysis.
To access demographic information, you can also download a complete list of all your patients' addresses, phone numbers, insurance details, and more at any time.
### Why is the Patient List Report useful?
The Patient List Report is a great tool for tracking, outreach and analysis.
* **Patient outreach** - Generate contact lists for preventive care reminders or appointment recalls.
* **Population health management** - Identify patients due for screenings, immunizations, or chronic condition management (e.g., diabetic patients overdue for A1c tests).
See the [Sample Reports](#SampleReports) section to get a better idea of the kinds of reports you can run.
## Workflow Instructions
### Generating a Patient List Report
| **1** | Click the **Reports** button in the blue navigation bar. |
| ----- | ---------------------------------------------------------------------------------------------------- |
| **2** | Click **Patient List** . |
| **3** | Filter for patients using the [Quick Views](#quick_views) feature or individual filters (see below). |
| **4** | Click Generate List when you have selected all of your views or filters. |
The results of all the patients who match the criteria will appear in the report. The results page will only display a summarized list of patient details. See the [Patient List result contents](#view_reports) section for more information.
You can generate a report of your entire patient panel by leaving everything blank and clicking Generate List.
#### Using Quick Views
The Quick Views feature allows you to apply preset filters to your report criteria, making it faster and easier to generate reports. Once a Quick View is selected, the report will generate automatically.
The Quick Views available are:
* **Initial Medicare AWV eligibility**
* Identifies patients that turned 65 years old within the last 12 months who don't have any of the following CPT Codes in their chart:
* G0402
* G0438
* G0439
* G0468
* G0498
* **Subsequent Medicare AWV eligibility**
* Identifies patients who are 65 or older and have a CPT code G0438 documented in their chart, but do not have a G0439 CPT code.
![Patient List filters showing "Subsequent Medicare AWV eligibility" Quick View applied, with Age set to "Older than 65" and CPT Codes filtering for "Has bill with G0438" and "No bill with G0439", returning one matching patient.]()
Once you have identified the patients who are due for their Medicare Annual Wellness Visit, your staff can contact each patient to ask them to schedule an appointment. Apply additional filters on top of the Quick View filters for additional filtering as needed (e.g. **Patient Status**).
#### Quick Views availability
Quick Views is a built-in feature available to all Elation practices. All users in your practice—including providers and staff—can access Quick Views when generating a Patient List Report.
If you do not see the Quick Views options when accessing the Patient List Report, try the following:
| **1** | Make sure you are using Chrome or Firefox and that they are up-to-date. |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Refresh your browser or clear your browser cache, then try again. |
| **3** | If Quick Views still does not appear, contact Elation Support by clicking **I need help** in the blue navigation bar. Please provide them with a non-PHI screenshot if possible. |
### Using filters
Each filter criteria has its own customization options. We recommended exploring each filter to understand the available options.
* General filters are based on specific characteristics.
* Demographics filters are based on data stored in the patient's demographics.
* The Clinical Data filters let you narrow down your patient list based on structured clinical data documented in the chart—such as diagnoses, medications, labs, and more.
* The matches **all**/**any** filter lets you apply conditional logic across the Clinical Data filters.
* Individual filters have their own options such **include**/**doesn’t include** a specific data point.
See the [Sample Reports](#SampleReports) below for live use-cases for the different filters.
#### Available filters
* **Provider** - patients of a specific provider in the practice, or patients of the entire practice
* Patients are classified as 'belonging' to a given provider if that provider is listed as their Provider assigned in practice in their demographics.
* General Filters
* **Last Seen (Last Signed Visit Note)** -
* Search for patients with signed visit notes within a specific timeframe.
* **Patient Passport** **Status**
* *Registered user*\* = Patients who have an active [Elation Patient Passport](/articles/elation-patient-passport-an-introduction) account.
* **Invited, not registered** = Patients who have been invited to Passport, but have not yet signed up.
* *Not invited*\* = Patients who have not been invited to Passport.
* **Order Status**
* **Outstanding**
* **Cancelled**
* **Fulfilled**
* **Order Hold Status**
* **On hold**
* Search for patients with [held lab orders](/articles/Order-Forms-Guide-Putting-lab-orders-on-hold-for-specimen-collection).
* **Auto-Created Charts**
* Search for charts that were automatically created via the Booking Site or third party integrations such as labs or refill requests.
* Demographics
* **Age**
* Search for patients older than, younger than or between certain ages.
* Search for patients that turn a specific age within a certain number of months.
* **Sex at Birth**
* Search for patients of a specific gender.
* **Race**
* Search for patients of a specific race.
* **Ethnicity**
* Search for patients of a specific ethnicity.
* **Preferred Language**
* Search for patients based on a specific language preference.
* **Preferred Contact Method**
* Search for patients based on a specific preferred contact method.
* **Patient Status**
* Search for patients based on their [chart status](/articles/Patient-Status).
* **State**
* Search for patients based on the State recorded in their address.
* Clinical Data
* **Risk Score**
* Search for patients with a [HCC Risk Score](/articles/how-to-use-elations-risk-assessment-feature) above, below, or between a certain number.
* **Most Recent Lab Results**
* Search for patients with/without a specific range of values for Hemoglobin A1c, Total Cholesterol, LDL-Cholesterol, HDL-Cholesterol, and Triglycerides
* This filter only applies for patient charts that have structured lab values, that is, lab values imported electronically into the chart or recorded via the [Structured Labs](/articles/record-structured-data-from-in-house-or-faxed-lab-reports) or [Point-of-Care Labs](/articles/point-of-care-labs) features.
* **Active Problems in Clinical Profile**
* Search for patient with/without specific **Active** problems in their [Problem List](/articles/managing-your-problem-list).
* Enter the name or ICD-10 code.
* **Permanent Medications in Clinical Profile**
* Search for patients with/without a specific medications listed in their active [Medication List](/articles/medication-history).
* **Active Allergies in Clinical Profile**
* Search for patients with/without specific active allergies.
* **Vaccinations in Clinical Profile**
* Search for patients with/without specific [Vaccinations](/articles/Vaccination-Form-Guide).
* **Patient Tags**
* Search for patients with/without specific [Patient Tags](/articles/adding-patient-tags) on their charts.
* **Document Tags**
* Search for patients with/without specific [tags for Visit Notes & Reports](/articles/tag-reports-and-notes-with-document-tags) in their chart records.
* **CPT Codes**
* Search for patients with/without [specific CPT Codes documented in their Visit Note Billing Information](/articles/billing) within a specific timeframe.
### Viewing Patient List Report contents
#### Viewing the report summary
The results of all the patients who match the criteria will appear on the page. You will find the search criteria applied and the number of qualifying patients displayed as well.
Each patient that matches your search criteria will appear with the following information:
* Patient Name: Legal first name, Middle Name, Legal last name
* HCC Score
* Date of Birth / Age
* Gender
* Preferred Contact Method
* Contact (based on Preferred Contact Method)
* Last Appointment (last signed visit note)
* Next Appointment
You can sort the Patient List report by Name, HCC Score, Date of Birth / Age, Gender or Preferred Contact Method by clicking the column headers. Clicking the patient's name will open the patient's chart.
#### Viewing the detailed report as a spreadsheet (CSV)
To view a more detailed report of your results, click **Download**-> **Download CSV** to save the list as an Excel-compatible file to your computer. From there, you can open the file in spreadsheet software like Excel to apply advanced sorting, filtering, or analysis as needed.
The spreadsheet that is exported contains the following information:
* First Name
* Middle Name
* Last Name
* Date of Birth
* Gender
* SSN
* Address information
* Phone Numbers
* Email
* Preferred Pharmacies
* Preferred Contact Method
* Provider assigned in practice
* Primary and Secondary Insurance Information
* Race. Ethnicity, and Language Preference
* Any Demographic Notes
* Last Appointment
* Next Appointment
* Passport Status
* Whether or not the Patient qualifies for a [Passport Invitation](/articles/elation-patient-passport-an-introduction#HowToGetStarted)
* HCC Score
### Exporting charts as C-CDA files
You can export a list of patients as C-CDA (CCDA) files to securely share clinical data with other collaborating providers who are also using an electronic health record system. Read our [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types) article to learn more about this feature.
## Sample Reports
### Patients who are due for an annual wellness visit
You can use the [Quick Views](#quick_views) feature to search for patients who are due for their Medicare Annual Wellness Visit. Once you have identified the patients who are due for the exam, your staff can contact each patient to ask them to schedule an appointment.
The Quick Views available are:
* **Initial Medicare AWV eligibility**
* Identifies patients that turned 65 years old within the last 12 months who don't have any of the following CPT Codes in their chart:
* G0402
* G0438
* G0439
* G0468
* G0498
* **Subsequent Medicare AWV eligibility**
* Identifies patients who are 65 or older and have a CPT code G0438 documented in their chart, but do not have a G0439 CPT code.
### Patients who are due for a flu vaccine
You can use the date of the patient's last encounter and clinical documentation in the patient's chart to identify a list of patients who have not received a flu vaccine during the current flu season by applying the following filters. Once you have identified the patients who need a flu vaccine, your staff can contact each patient to ask them to schedule an appointment to be vaccinated.
1. **Last Seen (Last Signed Visit Note)** *= Before* "10/1/2025"
2. **Vaccinations in Clinical Profile***Doesn't include*"influenza"
### Active patients with diabetes who need follow-up on their HbA1c levels
You can use a combination of **Patient Status** and clinical documentation to identify a list of active patients who are diabetic and need to have their Hemoglobin A1c levels monitored by applying the following filters. Once you have identified the patients, you can send an order to the lab for each patient to get tested.
1. **Patient Status***Active*
2. **Most Recent Lab Results** where *Hgb A1c >*"9"
3. **Active Problems in Clinical Profile***includes*"diabetes"
## Frequently Asked Questions
### Can I add my own Quick Views?
You cannot add your own Quick Views.
### Can I add my own filters?
You cannot add your own filters.
### Can I apply conditional logic to my searches?
The conditional logic options are limited to what you currently see in the Clinical Data criteria section.
### Why don’t I see Quick Views in my Patient List Report?
Quick Views is available to all Elation practices by default. If you do not see the Quick Views options when generating a Patient List Report:
1. Verify you are navigating to Reports → Patient List in the blue navigation bar.
2. Try refreshing your browser or clearing your cache.
3. If the issue persists, contact Elation Support by clicking **I need help**. Please provide them with a non-PHI screenshot if possible.
**Next Step**
**Run a Patient List Report and start managing your patient panel today!**
## Related Articles
* [List of all Elation Administrative Reports](/articles/lightning-reports)
* [Bulk Letter Guide- Mass communication with Patients](/articles/introduction-to-bulk-letters)
* [Patient Chart Guide- Sharing clinical care summaries with collaborating providers using C-CDA (CCDA) format](/articles/Supported-Elation-CCDA-types)
# Orders Guide- Following up on outstanding orders & referrals
Source: https://help.elationhealth.com/articles/follow-up-outstanding-orders-referrals
This article describes the Close-the-Loop functionality and how you can schedule reminders to follow up on outstanding orders and referrals.
## Overview
### What does Close-the-Loop mean?
Close-the-Loop is a feature that helps your practice follow-up on a patient’s orders and referrals.
* Orders and referrals are marked as ‘Outstanding’ until someone updates them to ‘Fulfilled’ when the test results or consult notes are added to the chart.
* You can also set a reminder to appear in your Practice Home **Reminders** inbox if an order hasn’t been marked as ‘Fulfilled’ by the date you choose.
### What are the benefits of the Close-the-Loop feature?
The Close-the-Loop feature marks unfulfilled orders and referrals as ‘Outstanding’ so you can easily see which ones need follow-up. You can also attach test results or consult notes to these items to keep everything organized and ensure care moves forward smoothly.
**Exception:** Reminders are not available for outstanding referrals at this time. If users need a follow-up reminder, they can use the **Post-Date** feature in Office Messages. [Click here for more information about the **Post-Date** feature](/articles/post-date-a-message-to-yourself-or-a-colleague) .
## Set Up
There are two versions of the Close-the-loop experience that you can request.
One option lists all of a patient’s outstanding referrals and orders together under the **Outstanding Items** chart section for easy access. The second option only shows the Close-the-Loop status when you scroll to each order and referral in the **Chronological Record** or **Reports** dialog. More details about this distinction can be found in the workflow instructions below.
To request the Close-the-Loop feature, click **I need help** -> **Contact Elation Support** and specify which version of the feature you prefer.
* \*\*Option 1:\*\**Please enable the Close-the-Loop feature. I want outstanding orders & referrals to always appear in the **Outstanding Items** section of my patient charts.*
* \*\*Option 2:\*\**Please enable the Close-the-Loop feature. I do not want outstanding orders & referrals to always appear in the **Outstanding Items** section of my patient charts.*
## Workflow Instructions
### Viewing outstanding orders and referrals
![Lab tab in the Reports dialog showing five lab orders dated 02/06/2020 through 11/25/2019 marked "Outstanding" in orange, highlighted to show how unfulfilled orders appear in the chart.]()
Unfulfilled orders and referrals show the **Outstanding** status before their name. The label is visible both in the **Chronological Record** and **Reports** dialog.
If you’ve opted for the feature that groups all of a patient’s unfulfilled referrals and orders in the **Outstanding Items** section, then the status will appear there too.
### Using reminders for outstanding orders
**Exception:** Reminders are not available for outstanding referrals at this time. If you need a follow-up reminder, use the **Post-Date** feature in Office Messages. [Click here for more information about the **Post-Date** feature](/articles/post-date-a-message-to-yourself-or-a-colleague) .
#### Setting reminders to follow up on outstanding orders
To set a reminder to follow up on an outstanding order:
| **1** | Create the order as you normally would. |
| ----- | ----------------------------------------------------------------------------------------------- |
| **2** | Select the name of the person who will receive the reminder in the **Reminder** field. |
| **3** | Enter the date you want the reminder to be sent in the date box next to the **Reminder** field. |
| **4** | Complete the order. |
#### Viewing a reminder
Reminders will appear in the assignees Practice Home **Reminders** inbox if an order isn’t marked as ‘Fulfilled’ by the reminder date. Additionally, assignees can view reminders in the **Requiring Actions** section of the patient’s chart.
If results come in before the reminder date, the reminder will be marked as complete and won’t appear in the assignee’s inbox.
#### Updating a reminder before it’s delivered
To update a reminder before it’s delivered:
| **1** | Locate the outstanding order in the patient's chart. |
| ----- | ---------------------------------------------------- |
| **2** | Click **Actions** -> **Remind Later** . |
| **3** | Choose a new date and/or assignee. |
| **4** | Click **Save** . |
#### Postponing a reminder after it’s delivered
To postpone a reminder after it’s delivered,
| **1** | Click **Remind Later** . |
| ----- | ---------------------------------- |
| **2** | Choose a new date and/or assignee. |
| **3** | Click **Save** . |
### Marking orders or referrals as fulfilled
#### Automatically associating electronic lab results with electronic lab orders
If your practice **eOrders lab tests**, we’re able to automatically update the status to fulfilled when the results arrive in the patient’s chart.
If your practice **faxes lab orders**, use the instructions below to manually mark the lab order as fulfilled once you receive the results.
#### Manually associating a faxed or uploaded report/result with outstanding orders and referrals
!["File Document into Chart" dialog with the "From Order" dropdown open, showing selectable lab orders including a checked "11/25/2019 LabCorp: Lipid Panel, Triglycerides, LDL Cholesterol" option and four additional unselected orders.]()
For faxed or uploaded reports or results, manually attach them to the right orders and referrals to show that these have been completed. To do this:
| **1** | Use any of the following workflows to add the report/result to the patient’s chart [Drag & drop](/articles/filing-documents-to-a-patient-chart) the report/result into the patient's chart. • File a faxed report/result from the [Fax Inbox](/articles/Fax-Inbox-Introduction). |
| ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | In the assignment window, click the **From Order** dropdown to select the order or referral that the report/result is associated with. |
| **3** | Click **File into Chart** to complete the filing workflow. |
| **4** | The linked order or referral will be marked as fulfilled. |
##### Linking a report that was already filed to the chart
To link a report that was already filed into the chart to an outstanding order or referral:
| **1** | Locate the outstanding order or referral in the patient's chart. |
| ----- | ------------------------------------------------------------------------ |
| **2** | Click **Actions** -> **Fulfilled** . |
| **3** | Select the report you want to link to the outstanding order or referral. |
| **4** | Click **Attach Item** . |
### Marking orders or referrals as canceled
To mark an order or referral as canceled when they’re no longer valid:
| **1** | Locate the outstanding order or referral in the patient's chart. |
| ----- | ---------------------------------------------------------------- |
| **2** | Click **Actions** -> **Canceled** . |
| **3** | Enter a reason for marking the order/referral as canceled. |
| **4** | Click **Mark Canceled** . |
Canceling an order or referral doesn’t automatically notify the facility or patient. If you need them to know it's canceled, please contact them directly.
### Searching for patients with outstanding orders or referrals
Use the [Patient List](/articles/find-patients-with-elations-patient-list) report to identify which patients have at least one outstanding order or referral in their chart:
**Exception:** The **Order Status (Close-the-Loop)** filter only appears in the Patient List report once your practice has enabled Close-the-Loop. If you don't see this filter, request the feature using the steps in the **Set Up** section above.
| **1** | Click **Reports** -> **Patient List** in the blue bar at the top of your Elation account. |
| ----- | ----------------------------------------------------------------------------------------- |
| **2** | Select the **Order Status (Close-the-Loop)** filter. |
| **3** | Select the **Outstanding** status. |
| **4** | (Optional) Select any other additional filters as needed. |
| **5** | Click **Generate List** to see a list of patients that match the filter criteria. |
Use this report to:
* Check the **Order Status** and **Next Appointment** columns to find patients who need to schedule a follow-up.
* Review any outstanding orders or referrals and follow up as needed.
## Frequently Asked Questions
### What happens if a report was linked to the wrong order or referral?
If a report was linked to the wrong order or referral:
| **1** | Find the referral or order that needs to be updated. |
| ----- | ---------------------------------------------------- |
| **2** | Click **Actions** -> **Fulfilled: Change Report** . |
| **3** | Select the correct report. |
| **4** | Click **Attach Item** . |
### An order or referral was canceled but the patient still completed it. What happened?
Canceling an order or referral doesn’t automatically notify the facility or patient. If you need them to know it's canceled, please contact them directly.
Update a canceled order or referral to fulfilled by following these steps:
| **1** | Locate the outstanding order or referral in the patient's chart. |
| ----- | ------------------------------------------------------------------------ |
| **2** | Click **Actions** -> **Fulfilled** . |
| **3** | Select the report you want to link to the outstanding order or referral. |
| **4** | Click **Attach Item** . |
### How do I update the reminder preferences after signing an order?
To update a reminder before it’s delivered:
| **1** | Locate the outstanding order in the patient's chart. |
| ----- | ---------------------------------------------------- |
| **2** | Click **Actions** -> **Remind Later** . |
| **3** | Choose a new date and/or assignee. |
| **4** | Click **Save** . |
### What types of records can be used to fulfill an order or referral?
Any [report category](/articles/report-types) can be attached to an order to fulfill the order.
The following documents can be attached to a referral to fulfill the referral:
* From the Fax Inbox, attach any [report category](/articles/report-types), including **Consult Reports**.
* From within the patient's chart, attach any [report category](/articles/report-types), visit notes, non-visit notes, direct messages, letters, or letter receipts.
**Can I remove the \*\* Outstanding** label without attaching a report?\*\*
To use the Close-the-Loop feature effectively, make sure you store a copy of the report or results in the patient’s chart after a patient completes an order or referral. You need to attach the report to the open order or referral before you can mark it as ‘Fulfilled’.
## Related Articles
* [Lab Orders & Results Introduction](/articles/Lab-Orders-and-Results-Introduction)
* [Lab Orders & Results - Using the electronic Lab Order Form](/articles/Electronic-Lab-Order-Form)
* [Lab Orders & Results - Managing electronic lab results](/articles/Viewing-results-from-lab-interfaces)
* [Letters & Referrals Introduction- Sharing clinical data outside of Elation](/articles/letter-and-referral-introduction)
* [Fax Inbox Guide- Managing inbound electronic faxes and uploading documents](/articles/Fax-Inbox-Introduction)
* [Patient Chart Guide- Uploading documents directly within the patient's chart](/articles/filing-documents-to-a-patient-chart)
* [Report Category Guide- Categorizing patient documents](/articles/report-types)
* [Patient List Report Guide- Searching your patient panel](/articles/find-patients-with-elations-patient-list)
# Getting to Know The Software
Source: https://help.elationhealth.com/articles/getting-to-know-the-software
Introduction to Elation Billing features and workflows
This article provides an introduction to Elation Billing, including how to find support and an overview of key features.
## Elation Billing Quick Start Video
This video walks you through the basics of using Elation Billing to submit claims to payers and manage submitted claims.
## Claim Creation Workflow
## Overview
### Browser Recommendation
While Elation Billing will function in most standard internet browsers, it is optimized for use in **Google Chrome**.
### Lifecycle of a Claim
Elation All-in-One Customers will rarely create a claim manually in Elation Billing. Manual claim creation is generally reserved for tracking payments from Capitation, Prop 56, etc.
![Flowchart showing the lifecycle of a claim: from signed patient note or manual creation, through Biller Review, Claims Queue, payer adjudication, ERA, payment posting, and final resolution as settled, transferred to patient, or routed to secondary/tertiary payer.]()
## Finding Support
There are a few ways to get help with Elation Billing:
1. **Chat Support** - Click the chat bubble in the lower-right corner of any Elation Billing page.
![Elation Billing chat support bubble icon, located in the lower-right corner of any Billing page]()
2. **Support Ticket Portal** - Use the toolbar: select **Support** → **Support Ticket Portal**.
![Support menu open in the toolbar, showing "Support Ticket Portal" and "Help Center" options listed below the selected Support tab.]()
3. **Help Center** - Navigate to the Help Center's dedicated page from the Support button.
## Key Features
### Favorite Payers and EDI Enrollments
Selecting your favorite (commonly used) payers and [enrolling in their EDI](/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi) is one of the first steps in establishing your practice.
### Claims
* **Filing a Claim** - Create superbills and submit claims. For All-in-One users, claims are generally created in the EHR by signing a Note with Billing Information.
* **Claims Queue** - Where claims land when you bill. Print paper claims, review what's ready, and transmit.
* **Claims Manager** - Manage all claims with filters and bulk updates.
* **Worklist** - Tag claims requiring further action with default or custom tags.
* **Notes and Alerts** - Leave permanent notes or temporary alerts on patients and claims.
* **Running Eligibility** - Get real-time eligibility updates for enrolled payers.
### Payments
* **Auto-Post ERAs** - Automatically generate payments from ERA data.
* **Collect Patient Payments** - Initiate collection from EHR or Elation Billing.
* **Post Payments Manually** - Full control for paper EOBs or ERAs with denials.
* **Claim Appeals** - Handle appeals from Claims Manager or Patient page.
* **Capitation Payments** - Track capitation, Prop 56, and similar payments.
### Statements and Patient Billing
* **Send Statements** - Available via mail, email, and text.
* **View and Print Statements** - Access previously sent statements.
* **Payment Plans** - Establish automatic payment plan statements.
### Reports & Tools
* **Document Center** - Upload and store files linked to Patients, Claims, or Payments.
* **⚡️Lightning Insights** - Powerful reporting tools for practice performance.
* **⚡️Lightning Reports** - Focused views of practice data.
## Related Articles
* [Filing a Claim](/articles/filing-a-claim)
* [Enrolling for Claims Submission, ERA, and Real-Time Eligibility](/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi)
* [Posting a Payment in Elation Billing](/articles/posting-a-payment-in-elation-billing)
# Clinical Profile Guide - Viewing growth charts for pediatric patients
Source: https://help.elationhealth.com/articles/growth-charts-for-pediatric-patients
View Elation’s Growth Charts for your pediatric patients to help your practice trend patient vitals, including height, weight, BMI and head circumference over time and against age-specific percentiles.
## Overview
### What are growth charts?
Growth charts help you track a patient's height, weight, BMI, and head circumference distribution over time for patients 21 and younger. Elation's growth charts use the following guidelines:
* WHO guidelines for children from birth to 24 months.
* CDC guidelines for children between 2 and 20 years.
These growth chart standards are fixed and cannot be configured at the practice level. Elation automatically applies the appropriate standard based on the patient's age.
In addition to standard growth charts, you can also view growth charts for pre-term infants and patients with Down Syndrome.
### How do growth charts work?
Once you add a patient's height, weight, and/or head circumference in the Vitals section of a note, that data point will automatically plot on the corresponding growth chart. The percentiles for height, weight, and BMI will also appear on the charts.
When entering vitals, you can type values in any common unit — including metric and imperial — and Elation will automatically convert them to the standard stored unit. This is especially useful for pediatric workflows where you may frequently switch between metric and imperial measurements. For example, you can enter height as `170 cm` or `5'10"`, weight as `70 kg`, and head circumference as `14 in`. Compound inputs, fractions, and European-style decimal commas are also supported.
Visit notes do not need to be signed in order for you to see vitals from that visit populated on the growth chart.
### Which growth charts are available?
There are five categories of growth charts available in Elation:
* 0-24 months (WHO)
* Height
* Weight
* Age
* Head Circumference
* 24-36 months (CDC)
* Head Circumference
* 2-20 years (CDC)
* Height
* Age
* BMI
* Pre-Term\*
* Height
* Weight
* Head Circumference
* Down Syndrome (0-36 months)
* Height
* Weight
* Head Circumference
* Down Syndrome (2-20 years)
* Height
* Weight
* BMI
* Head Circumference
To plot values on the **Pre-Term** Growth Chart, you first need to add a preterm infant diagnosis to the patient's Problem List. The diagnosis must specify the number of weeks of gestation (e.g., **Preterm infant, birth weight 500-749 grams, with 24 completed weeks of gestation**). Additionally, the vitals must be recorded on a visit note that is dated before the 40-week gestation period to appear on the chart.
## Workflow Instructions
### Viewing growth charts
You have four options for accessing growth charts in Elation:
| **Clinical Profile** | Click **Growth Charts** at the top of the Clinical Profile. | |
| ------------------------------------------------------------ | -------------------------------------------------------------- | - |
| Go to **Other Info** -> **Actions** -> **See Growth Charts** | | |
| **Legacy Visit Note** (any 2-column format) | Go to **Vitals** -> **Growth Charts** | |
| **Elation Note** | Go to the **Vitals & Observations** block -> **Growth Charts** | |
Here's how to read a growth chart:
* The chart is color-coded to help you easily identify percentile trends.
* The patient’s vitals are marked by a dark blue dot. You can hover over any dot on the graph to see the exact value, percentile and record date.
* To view the patient's growth chart data in a table format, simply scroll down within the growth chart window.
![Growth Charts modal showing the CDC 2-20 years Height for Age chart for a 9-year-8-month-old patient. A data point at 53 inches is highlighted at the 35th percentile on 09/15/2025, with a tooltip showing percentile reference values and a table entry at the bottom confirming the recorded measurement.]()
### Sharing growth charts
#### Attaching growth charts to Letters or Referrals
To attach a growth chart to a Patient Letter, Provider Letter or Referral:
1. Open a new **Patient Letter**, **Provider Letter** or **Referral** draft.
2. Click **Select Chart Items to Attach**.
3. Select **Growth Charts**.
4. Select the growth charts you want to attach.
5. Click **Attach Items**.
#### Printing growth charts
Click the **Print Chart** button at the top of each growth chart to print a growth chart. Growth charts will print in black and white. The percentile lines and exact value will be printed but the exact percentile of each value will not be printed.+
If you would like to print a growth chart in color, we recommend taking a screenshot (or snippet) of the screen and printing out the screenshot/snippet.
### Troubleshooting missing or unexpected percentiles
If percentiles are not displaying on a growth chart or appear incorrect, verify the following:
| **1** | **Confirm the patient's age is within the supported range** Growth charts are only available for patients 20 years and younger. • The patient must have a date of birth recorded in their demographics to calculate age-appropriate percentiles. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | **Confirm the Sex field is correct** Open the patient's demographics and verify the **Sex at birth** field matches the patient's biological sex. Growth standards differ by sex, so an incorrect or missing value will affect percentile calculations. |
| **3** | **Confirm vitals are entered as structured data** Height, weight, and head circumference must be entered in the **Vitals** section of a visit note or Elation Note. • Vitals documented in scanned PDFs, free-text notes, custom blocks, or imported documents will not populate growth charts. |
| **4** | **Verify measurement dates** Each vital must have a valid measurement date. Vitals without valid dates cannot be plotted on the chart. |
| **5** | **Check for special population requirements** **Pre-term infants:** To use the Pre-Term Growth Chart, you must first add a preterm infant diagnosis to the patient's **Problem List**. The diagnosis must specify the number of weeks of gestation (e.g., **Preterm infant, birth weight 500-749 grams, with 24 completed weeks of gestation**). Vitals must also be recorded on a visit note dated before the 40-week gestation period. • **Down Syndrome:** Patients with Down Syndrome documented in their Problem list will have their percentiles displayed on the appropriate Down Syndrome growth chart. |
| **6** | **Confirm the correct chart type is displaying** Elation automatically selects the chart type based on the patient's age and any relevant diagnoses. If a patient appears on an unexpected chart, verify their date of birth and Problem List entries. |
If further assistance is required after following the above troubleshooting steps, click **I need help** -> **Contact Elation Support** to submit a request.
## Related Articles
* [Visit Note Documentation Guide- Visit Note Formats](/articles/Visit-Note-Documentation-Guide-Visit-Note-Formats)
* [Clinical Profile Guide- A snapshot of the patient's health status](/articles/clinical-profile-record-patient-medical-history)
* [Pediatric Features Guide](/articles/Pediatric-Features)
# Version 1.0.1: April 2023
Source: https://help.elationhealth.com/articles/hdb/2023-04-07-ver-101
## Product Enhancements
| Table | Updates |
| ----------------- | ---------------------------------- |
| appointment | added service\_location\_id column |
| service\_location | added name column |
***
## Release Highlights
This was a hotfix release to add appointment location data requested by customers. The changes were extended to all HDB customers since the data is broadly useful.
**Added service\_location\_id to appointments table**
The `service_location_id` column was added to the `appointment` table as a foreign key joining to `service_location.id`, allowing customers to report on which location an appointment was scheduled at.
**Added name to service\_location table**
The `name` column was added to the `service_location` table so customers can join from `appointment.service_location_id` and retrieve the human-readable location name.
# Version 1.1: April 2023
Source: https://help.elationhealth.com/articles/hdb/2023-04-14-ver-11
## Product Enhancements
| Table | Updates |
| ------------- | ---------------------------------------------------- |
| patient\_tag | added creation\_time, created\_by\_user\_id columns |
| patient\_tag | added deletion\_time, deleted\_by\_user\_id columns |
| patient\_tag | removed is\_deleted column |
| document\_tag | added creation\_time, created\_by\_user\_id columns |
| document\_tag | added deletion\_time, deleted\_by\_user\_id columns |
| document\_tag | removed is\_deleted column |
| patient\_hcc | renamed valid\_till to last\_calculated |
| patient | added patient\_status column |
| patient | removed primary\_practice\_provider\_user\_id column |
***
## Release Highlights
This release delivered the first round of priority fixes needed to support the general availability (GA) migration for existing legacy HDB customers.
**Audit columns added to patient\_tag and document\_tag**
`creation_time`, `created_by_user_id`, `deletion_time`, and `deleted_by_user_id` were added to both tables to replace the previous `is_deleted` boolean. This change aligns with coding standards and provides richer audit history.
**patient\_hcc.valid\_till renamed to last\_calculated**
The column was renamed to more accurately describe what it represents: the date the HCC value was last computed.
**patient.patient\_status added**
The `patient_status` column was added to enable reporting on whether a patient is active, inactive, prospect, etc.
**patient.primary\_practice\_provider\_user\_id removed**
This duplicate column was removed. Use `primary_care_provider_id` instead.
# Version 1.1.1: May 2023
Source: https://help.elationhealth.com/articles/hdb/2023-05-12-ver-111
## Product Enhancements
| Table | Updates |
| --------------- | ------------------------------- |
| referral\_order | added processing\_status column |
| referral\_order | added resolution\_state column |
| referral\_order | added is\_deleted column |
| referral\_order | fixed fax\_status not updating |
| misc\_orders | added is\_deleted column |
| misc\_orders | added resolution\_state column |
## Deprecations
| Table | Updates |
| ------------- | ---------------------------------------------------------------- |
| patient\_tag | removed is\_deleted column (replaced by deletion\_time in v1.1) |
| document\_tag | removed is\_deleted column (replaced by deletion\_time in v1.1) |
| patient | removed primary\_practice\_provider\_user\_id (duplicate column) |
| patient\_hcc | renamed valid\_till to last\_calculated |
***
## Release Highlights
**referral\_order: processing\_status and resolution\_state**
Practices can now report on the full lifecycle of their referrals: tracking processing status and whether a referral is outstanding, fulfilled, or canceled.
**referral\_order: fax\_status fix**
The `fax_status` column had stopped updating due to a backend change. This is now fixed.
**misc\_orders: is\_deleted and resolution\_state**
Practices can now identify whether a miscellaneous order has been deleted and track its resolution state.
# Hot Fix: June 2023
Source: https://help.elationhealth.com/articles/hdb/2023-06-07-hotfix
## Bug Fixes
| Table | Description |
| ----------------- | ---------------------------------------------------------------- |
| patient\_employer | added is\_deleted column so deleted employer records are visible |
***
## Release Highlights
**patient\_employer: is\_deleted**
Practices can now determine whether an employer record on a patient has been deleted, enabling accurate filtering in downstream reports.
# Version 1.2: August 2023
Source: https://help.elationhealth.com/articles/hdb/2023-08-01-ver-12
## Product Enhancements
| Table | Updates |
| --------------------- | ------------------------------------- |
| patient | added deceased\_date column |
| visit\_note\_bullet | added is\_deleted column |
| user | added direct\_message\_address column |
| report\_document\_tag | added is\_deleted column |
## Bug Fixes
| Table | Description |
| ------------------ | ----------------------------------------------------------------------- |
| referral\_order | uq\_referral\_order column logic updated to fix incremental build issue |
| patient\_insurance | various bugs fixed |
***
## Release Highlights
**patient.deceased\_date**
Practices can now report on and filter by patient deceased date directly from the `patient` table.
**user.direct\_message\_address**
Customers can pull a list of all direct message addresses configured for their practice, useful for directory and communication audits.
**visit\_note\_bullet and report\_document\_tag: is\_deleted**
The `is_deleted` flag was added to both tables to account for both hard and soft deletes, ensuring deleted records surface correctly in incremental builds.
# Version 1.3: September 2023
Source: https://help.elationhealth.com/articles/hdb/2023-09-06-ver-13
## Product Enhancements
| Table | Updates |
| ------- | ---------------------------------- |
| patient | added primary\_care\_provider\_id |
| patient | added primary\_care\_provider\_npi |
| patient | added pronouns |
***
## Release Highlights
This release adds patient metadata fields to better align the HDB `patient` table with the patient view in the Elation EHR.
**patient: primary\_care\_provider\_id and primary\_care\_provider\_npi**
Practices can now report directly on a patient's assigned primary care provider without needing an additional join to the `physician` table. The NPI is included for interoperability use cases.
**patient: pronouns**
The patient's preferred pronouns are now available in the HDB, matching the field available in the EHR.
# Version 1.4: October 2023
Source: https://help.elationhealth.com/articles/hdb/2023-10-05-ver-14
## Product Enhancements
| Table | Updates |
| ---------------------- | ------------------------------ |
| physician\_license | added new table |
| provider\_availability | added new table |
| patient | added vip column |
| visit\_note | added time\_with\_patient |
| visit\_note | added time\_documenting column |
***
## Release Highlights
**physician\_license and provider\_availability: new tables**
Two new tables were added to expose provider credentialing and scheduling availability data. These tables enable practices to report on multi-state licensing and provider schedule blocks.
**patient: vip**
The `vip` flag was added to the `patient` table to reflect the VIP designation available in the EHR.
**visit\_note: time\_with\_patient and time\_documenting**
Two new columns were added to capture how time was spent during a visit, supporting reporting on clinical efficiency and documentation burden.
# Version 1.5: November 2023
Source: https://help.elationhealth.com/articles/hdb/2023-11-06-ver-15
## Product Enhancements
| Table | Updates |
| ------------------- | ------------------------------------------------- |
| med\_order | added days\_supply column |
| patient | added preferred\_service\_location\_id column |
| patient | added full\_name column |
| patient | added consented column |
| patient | updated gender\_identity column |
| master\_patient | removed duplicate column canonical\_physician\_id |
| patient\_insurance | added payment\_program column |
| referral\_order\_dx | added table referral\_order\_dx |
## Bug Fixes
| Table | Description |
| -------- | ------------------------------------------------------------------- |
| passport | minor bug where there was an issue showing deleted unsigned records |
***
## Release Highlights
**med\_order: days\_supply**
The `days_supply` column was added for non-Surescripts (user-created) prescriptions, enabling reporting and auditing of prescription duration.
![Prescription Form showing the Days Supply field highlighted with a red border, containing the value 30, for a new Tylenol Extra Strength 500 mg Tab prescription.]()
**patient: full\_name, preferred\_service\_location\_id, consented**
The patient's non-legal full name is now available for search and reporting. `preferred_service_location_id` links to `service_location.id`. `consented` records whether the patient consented to external data sharing.
![Patient Details panel showing the "Full name (if different than legal)" field highlighted in red, containing "Sample Other Name" — the source of the new full_name column in the patient table.]()
**patient: gender\_identity values updated**
Gender identity values were updated to match the current options in the EHR.
![Gender field dropdown in the EHR Patient Details form showing updated gender identity options: Woman, Man, Transgender woman/trans feminine, Transgender man/trans masculine, Non-binary/genderqueer/gender fluid, Two spirit, Option not listed, Prefer not to say, with current value set to Unknown.]()
**master\_patient: canonical\_physician\_id removed**
The duplicate `canonical_physician_id` column was removed. Use `primary_care_provider_id` instead.
**patient\_insurance: payment\_program**
The `payment_program` column was added to expose the payment program associated with a patient's insurance.
**referral\_order\_dx: new table**
The new `referral_order_dx` relationship table enables reporting on which diagnosis codes were used for a referral.
![Referral form showing the "Add Dxs" diagnosis field highlighted with a red border, illustrating the diagnosis codes captured in the new referral_order_dx table.]()
# Version 1.6: February 2024
Source: https://help.elationhealth.com/articles/hdb/2024-02-13-ver-16
## Product Enhancements
| Table | Updates |
| ------------------ | ------------------------------------- |
| medication\_rxnorm | is\_deleted flag added |
| patient | Updated the Sexual Orientation values |
| patient | Updated sex options |
| appointment | in\_person\_or\_virtual added |
| appointment | instructions added |
***
## Release Highlights
**medication\_rxnorm: is\_deleted**
The `is_deleted` flag was added to allow filtering out deleted medications and to explain why some duplicate records may appear.
**patient: sexual\_orientation, sex, and gender\_identity values updated**
The valid values for `sexual_orientation`, `sex`, and `gender_identity` were updated to match the current options available in the EHR.
![Sexual orientation dropdown in the EHR showing available values: Asexual, Bisexual, Gay, Lesbian, Straight, Queer, Option Not Listed, and Prefer Not To Say.]()
![Sex at birth dropdown open showing options: Female, Male (currently selected), Intersex/Other, and Unknown, with a note that sex is assigned at birth based on appearance of genitalia.]()
![Gender identity field expanded in Patient Details, showing options: Unknown (selected), Woman, Man, Transgender woman/trans feminine, Transgender man/trans masculine, Non-binary/genderqueer/gender fluid, Two spirit, Option not listed, Prefer not to say.]()
**appointment: in\_person\_or\_virtual and instructions**
Two new columns were added to distinguish appointment modality and capture provider-facing appointment instructions.
![Appointment scheduling form showing "In person" selected (vs. Virtual toggle) and an empty "Visit instructions for patient" text field with a 1600-character limit and PHI warning.]()
# Version 1.7: July 2024
Source: https://help.elationhealth.com/articles/hdb/2024-07-29-ver-17
## Infrastructure Changes
| Change | Details |
| ------------------------- | ----------------------------------------------------------------- |
| Timestamp standardization | All customer-visible timestamps changed to `TIMESTAMPNTZ(9)` |
| Event Streaming migration | Majority of tables migrated to Event Streaming as the data source |
***
## Release Highlights
**Timestamp standardization to TIMESTAMPNTZ(9)**
All timestamps visible to customers were standardized to `TIMESTAMPNTZ(9)`. Previously, timestamp types were inconsistent across tables. No column names changed, but if your queries or downstream tools rely on timezone-aware timestamp types (`TIMESTAMP_TZ`), you may need to update them.
**Event Streaming migration**
The majority of HDB tables were migrated to use Event Streaming as their data source. This is an infrastructure change that improves data freshness and reliability. No schema changes resulted from this migration.
# Version 1.8: January 2025
Source: https://help.elationhealth.com/articles/hdb/2025-01-15-ver-18
## Product Enhancements
| Table | Updates |
| ------------------------------- | -------------------------------------------------------- |
| physician\_license | added dea column |
| physician\_license | added rx\_auth column |
| physician\_license | added credentials column |
| physician\_license | added supervising\_physician\_id column |
| visit\_note\_document\_tag | added is\_deleted column |
| non\_visit\_note\_document\_tag | added is\_deleted column |
| clinical\_form\_collection | added loinc\_code column, removed loinc\_id column |
| passport | added chart\_feed\_date column |
| patient | added last\_patient\_status\_change column |
| patient | renamed ethnicity to primary\_ethnicity |
| patient | added detailed\_primary\_ethnicity column |
| patient | added secondary\_ethnicity column |
| patient | added detailed\_secondary\_ethnicity column |
| patient | removed ethnicity column (renamed to primary\_ethnicity) |
***
## Release Highlights
**physician\_license: full multi-state licensing details**
Four new fields were added to give customers full visibility into physician multi-state licensing:
* `dea`: DEA registration number
* `rx_auth`: prescribing authorization
* `credentials`: license type and credentials
* `supervising_physician_id`: supervising physician for the license
**Document tag deletion now visible**
`is_deleted` was added to both `visit_note_document_tag` and `non_visit_note_document_tag`. Tags that have been deleted will now appear with `is_deleted = true` rather than being silently excluded.
**clinical\_form\_collection: loinc\_code replaces loinc\_id**
The `loinc_code` column was added to carry the LOINC code directly on the table. The `loinc_id` foreign key has been removed. Update any queries that joined to the `shareable_loinc` table via `loinc_id`.
**passport: chart\_feed\_date**
The `chart_feed_date` column was added to show where the record is located in the patient's chronological chart.
**patient: expanded ethnicity and status fields**
* `ethnicity` has been renamed to `primary_ethnicity` to accommodate new secondary ethnicity fields. Update any queries referencing `ethnicity`.
* `detailed_primary_ethnicity`, `secondary_ethnicity`, and `detailed_secondary_ethnicity` were added to reflect the full set of ethnicity options available in the EHR.
* `last_patient_status_change` was added to track when a patient's status last changed, enabling analysis of patient lifecycle transitions.
# Version 1.9: December 2025
Source: https://help.elationhealth.com/articles/hdb/2025-12-16-ver-19
## Product Enhancements
| Table | Updates |
| ---------------------------- | --------------------------------------- |
| office\_messages | added report\_id column |
| office\_messages\_recipients | added removed\_from\_thread column |
| office\_messages\_recipients | added removed\_at column |
| appointment | added is\_blocking column |
| med\_order | added supervising\_physician\_id column |
| med\_order | added fulfillment\_state column |
| med\_order | added num\_samples column |
| med\_order | added patient\_adherence column |
| provider\_letter | added viewed\_at column |
| referral\_order | removed clinical\_reason column |
## Bug Fixes
| Table | Description |
| ---------------- | --------------------------------------------------------------------------------------------------- |
| patient\_problem | fixed duplicate row issue caused by incorrect fields in unique key: **all unique keys will change** |
| patient\_phone | fixed bug where deleted phone numbers (empty strings) were hidden instead of shown |
## New Tables (Beta)
The following tables are in **beta** and may be altered without prior notification. The older `vn2_*` visit note tables will be removed in a future release.
| Table | Description |
| -------------------------------------- | ------------------------------------------------------------------------ |
| elation\_note | Cleaned, structured data to reconstruct custom note blocks by note |
| elation\_note\_structured\_data | Granular form data linking to questions and blocks |
| elation\_note\_response\_option | Response options for checkbox, dropdown, and radio button question types |
| elation\_note\_question | Current state of each question in a custom block |
| elation\_note\_custom\_block\_snapshot | Snapshot of the custom block at the time the note was created (static) |
| elation\_note\_custom\_block | Current active state of a custom block (may drift from note content) |
***
## Release Highlights
**office\_messages: report\_id**
If a report is attached to an office message, `report_id` now links to the `report` table.
**office\_messages\_recipients: thread removal tracking**
`removed_from_thread` (boolean) and `removed_at` (timestamp) were added to track when recipients are removed from a message thread.
**appointment: is\_blocking**
The `is_blocking` flag indicates whether an appointment blocks the provider's schedule. Defaults to `true`.
**med\_order: prescription lifecycle and sample tracking**
* `supervising_physician_id`: the supervising physician for the order
* `fulfillment_state`: current state of the prescription: `new`, `failure`, `error`, `sent`, `complete`, `pending_complete`, `denied`, `sending`
* `num_samples`: populated when the medication is a sample
* `patient_adherence`: patient adherence data for the medication
**provider\_letter: viewed\_at**
Records the timestamp when a provider letter was initially viewed.
**referral\_order: clinical\_reason removed**
The `clinical_reason` column has been removed. Use the `body` column instead, which is pulled from the body of the referral.
**patient\_problem: unique key change**
A bug caused duplicate rows due to incorrect fields being included in the unique key. All unique keys for this table will change as a result of this fix. Customers doing incremental builds will need to account for this.
**patient\_phone: empty string deletions now visible**
When a phone number was manually removed from a chart, it was previously filtered out. It will now appear as an empty phone number (not as deleted).
**New Elation Note tables (beta)**
Six new tables expose structured data from Elation's custom note blocks. See the [entity relationship diagram](https://dbdocs.io/hosteddb_support/hosted_database_snowflake) for details on how these tables relate.
![Entity relationship diagram showing six beta elation note tables. visit_note links to elation_note, which connects to elation_note_question, elation_note_structured_data, and elation_note_custom_block_snapshot. elation_note_custom_block_snapshot links to elation_note_custom_block (with a self-referencing copied_from_block_id). elation_note_structured_data links to elation_note_question and elation_note_response_option. The versioned_custom_block_id relationship between elation_note_structured_data and elation_note_custom_block_snapshot is highlighted in gold as highly likely to change.]()
These tables are beta. Schema may change without notice. The `vn2_*` tables will be removed in a future release.
# Version 1.9.2: June 2026
Source: https://help.elationhealth.com/articles/hdb/2026-06-17-ver-192
## New Tables (GA)
The following tables have been moved from **beta** to **General Availability (GA)**. These schemas are now stable and will follow standard change management processes.
| Table | Description |
| -------------------------- | ----------------------------------------------------------------- |
| recurring\_event\_group | Recurring appointment and event schedules for practice scheduling |
| recurring\_event\_schedule | Individual schedule definitions within a recurring event group |
***
## Release Highlights
**recurring\_event\_group and recurring\_event\_schedule: Now GA**
The `recurring_event_group` and `recurring_event_schedule` tables have been promoted to General Availability. These tables enable reporting and analysis on recurring appointment schedules, provider availability patterns, and practice scheduling workflows.
**recurring\_event\_group**
Stores the top-level configuration for recurring appointment schedules:
* `id`: unique identifier for the recurring event group
* `practice`: practice ID
* `time_slot_type`: type of time slot (`appointment`, `appointment_slot`, or `event`)
* `is_blocking`: whether the schedule blocks provider availability
* `created_date`: when the recurring event group was created
* `deleted_date`: when the recurring event group was deleted (if applicable)
* `reason`: optional reason or description for the schedule
**recurring\_event\_schedule**
Contains the specific schedule details for each recurring event:
* `duration`: duration of each event in minutes
* `event_time`: time of day for the event
* `physician`: provider assigned to the schedule
* `series_start`: start date for the recurring series
* `series_stop`: end date for the recurring series (if applicable)
* `description`: optional description of the schedule
* `dow_monday` through `dow_sunday`: boolean flags indicating which days of the week the event recurs
* `created_date`: when the schedule was created
Use these tables to analyze provider scheduling patterns, identify gaps in coverage, and build custom scheduling reports.
These tables are now GA and will follow standard deprecation policies. Any future schema changes will be communicated via release notes with appropriate migration guidance.
# Version 1.9.4: June 2026
Source: https://help.elationhealth.com/articles/hdb/2026-06-29-ver-194
This release introduces the first Elation Billing tables to the Hosted Database. They are present only for practices on the Elation Billing product; other practices will not have them.
## New Tables
| Table | Added in | Description |
| ------------------------ | -------- | -------------------------------------------------------------------------------------------------------------------------------- |
| era\_matched\_adjustment | 1.9.1 | ERA charge-level adjustment records with HDB practice, provider, and appointment cross-references applied. |
| user\_role | 1.9.1 | Lookup mapping Elation Billing role identifiers (Admin, Biller, Staff, etc.) to human-readable names. |
| claim | 1.9.3 | The bill submitted to a payer for a patient visit, with the EHR bill, patient, practice, and five denormalized provider roles. |
| authorization | 1.9.4 | Prior authorizations issued by payers to patients at a practice, including authorized units, validity dates, and an active flag. |
| charge | 1.9.4 | Charge line items - the per-CPT lines on a claim, with units, total charged, adjustments, payments, and outstanding balance. |
***
## Release Highlights
**era\_matched\_adjustment (1.9.1)**
Each row represents one charge-level adjustment within an Electronic Remittance Advice, joined to HDB's practice and canonical-physician identifiers and, where possible, the originating appointment. The `match_confidence` column grades the appointment-id inference - filter to `provider_match` for high-trust per-provider analytics. Other values (`provider_mismatch`, `patient_practice_date_only`, `no_match`) indicate progressively weaker attributions; `provider_mismatch` is common in incident-to billing where charges file under a supervising physician while the visit is scheduled under the rendering NP or PA. See the [ERA Matched Adjustment article](/articles/hdb/era-matched-adjustment) for example queries.
**user\_role (1.9.1)**
Use the `user_role` lookup to translate role identifiers on Elation Billing user records into the labels shown in the application. See the [User Role article](/articles/hdb/user-role) for example queries.
**claim (1.9.3)**
One row per Elation Billing claim - the bill submitted to a payer for the services on a patient visit. Each claim links to its patient, practice, service location, and the EHR-side `bill` it corresponds to (via `bill_id`, empty when no matching bill exists in HDB). Provider data is denormalized: for each of the five provider roles the row carries the provider's name and NPI directly:
* `rendering_provider_name` / `rendering_provider_npi`
* `referring_provider_name` / `referring_provider_npi`
* `supervising_provider_name` / `supervising_provider_npi`
* `billing_provider_name` / `billing_provider_npi`
* `ordering_provider_name` / `ordering_provider_npi`
Use the claim table to analyze submission status (`is_billed`), reconcile claims to EHR bills (`bill_id`), follow corrected and voided resubmissions (`icn`, `icn_code`), or roll up volume per provider via the rendering or billing NPI. See the [Claim article](/articles/hdb/claim) for example queries.
**authorization (1.9.4)**
Prior authorizations issued by payers, with authorized units, validity dates, and an active flag. There is no built-in "units used" counter; join `claim` on `claim.authorization_id` to see how an authorization has been consumed. The `claim.authorization_id` field is only populated when staff explicitly linked the authorization on the claim, so untagged claims will not appear in the join. See the [Authorization article](/articles/hdb/authorization) for example queries.
**charge (1.9.4)**
One row per Elation Billing charge line - the per-CPT detail beneath a claim. Each row carries the CPT and modifiers, units, line note, NDC drug fields, and the running financial state: `total_charges`, `adjustments`, `payments`, and `balance`, plus `balance_responsibility` (the party currently on the hook). Use `charge` to split patient-AR from payer-AR, drive a "ready to bill" worklist (`first_billed is null`), reconcile claim totals against the sum of their lines, or report per-CPT volume and revenue. For the per-ERA adjustment *history* rather than the latest running totals, use `era_matched_adjustment`. See the [Charge article](/articles/hdb/charge) for example queries.
The Elation Billing tables are present only for EB-qualified practices. If your practice is not on Elation Billing, they are not created.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Version 1.9.5: June 2026
Source: https://help.elationhealth.com/articles/hdb/2026-06-30-ver-195
Starting with the next release, HDB updates will be identified by **release date only** — no more version numbers. This makes it easier to see at a glance when a change shipped. Release notes will continue to live in this section, dated in `YYYY-MM-DD` form.
This release deletes visit-note records consistently across `bill`, `bill_item`, and `bill_item_dx`, exposes a unified `is_deleted` flag on each of those tables, and retires a handful of columns that are no longer populated.
## Schema Changes
| Table | Change |
| -------------- | ----------------------------------------------------------------------------------------------------------------------------------------- |
| bill | added `is_deleted` column |
| bill\_item | added `is_deleted` column |
| bill\_item | **deprecated** — `deletion_time` and `deleted_by_user_id` are now always `NULL` and will be removed in a future release |
| bill\_item\_dx | added `is_deleted` column |
| bill\_item\_dx | **deprecated** — `icd9_code`, `bill_item_deletion_time`, and `deletelog_id` are now always `NULL` and will be removed in a future release |
***
## Release Highlights
**Visit-note deletions now propagate to bills**
When a visit note is deleted, the bill (`bill`), its line items (`bill_item`), and the diagnosis codes on those line items (`bill_item_dx`) are now flagged as deleted along with it. Previously each table tracked deletion independently, so a deleted visit note could still appear to have live bills and CPT/DX rows.
**`is_deleted` on bill, bill\_item, and bill\_item\_dx**
A new boolean `is_deleted` column is now available on all three tables. Filter on `is_deleted = false` to scope queries to live records:
```sql theme={null}
select *
from bill
where is_deleted = false
```
For `bill_item`, the flag is `true` when the line item itself was deleted **or** when the parent bill is deleted. For `bill_item_dx`, the flag is `true` when the diagnosis row was deleted **or** when the parent bill item is deleted.
**Deprecated columns on `bill_item`**
The following columns are deprecated and now always return `NULL`. They remain in the schema for backwards compatibility and will be removed in a future release — migrate any queries that depend on them.
* `bill_item.deletion_time` — superseded by `bill_item.is_deleted`.
* `bill_item.deleted_by_user_id` — superseded by `bill_item.is_deleted`.
**Deprecated columns on `bill_item_dx`**
The following columns are deprecated and now always return `NULL`. They remain in the schema for backwards compatibility and will be removed in a future release — migrate any queries that depend on them.
* `bill_item_dx.icd9_code` — ICD-9 codes have not been used by Elation in production billing for many years; only `icd10_code` is populated going forward.
* `bill_item_dx.bill_item_deletion_time` — superseded by `bill_item_dx.is_deleted`.
* `bill_item_dx.deletelog_id` — superseded by `bill_item_dx.is_deleted`.
If you have existing queries that filter on `bill_item.deleted_by_user_id is null`, `bill_item_dx.deletelog_id is null`, or `bill_item_dx.bill_item_deletion_time is null` to exclude deleted records, update them to use `is_deleted = false`. See the [Visit Notes and Bills article](/articles/hdb/visit-notes-and-bills) for an updated example query.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-07-10
Source: https://help.elationhealth.com/articles/hdb/2026-07-10
This release adds five Elation Billing tables to the Hosted Database, completing the lookup-table set that surrounds Elation Billing claims, and documents the `claim` -> `legal_entity` relationship.
## New Tables
| Table | Description |
| ---------------- | ---------------------------------------------------------------------------------------------------------- |
| legal\_entity | The tax-ID-holding billing group a practice bills claims under. Referenced by `claim.legal_entity_id`. |
| worklist | Claims flagged onto a biller worklist, with the claim's outstanding balance at the time. |
| worklist\_reason | The reason a claim was placed on a biller worklist. |
| tag\_system | The Elation Billing tag catalog - tag definitions (label, color, type), including global Elation defaults. |
| tag | Individual tags applied to claims, patients, and other billing entities. |
## Schema Changes
| Table | Column | Description |
| ----- | ----------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| claim | `legal_entity_id` | Now documented as a foreign key to the new `legal_entity` table - the billing entity the claim was submitted under. The column already existed; this release adds the documented relationship. |
***
## Release Highlights
**legal\_entity**
The tax-ID-holding billing group a practice bills under - name, tax id, NPI, taxonomy, addresses, and the default-entity flag. Each claim records the entity it was billed under via `claim.legal_entity_id`, now documented as a foreign key so the relationship shows up in the schema/ERD. See the [Legal Entity article](/articles/hdb/legal-entity) for example queries.
**worklist**
Claims flagged onto a biller worklist, with the claim's outstanding balance captured when it was flagged. Joins to the claim via `claim_id` (the Elation Billing claim id, `claim.id` - not the EHR `bill`). See the [Worklist article](/articles/hdb/worklist) for example queries.
**worklist\_reason**
The free-text reason a claim was placed on a worklist, joined to the claim via `claim_id`. A worklisted claim can have one or more reasons. See the [Worklist Reason article](/articles/hdb/worklist-reason) for example queries.
**tag\_system**
The catalog of tags (label, color, type) a practice can apply, including the global Elation defaults (for example `QUEUED`, `BILLED`) replicated per practice with a null `practice_id`. The `custom` flag separates practice-created tags from Elation defaults. See the [Tag System article](/articles/hdb/tag-system) for example queries.
**tag**
Individual applied tags. The tagged object is identified polymorphically by `related_id` + `tag_type`; the label and color come from `tag_system` via `tag_system_id`. For claim-type tags, `related_id` is the Elation Billing claim id and joins to `claim.id`. See the [Tag article](/articles/hdb/tag) for example queries.
These tables are present only for practices on the Elation Billing product. If your practice is not on Elation Billing, they are not created in your Hosted Database.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-07-13
Source: https://help.elationhealth.com/articles/hdb/2026-07-13
This release adds a granular `billing_status_detail` column and provider reference columns to the `bill` table, exposing the provider roles recorded in the visit note billing section.
## Schema Changes
| Table | Column | Description |
| ----- | -------------------------------------------------------------------------------------------------- | -------------------------------------------------- |
| bill | `billing_status_detail` | Detailed billing status for each bill |
| bill | `rendering_provider_id`, `supervising_provider_id`, `billing_provider_id`, `referring_provider_id` | Provider roles from the visit note billing section |
***
## Release Highlights
**Billing Status Detail**
The existing `billing_status` column collapses eight underlying bill statuses into four categories (`Unbilled`, `Billed`, `UnresolvedError`, `ResolvedError`). The new `billing_status_detail` column exposes the full status shown in Billing Home, so you no longer have to reconstruct it. `billing_status` is unchanged. Values:
| Status | Meaning |
| ----------------- | ----------------------------------- |
| Awaiting sign-off | Unbilled, visit note not yet signed |
| Signed | Unbilled, visit note signed |
| Received by PMS | Billed |
| Sent to PMS | Transmitted to a PMS |
| Marked as billed | Billed manually |
| Failed to send | Errored (unresolved or resolved) |
**Provider reference columns on `bill`**
The `bill` table now carries the provider roles from the visit note billing section. Previously only `visit_note.physician_user_id` was available, which does not always match the rendering provider shown on the bill.
Three of the columns identify Elation user accounts. Resolve them to provider name, NPI, and credentials by joining the `user` table on `user.physician_id`:
* `rendering_provider_id` — the provider who rendered the services on the bill.
* `supervising_provider_id` — the supervising provider.
* `billing_provider_id` — the billing provider (for example, incident-to billing).
```sql theme={null}
select
b.id as bill_id
, ru.first_name as rendering_first_name
, ru.last_name as rendering_last_name
from bill b
left join user ru on ru.physician_id = b.rendering_provider_id
```
The remaining column is a record ID into the bill's referring-provider record, not a user account:
* `referring_provider_id` — the referring-provider record; its name and state are already surfaced on `bill` as `referring_provider` and `referring_provider_state`.
Join the three user-backed `*_provider_id` columns to `user` on `user.physician_id`, not `user.id`.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-07-22
Source: https://help.elationhealth.com/articles/hdb/2026-07-22
This release adds six Elation Billing tables to the Hosted Database: two patient-level billing tables, the user-practice bridge, the SSO crosswalk that resolves Elation Billing users to their Elation EHR user accounts, and the payment and financial-transaction tables that record billing money movements.
## New Tables
| Table | Description |
| ---------------------------- | ------------------------------------------------------------------------------------------------------------------------------- |
| patient\_guarantor | Responsible-party (guarantor) demographics for a patient's Elation Billing account. Joins to `patient` via `patient_id`. |
| patient\_statement\_tracking | Billing statement state per patient - statements sent, last statement date, and send flag. Joins to `patient` via `patient_id`. |
| user\_practice | Bridge associating Elation Billing users with the practices they belong to. |
| elation\_sso\_user | Crosswalk from Elation Billing users to Elation EHR (`user`) accounts, via Elation Billing SSO. |
| payment | Insurance and patient payments recorded in Elation Billing - amounts, dates, and how they apply to claims. |
| financial\_transaction | The most granular billing financial movements - payments and adjustments applied to charges and claims. |
***
## Release Highlights
**patient\_guarantor**
The responsible party financially accountable for a patient's Elation Billing account - name, date of birth, address, phone, and email. Often the patient, sometimes a parent, spouse, or other party. HDB `patient` stays the source of truth for the patient's own demographics; this table adds only the responsible-party fields, which have no EHR equivalent. The responsible party's SSN is not exposed. See the [Patient Guarantor article](/articles/hdb/patient-guarantor) for example queries.
**patient\_statement\_tracking**
Billing statement state for each patient - how many statements have been sent, when the most recent went out, and whether statements should be sent at all. Joins to `patient` via `patient_id`. See the [Patient Statement Tracking article](/articles/hdb/patient-statement-tracking) for example queries.
**user\_practice**
Which practices each Elation Billing user belongs to, one row per membership. Ties the Elation Billing users that appear on claims, payments, and financial transactions to the practices they operate in. See the [User Practice article](/articles/hdb/user-practice) for example queries.
**elation\_sso\_user**
Resolves an Elation Billing user to their Elation EHR user account via Elation Billing single sign-on. `user_id` is the resolved HDB `user.id` (null when the EHR user has no HDB match). Use it to attribute claims, payments, and financial transactions to an Elation EHR user. See the [Elation SSO User article](/articles/hdb/elation-sso-user) for example queries.
**payment**
Insurance and patient payments recorded in Elation Billing, one row per payment - amount, dates, type and method, and how much has been applied to charges. Insurance payments have no EHR equivalent, so `patient_id` and `claim_id` are often empty. See the [Payment article](/articles/hdb/payment) for example queries.
**financial\_transaction**
The most granular record of billing financial movements - one row per payment or adjustment applied to a charge or claim, with its type, amount, and running balance. Links to the charge, claim, payment, patient, and patient insurance involved, where known. See the [Financial Transaction article](/articles/hdb/financial-transaction) for example queries.
These tables are present only for practices on the Elation Billing product. If your practice is not on Elation Billing, they are not created in your Hosted Database.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-07-27
Source: https://help.elationhealth.com/articles/hdb/2026-07-27
This release adds three Elation Billing tables to the Hosted Database: two that cover insurance eligibility from different angles, and one that tracks how a claim moves through the clearinghouse. It also converts the guarantor flag on `patient_guarantor` to a boolean.
## New Tables
| Table | Description |
| ------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------- |
| insurance\_eligibility\_check | Individual insurance eligibility verification checks sent to a payer through the ClaimMD clearinghouse, and the result of each. |
| patient\_insurance\_eligibility | Eligibility and coverage detail for a patient's insurance - eligibility status and check date, Medicare code, and the coverage window. |
| clearinghouse\_transaction | Lifecycle events for a claim as it moves through the ClaimMD clearinghouse - submitted, acknowledged, accepted or rejected, ERA received, crossed over. |
## Schema Changes
| Table | Column | Change |
| ------------------ | ----------- | ---------------------------------------------------------------- |
| patient\_guarantor | `guarantor` | Renamed to `is_guarantor` and changed from a number to a boolean |
***
## Release Highlights
**insurance\_eligibility\_check**
A verification request sent to a payer through the ClaimMD clearinghouse, together with its outcome. `is_eligible` carries the payer's determination (`true` = active or eligible coverage, `false` = inactive) and is the source of the eligibility status carried on `patient_insurance`. `is_internal` separates checks triggered by an internal Elation pathway, such as EHR insurance sync or agentic billing, from those a billing user ran. Join to `patient` and `patient_insurance` for the patient and the policy that were checked. See the [Insurance Eligibility Check article](/articles/hdb/insurance-eligibility-check) for example queries.
**patient\_insurance\_eligibility**
The eligibility and coverage fields the `patient_insurance` policy record does not carry - eligibility status and the date it was last checked, the Medicare Secondary Payer value code, and the coverage start and end dates, keyed to a patient's insurance. The two eligibility tables answer different questions: `insurance_eligibility_check` records each individual check as it happened, while `patient_insurance_eligibility` records the resulting state for the policy. Note that `is_active` marks the current, non-superseded record rather than coverage being in effect - use `coverage_start` and `coverage_end` for that. See the [Patient Insurance Eligibility article](/articles/hdb/patient-insurance-eligibility) for example queries.
**clearinghouse\_transaction**
Each lifecycle event for a claim as it moves through ClaimMD, giving you the claim's full path over time. `type` is the normalized lifecycle category (for example `SUBMITTED`, `ACKNOWLEDGED`, `accepted`, `DENIED`, `REJECTED`, `ERA RECEIVED`, `CROSSOVER`) and `status` is the detailed, human-readable message for the same event, which usually names the payer. `claimmd_id` is the identifier the clearinghouse assigned, useful for tracing a transaction back to ClaimMD, and is not a Hosted Database key. See the [Clearinghouse Transaction article](/articles/hdb/clearinghouse-transaction) for example queries.
**`patient_guarantor.guarantor` is now the boolean `is_guarantor`**
The `guarantor` column on `patient_guarantor` was a number holding 0 or 1. It is now a boolean named `is_guarantor`. `true` means the patient has a distinct responsible party on file and the `resp_*` fields are populated; `false` means the patient is their own guarantor or none is recorded, and the `resp_*` fields are blank. Queries that referenced `guarantor` need updating:
```sql theme={null}
select *
from patient_guarantor
where is_guarantor
and is_deleted = false
```
See the [Patient Guarantor article](/articles/hdb/patient-guarantor) for example queries.
These tables are present only for practices on the Elation Billing product. If your practice is not on Elation Billing, they are not created in your Hosted Database.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-07-28
Source: https://help.elationhealth.com/articles/hdb/2026-07-28
This release simplifies how deletion is represented on the `patient_problem_code` table and resolves inconsistencies between how the Elation application (frontend) and the underlying data (backend) handled duplicate codes and deleted problems. Deletion is now represented by a single boolean `is_deleted` flag. The `deletion_time` and `deleted_by_user_id` columns are deprecated: they remain on the table but are now always `null`, and they will be fully removed at a future date.
## Schema Changes
| Table | Column | Change |
| ---------------------- | -------------------- | -------------------------------------------------------------------------------------------- |
| patient\_problem\_code | `deletion_time` | Deprecated — column remains but is now always `null`; will be fully removed at a future date |
| patient\_problem\_code | `deleted_by_user_id` | Deprecated — column remains but is now always `null`; will be fully removed at a future date |
| patient\_problem\_code | `is_deleted` | Now the only indicator of deletion state |
***
## Release Highlights
**Deletion represented as a single `is_deleted` flag**
Previously `patient_problem_code` carried both a `deletion_time` timestamp and a `deleted_by_user_id` reference alongside the `is_deleted` boolean. Deletion is now represented solely by `is_deleted` (`true`/`false`), which is the single source of truth for whether a patient problem code has been deleted. The `deletion_time` and `deleted_by_user_id` columns are deprecated — they still appear on the table for now but are always `null`, and they will be fully removed at a future date. Update any queries that read them to use `is_deleted` before that removal.
To exclude deleted rows, filter on the boolean directly:
```sql theme={null}
select *
from patient_problem_code
where is_deleted = false
```
**Consistent duplicate and deletion handling**
We also resolved cases where the deletion state in the Hosted Database could disagree with what the Elation application shows. Two sources of inconsistency were addressed:
* **Duplicate codes.** A single problem code could be backed by multiple underlying code records (for example, superseded or duplicate entries that resolve to the same code). These rows could disagree on deletion state, producing duplicate `patient_problem_code` rows for the "same" code. Rows are now de-duplicated by the resolved code, so each code appears once with a single, consistent deletion state.
* **Deleted problems.** `is_deleted` now reflects deletion whether the patient problem itself was deleted or its underlying diagnosis-code link was removed, matching what the application displays. Previously a code could remain marked as not deleted in the data even though it no longer appeared in the application.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-07-29
Source: https://help.elationhealth.com/articles/hdb/2026-07-29
This release adds two tables: `health_maintenance` for preventive care item completions, and `payer` for the payers a practice bills through Elation Billing enriched with the Claim.MD payer directory.
## New Tables
| Table | Description |
| ------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| health\_maintenance | One row per health maintenance item completion per patient, with the measure name, completion date, clinician note, quality measure code, and result flags. |
| payer | Payers a practice bills through Elation Billing, combined with the Claim.MD payer directory - payer identity and type, plus which transaction types Claim.MD supports for each payer. |
***
## Release Highlights
**health\_maintenance**
Each row records when a clinician marked a preventive care item as done, including the measure name (e.g., Cervical Cancer Screening), the date of completion, any free-text note entered at the time, and the result flags (`normal_result`, `abnormal_result`) defined by the measure rule. `measure_code` carries the clinical quality measure identifier (CMS or Elation-specific) for practices reporting on quality measures such as HEDIS or CQM. `physician_id`, `firstname`, and `lastname` identify the clinician who recorded the item. Rows with a non-null `deleted_date` have been removed from the patient's chart and should generally be excluded from reporting. See the [Health Maintenance article](/articles/hdb/health-maintenance) for example queries.
**payer**
One row per payer saved on an Elation Billing account, per practice. Each row pairs the payer as your account named it with the matching entry from the Claim.MD payer directory:
* `custom_payer_name` is the name your billing account gave the payer, which may differ from Claim.MD's.
* `claimmd_payer_name` is Claim.MD's canonical name for the same payer.
* `payer_id` is the Claim.MD-issued payer identifier. It is an external clearinghouse reference, not a Hosted Database key.
* `payer_type` is Claim.MD's category for the payer - `commercial`, `medicaid`, `medicare`, `bcbs`, `champus`, or `workerscomp`.
* `payer_alt_names` and `payer_alt_ids` list the other names and ids Claim.MD knows the payer by, where there are any.
The capability columns describe what Claim.MD supports for the payer: `institutional_claims`, `professional_claims`, `dental_claims`, `era`, `eligibility`, `workers_compensation`, `secondary`, `auto_insurance`, and `electronic_attachment`. Each is `yes`, `no`, or `enrollment` - `enrollment` meaning the payer supports it once your practice completes enrollment with them. `avg_era_enroll_days` carries Claim.MD's average number of days for ERA enrollment to complete with that payer.
Claim.MD does not record a value for every payer. Where it has no answer the column is `null`, never an empty string, so test for a missing value with `is null` rather than comparing against `''`. This applies to `payer_type`, to `payer_state` (which is `null` for national payers), and to the capability columns `institutional_claims`, `professional_claims`, `dental_claims`, `era`, `eligibility`, `secondary`, `auto_insurance`, and `electronic_attachment`. Note that a `null` matches neither `= 'yes'` nor `<> 'yes'`, so a filter on one of these columns leaves out the payers with no recorded value - the query below returns only payers Claim.MD explicitly marks as supporting eligibility checks.
`practice_id` joins to `practice` and `account_id` joins to `elation_billing_account`.
To list the payers set up for your practices that support electronic eligibility checks:
```sql theme={null}
select custom_payer_name, claimmd_payer_name, payer_type, era, eligibility
from payer
where is_deleted = false
and eligibility = 'yes'
order by custom_payer_name
```
The `payer` table is present only for practices on the Elation Billing product. If your practice is not on Elation Billing, it is not created in your Hosted Database.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-07-30
Source: https://help.elationhealth.com/articles/hdb/2026-07-30
This release adds one Elation Billing table: `clearinghouse_message`, the individual messages the ClaimMD clearinghouse returns against a claim submission.
## New Tables
| Table | Description |
| ---------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| clearinghouse\_message | Individual messages returned by the ClaimMD clearinghouse against a claim submission - validation and scrubbing errors, acknowledgments, and payment detail lines from an ERA. |
***
## Release Highlights
**clearinghouse\_message**
One row per message the clearinghouse returned within a clearinghouse transaction, so a single transaction usually has several messages. Join on `clearinghouse_transaction_id`, or filter directly using `claim_id` and `practice_id`, which are copied from the parent transaction.
`message_subject` and `message` change meaning together. On a validation or scrubbing message, `message_subject` names the claim form field at fault (`diag_1`, `ins_number`, `prov_npi`) and `message` is readable text such as "Diagnosis code invalid \[R108]." On a message derived from an ERA, `message_subject` is a label (`Total Paid`, `ICN`, `Paid Date`) and `message` holds that label's value. `message_code` distinguishes the two: it is populated for messages the clearinghouse returned against a submission and `null` for ERA-derived rows and Elation Billing's own scrubbing status lines, so filter with `message_code is not null` for submission responses.
Only messages the clearinghouse linked back to a transaction are included. The rest are mostly acknowledgments, plus payer denial reason lines that arrive with a remittance rather than a claim submission, and cannot be attributed to a practice. Use `clearinghouse_transaction.type` for the acknowledgment lifecycle, and [era\_matched\_adjustment](/articles/hdb/era-matched-adjustment) for denial reason analysis - it carries the payer's adjustment and remark codes with the amounts and the claim they apply to.
`clearinghouse_message` is documented together with its parent table in the [Clearinghouse transactions and messages](/articles/hdb/clearinghouse-transaction) article.
The `clearinghouse_message` table is present only for practices on the Elation Billing product. If your practice is not on Elation Billing, it is not created in your Hosted Database.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-08-03
Source: https://help.elationhealth.com/articles/hdb/2026-08-03
This release documents an existing table rather than adding a new one: `patient_history`, the entries recorded in the History section of a patient's chart.
## Documentation Updates
| Table | Description |
| ---------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| patient\_history | Entries recorded in the History section of a patient's chart - past medical and surgical history, social history, habits, family history, smoking status, and health maintenance notes. Already present in your Hosted Database; now documented with full column descriptions and an article. |
***
## Release Highlights
**patient\_history**
`patient_history` has been in your Hosted Database all along, but had no article and no column descriptions. Both are now in place: every column is described in the [Hosted Database schema](/articles/hdb/schema), and the new [patient\_history](/articles/hdb/patient-history) article covers the entry types with example queries.
The `type` column identifies which kind of entry a row holds. Two of its values overlap with dedicated tables.
`type = 'Maintenance'` rows are health maintenance **notes** typed into the chart. Completed preventive care measures, with their measure codes and result flags, are in [health\_maintenance](/articles/hdb/health-maintenance) instead. Likewise `type = 'Immunization'` rows are free-text notes rather than administered vaccines, which are in `patient_immunization`.
`type = 'Family'` covers two different things. Structured family history entries populate `relationship_type`, plus `icd9_id` or `snomed_id` where the clinician selected a code. Free-text notes filed under family history leave `relationship_type` null. Filter on `relationship_type is not null` when you want only the structured entries.
Deleted entries are retained with `deletion_time` set, so filter on `deletion_time is null` for the entries currently visible in the chart.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# 2026-08-31
Source: https://help.elationhealth.com/articles/hdb/2026-08-31
This release adds six Elation Billing tables: the people who work claims, the queue they submit them from, the diagnosis codes on each charge line, the payer addresses paper claims are mailed to, and the notes billers leave on claims and on payments.
## New Tables
| Table | Description |
| ---------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| elation\_billing\_user | The billers, administrators, and practice staff who work claims in Elation Billing, with their role, contact details, and last login. |
| claim\_queue | Claims queued for submission to the clearinghouse, recording which biller sent each claim out and when. |
| charge\_dx | The diagnosis codes attached to each Elation Billing charge line, in the order they appear on the claim. |
| payer\_address | The mailing addresses a practice holds for each payer, used for paper claim runs. |
| claim\_note | Notes billers leave on an Elation Billing claim - the note text, the user who wrote it, and when. Every note is attributed to a user. |
| payment\_note | Notes recorded against an Elation Billing payment - the note text, who wrote it, and when. Notes come either from a billing user or from the EHR patient-payment integration. |
***
## Release Highlights
**elation\_billing\_user**
One row per Elation Billing user, per warehouse. [elation\_billing\_user](/articles/hdb/elation-billing-user) is the first table to name the people behind Elation Billing activity, and it is what makes the user references on `claim_queue`, `claim_note`, and `payment_note` resolve to a named person.
Elation Billing accounts are separate from the Elation EHR users in `user`; join through [elation\_sso\_user](/articles/hdb/elation-sso-user) to connect the two. There is no `practice_id` on this table, because one user can work across several practices - the practices they work in are in [user\_practice](/articles/hdb/user-practice).
`is_active` and `is_deleted` mean different things. `is_active = false` is a user whose access was withdrawn but whose record remains; `is_deleted = true` is a record removed in Elation Billing. Filter on both when you want only current, usable accounts. `role_id` points at [user\_role](/articles/hdb/user-role), but a small number of users carry a role that no longer exists there, so use a left join if you need every user in the result.
**claim\_queue**
One row per claim queued for submission to the clearinghouse. [claim\_queue](/articles/hdb/claim-queue) is mostly history rather than a live worklist: Elation Billing removes a claim from the queue once the claim leaves it, so well over 99% of rows are completed work. Any question about what is waiting to be submitted must filter on `is_deleted = false` - a plain row count over the whole table will overstate pending work by several orders of magnitude.
Those completed rows are kept because they are the only record in the Hosted Database of which biller sent a claim out and when. [claim](/articles/hdb/claim) carries no user, and no other Elation Billing table attributes a claim submission to a person.
`status` changes meaning with `is_deleted`. On a row that has left the queue, `pending` means the claim was paper billed or pulled back by a biller, and a `batch-` label is the audit trail of the run that submitted it. On a row still in the queue, a `batch-` label should exist only momentarily, so a surviving one means that submission run did not finish and the claim is stranded. `is_submitted` covers electronically confirmed submissions only; for the billing outcome itself use [clearinghouse\_transaction](/articles/hdb/clearinghouse-transaction) and `claim.is_billed`.
**charge\_dx**
One row per diagnosis code per charge line, ordered by `sequence_number`. [charge\_dx](/articles/hdb/charge-dx) is the Elation Billing counterpart to `bill_item_dx` on the Elation EHR side.
There is no `id` column. Elation Billing holds no single key for these rows, so a row is identified by its charge, diagnosis code, and sequence together - all three parts are needed, because neither charge and sequence nor charge and code is unique on its own.
`dx` holds the ICD-10 code with the decimal point removed: `I10`, `E785` for E78.5, `Z0000` for Z00.00. This matches the format used by `bill_item_dx.dx`, so it does not join directly to `icd10.code` without reinstating the decimal point.
**payer\_address**
One row per saved payer mailing address. A practice can hold more than one address for the same payer.
[payer\_address](/articles/hdb/payer-address) is an address book kept against the Claim.MD payer directory rather than against the practice's own saved payer list, so `payer_id` resolves on roughly two thirds of rows. The rest are directory payers the practice holds a mailing address for but has never saved as a payer of its own. `claimmd_payer_id` is populated on every row, so use it rather than `payer_id` when you need payer identity across the whole table.
`claimmd_payer_id` is held as text, and not every value is numeric - `PAPER`, `EAP20`, and `00060` are all valid codes - so leading zeros are significant and it should not be cast to a number. `zip` formatting is inconsistent in the source, in both five-digit and nine-digit forms with and without a hyphen, so normalize it before matching on it.
**claim\_note**
One row per note per claim. Until now the Hosted Database had no way to answer who worked a claim and what they said about it: `claim.narrative` and `charge.line_note` hold only the current text with no author and no history, and `worklist_reason` records when a claim was worklisted but not by whom. [claim\_note](/articles/hdb/claim-note) is the full trail, oldest note to newest, with an author on every row.
Join on `claim_id` to reach the claim, and on `elation_billing_user_id` to reach the author's name and login. Attribution is complete: every note carries a user.
`is_statement_note` marks notes flagged with the star toggle in the claim notes panel, which are the notes counted toward the patient's statement. Filter on `is_deleted = false` for the notes still visible in Elation Billing.
**payment\_note**
One row per note per payment. Notes reach [payment\_note](/articles/hdb/payment-note) by two paths, and the difference matters when you report on them.
A billing user working the payment in Elation Billing produces a note with `elation_billing_user_id` set, which joins to `elation_billing_user` for the author's name. The EHR patient-payment integration, which posts payments taken in the EHR, produces notes with no `elation_billing_user_id` and text prefixed `INTERNAL MEMO - `. These are the majority of notes today, so a null user id means system-created rather than unknown, and an inner join to `elation_billing_user` will drop them.
`author_login` is a snapshot of the author's login taken when the note was written. A user who was later deactivated keeps their old login on historical notes, so it will not always match the current `elation_billing_user.email`. Treat it as display text, not a key.
Every column on all six tables is described in the [Hosted Database schema](/articles/hdb/schema).
The tables in this release are present only for practices on the Elation Billing product. If your practice is not on Elation Billing, they are not created in your Hosted Database.
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Accessing Your Hosted Database
Source: https://help.elationhealth.com/articles/hdb/accessing-your-hosted-database
## Accessing your Hosted Database
Once your Hosted Database setup is complete, Elation will send a secure email with your URL, username, and password.
Click on the link under Login Credentials and follow the 1password steps to access your username and password
Reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - Hosted Database Login Help
# Appointments
Source: https://help.elationhealth.com/articles/hdb/appointments
Appointment report on volume, trends by status, date range, and type.
**For reporting on but not limited to:**
* Appointment volume for a given time period
* Trends by status
* Trends by type
* Provider on the appointments
* Appointment creation details
```sql sql theme={null}
with appt_status as (
select appointment_id,
status,
note,
creation_time
from appointment_status
qualify row_number() over (partition by appointment_id order by creation_time desc) = 1
)
select
p.id as PATIENT_ID
, concat(p.first_name, ' ', p.last_name) as PATIENT_NAME
, p.dob
, appt_time
, concat('(',u.id, ') ',u.first_name, ' ', u.last_name) as PROVIDER_ON_APPT
, concat('(',a.created_by_user_id, ') ',ppu_user.first_name, ' ', ppu_user.last_name) as PRIMARY_CARE_PROVIDER
, a.appt_type
, sl.name as SERVICE_LOCATION_NAME
, stat.status
, a.description
, a.copay_amount
, stat.note
, concat('(',a.created_by_user_id, ') ',c_user.first_name, ' ', c_user.last_name) as CREATED_BY
, a.creation_time
, concat('(',a.deleted_by_user_id, ') ',d_user.first_name, ' ', d_user.last_name) as DELETED_BY
, a.deletion_time
, a.last_modified
from appointment a
left join service_location sl on sl.id = a.service_location_id
left join appt_status stat on stat.appointment_id = a.id
join patient p on p.id = a.patient_id
join user u on u.id = a.physician_user_id
left join user c_user on c_user.id = a.created_by_user_id
left join user d_user on d_user.id = a.deleted_by_user_id
join user ppu_user on ppu_user.id = p.primary_physician_user_id;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Authorization
Source: https://help.elationhealth.com/articles/hdb/authorization
Query prior authorizations issued by payers - look up authorized units, validity dates, and the claims billed against each authorization.
Prior authorizations issued by payers to patients at a practice. One row per authorization, including the payer, authorization number, number of authorized units, period start and expire dates, an active flag, and any free-text notes. Referenced by `claim.authorization_id`.
The table schema can be found in our [HDB dbdocs reference](https://dbdocs.io/hosteddb_support/hosted_database_snowflake?view=authorization).
**For reporting on but not limited to:**
* Currently active authorizations for a patient or practice
* Authorizations expiring soon that may need renewal
* How many claims have been billed against an authorization
* Authorization counts and authorized-unit totals by payer
The `authorization` table does not store a "units used" counter. To see how an authorization has been consumed, join to `claim` on `claim.authorization_id`. The `claim.authorization_id` field is only populated when staff explicitly linked the authorization on the claim, so untagged claims will not appear in the join.
## Active authorizations
Returns authorizations the practice has flagged active that have not been soft-deleted.
```sql sql theme={null}
select
auth.id as authorization_id
, auth.patient_id
, auth.practice_id
, auth.payer_name
, auth.auth_num
, auth.auth_units
, auth.starts
, auth.expires
, auth.auth_note
, auth.creation_time_utc
, auth.last_modified_utc
from authorization auth
where auth.is_deleted = false
and auth.active = 1
order by auth.expires;
```
## Authorizations expiring soon
Identifies authorizations expiring within the next 30 days. Useful for proactively requesting renewals.
```sql sql theme={null}
select
auth.id as authorization_id
, auth.patient_id
, auth.practice_id
, auth.payer_name
, auth.auth_num
, auth.auth_units
, auth.starts
, auth.expires
, datediff(day, current_date, auth.expires) as days_until_expiration
from authorization auth
where auth.is_deleted = false
and auth.active = 1
and auth.expires between current_date and dateadd(day, 30, current_date)
order by auth.expires;
```
## Claims billed against each authorization
Counts the claims that were linked to each authorization. This is the right way to see how an authorization has been used, since the `authorization` table itself does not record consumption.
One claim is not necessarily one authorized unit - payers may count units per CPT line or per service date. If you need unit-level accounting, drop down to the charge grain rather than counting claims. Also, claims only appear here when staff tagged the authorization on the claim; untagged claims are invisible to this join.
```sql sql theme={null}
select
auth.id as authorization_id
, auth.patient_id
, auth.payer_name
, auth.auth_num
, auth.auth_units as units_authorized
, auth.starts
, auth.expires
, count(c.id) as claims_linked
from authorization auth
left join claim c on c.authorization_id = auth.id
where auth.is_deleted = false
and auth.active = 1
group by auth.id, auth.patient_id, auth.payer_name, auth.auth_num, auth.auth_units, auth.starts, auth.expires
order by claims_linked desc;
```
## Patient authorization history
Returns every authorization on file for a single patient, deleted rows included, ordered by most recently created.
```sql sql theme={null}
select
auth.id as authorization_id
, auth.payer_name
, auth.auth_num
, auth.auth_units
, auth.active
, auth.starts
, auth.expires
, auth.auth_note
, auth.is_deleted
, auth.creation_time_utc
, auth.last_modified_utc
from authorization auth
where auth.patient_id = 12345 -- Replace with actual patient ID
order by auth.creation_time_utc desc;
```
## Authorizations by payer
Aggregates authorization counts and total authorized units per payer.
```sql sql theme={null}
select
auth.payer_name
, count(*) as total_authorizations
, count(distinct auth.patient_id) as unique_patients
, sum(auth.auth_units) as total_units_authorized
from authorization auth
where auth.is_deleted = false
group by auth.payer_name
order by total_authorizations desc;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Bill
Source: https://help.elationhealth.com/articles/hdb/bill
Query the EHR-side bill a practice generates from a visit note - its billing status, the providers on it, and the Elation Billing claim it produced.
One row per bill generated from a visit note - the EHR-side billing record a practice creates to capture what was billed for an encounter. Each bill links to its `visit_note` (and, through the note, the `patient`), `practice`, and `service_location`, and carries the billing-section provider roles and the current billing status. On the Elation Billing side, a `claim` points back to the bill it was generated from via `claim.bill_id`.
The CPT lines billed on a bill live in `bill_item` (`bill_item.bill_id` → `bill.id`), and their diagnosis pointers in `bill_item_dx` (`bill_item_dx.bill_item_id` → `bill_item.id`).
The table schema can be found in our [HDB dbdocs reference](https://dbdocs.io/hosteddb_support/hosted_database_snowflake?view=bill).
**For reporting on but not limited to:**
* What was billed for a patient's visit, and when (`billing_date`)
* Bill status and any billing errors (`billing_status`, `billing_status_detail`, `billing_error`)
* The rendering, supervising, and billing providers on a bill
* Reconciling EHR bills to Elation Billing claims via `claim.bill_id`
* CPT- and diagnosis-level detail by joining `bill_item` and `bill_item_dx`
`rendering_provider_id` is only populated when the rendering provider **differs from the note's provider**. When it is null, the rendering provider is the visit note's author - `visit_note.physician_user_id`. To get the effective rendering provider, fall back to the note's author whenever `rendering_provider_id` is empty (see [Effective rendering provider](#effective-rendering-provider) below).
Watch the join keys: the provider-role columns on `bill` (`rendering_provider_id`, `supervising_provider_id`, `billing_provider_id`, `referring_provider_id`) join to `user` on `user.physician_id`, whereas `visit_note.physician_user_id` joins to `user.id`. Divergence between the note's provider and the rendering provider is common in practices with supervising relationships or incident-to billing (`incident_to = true`).
## Bills for a date range
Returns every bill with a billing date in a window, with its status, reference number, and any billing error.
```sql sql theme={null}
select
b.id as bill_id
, b.practice_id
, b.visit_note_id
, b.service_location_id
, b.billing_date
, b.billing_status
, b.billing_status_detail
, b.ref_number
, b.billing_error
from bill b
where b.billing_date between '2026-01-01' and '2026-03-31'
order by b.billing_date, b.practice_id;
```
## Effective rendering provider
Resolves the provider who rendered the services on each bill. Because `rendering_provider_id` is only set when it differs from the note's author, this falls back to `visit_note.physician_user_id` when the column is empty. Note the two joins to `user` use different keys.
```sql sql theme={null}
select
b.id as bill_id
, b.visit_note_id
, vn.patient_id
, b.rendering_provider_id
, coalesce(rp.id, np.id) as effective_rendering_provider_user_id
, coalesce(
rp.first_name || ' ' || rp.last_name
, np.first_name || ' ' || np.last_name
) as effective_rendering_provider_name
, case when b.rendering_provider_id is null
then 'note author' else 'bill override' end as source
from bill b
join visit_note vn on vn.id = b.visit_note_id
left join user np on np.id = vn.physician_user_id
left join user rp on rp.physician_id = b.rendering_provider_id
where vn.deleted_by_user_id is null
order by b.billing_date desc;
```
## Bill volume by status
Rolls up bill counts by practice and billing status over the last 90 days. `billing_status_detail` is the full status shown in Billing Home; `billing_status` is the collapsed category.
```sql sql theme={null}
select
b.practice_id
, b.billing_status_detail
, count(*) as bills
from bill b
where b.billing_date >= dateadd(day, -90, current_date)
group by b.practice_id, b.billing_status_detail
order by b.practice_id, bills desc;
```
## Reconcile a bill with its claim
Joins each EHR bill to the Elation Billing claim it produced via `claim.bill_id`, so you can confirm which bills made it to a claim and which have not.
```sql sql theme={null}
select
b.id as bill_id
, b.visit_note_id
, b.billing_date
, b.billing_status_detail
, c.id as claim_id
, c.local_id
, c.is_billed
from bill b
left join claim c
on c.bill_id = b.id
and c.is_deleted = false
where b.billing_date >= dateadd(day, -30, current_date)
order by b.billing_date desc;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Can I load data into the Hosted Database?
Source: https://help.elationhealth.com/articles/hdb/can-i-load-data-into-the-hosted-database
Your Elation Snowflake account is a read only account. You will not be able to add any outside data from another source.
We recommend setting up a Direct Share to gain write access.
Please refer to this article for more information on Direct Shares: [How To Setup Direct Share](/articles/hdb/how-to-setup-direct-share)
# Can you grant me write permissions?
Source: https://help.elationhealth.com/articles/hdb/can-you-grant-me-write-permissions
Your Elation Snowflake account is a read only account. You will not be able to modify, delete, or add data in a reader account.
We recommend creating your own Snowflake account and setting up a Direct Share with your Elation read only account to gain write access.
Please refer to these articles for more information on Direct Shares:
* [https://docs.snowflake.com/en/guides-overview-sharing](https://docs.snowflake.com/en/guides-overview-sharing)
* [How To Setup Direct Share](/articles/hdb/how-to-setup-direct-share)
# Change Management and Schema Versioning
Source: https://help.elationhealth.com/articles/hdb/change-management
How Elation classifies, announces, and rolls out changes to the Hosted Database schema and data, and the notice you can expect before each type of change.
The Hosted Database is delivered directly into your Snowflake account, so a change we make to the schema or to the data lands in your environment and can affect pipelines you have built on top of it. This article explains how we classify changes, how much notice you get for each class, and where those notices are published.
This article is for the engineering and analytics teams who build on the Hosted Database. If you are looking for what actually shipped, see the [Release Notes](/articles/hdb/hdb-snowflake). If you would rather query a change before its release date than wait for it, see [Early Release](/articles/hdb/early-release).
## How changes are classified
Every Hosted Database change is classified into one of three categories before it ships. The category determines how much advance notice you receive.
| Category | What it means | Advance notice |
| --------------- | ------------------------------------------------------------------------------------------------------------------- | -------------------- |
| Breaking | An existing query can stop working, or start returning materially different values, without any change on your side | 30 calendar days |
| Behavior change | The schema is untouched and queries keep working, but the amount of data behind them shifts substantially | 7 calendar days |
| Non-breaking | Purely additive. Existing queries are unaffected | Announced at release |
### Breaking changes
A change is breaking when it removes something you may be selecting, changes the type of something you are selecting, or changes what a value means. Specifically:
* Removing a table or a column
* Renaming a table or a column
* Changing a column's data type
* Changing the semantic meaning of an existing column, including a column that begins returning `null` where it previously carried a value
* Changing a table's primary key
### Behavior changes
A behavior change leaves the schema untouched. Every table and column keeps its name, type, and meaning, so nothing you have written stops working, but the amount of data behind it shifts enough that a query you already run would return a noticeably different answer. Behavior changes get 7 calendar days of notice and an impact analysis naming the tables affected and the approximate change in row count.
Examples:
* A table's row count changes substantially, in either direction
* The span of history a table carries changes substantially
### Non-breaking changes
Additive changes are announced in the release notes when they ship, with no advance notice period:
* Adding a new table
* Adding a new column to an existing table
* Adding documentation, column descriptions, or entity relationship diagram detail
We ship these frequently and intend to keep doing so. If your pipeline selects specific columns rather than `select *`, and does not assume a fixed column count or column order, additive changes are transparent to you.
***
## Emergency changes
We reserve the right to ship a change without the notice period when a delay would cause greater harm than the change itself. In practice this is limited to:
* A security or privacy issue, including data exposed to the wrong party
* A data integrity problem severe enough that the data cannot responsibly be left in place
* A change required by an upstream vendor or by regulation on a fixed deadline
When this happens we publish the release note at the same time as the change and state plainly that the notice period was not met and why.
***
## Where notices are published
Advance notices and release notes both go to the [Hosted Database Release Notes](/articles/hdb/hdb-snowflake) page. An advance notice appears as its own entry ahead of the change, naming the category and the tables affected, and the release itself gets a second entry when it ships. To have entries reach you automatically, see [Subscribe to release feeds](/articles/subscribe-to-release-feeds).
***
## Building an integration that tolerates change
A few conventions on your side make almost all of our changes invisible to you:
* **Select named columns, not `select *`.** A new column added to a table should not change the shape of your result set.
* **Do not depend on column order or column count.** Both can change when a table gains columns.
* **Join on documented foreign keys.** The entity relationship diagram at [dbdocs.io/hosteddb\_support/hosted\_database\_snowflake](https://dbdocs.io/hosteddb_support/hosted_database_snowflake) shows the supported relationships.
***
## Frequently Asked Questions
### Can I stay on the previous schema while I migrate?
No. The Hosted Database is shared live into your account, so there is a single current schema. The notice periods described above exist to give you a migration window without needing a parallel version.
What you can do is work ahead of the change rather than behind it. [Early Release](/articles/hdb/early-release) is an optional channel that delivers a copy of the affected tables with a pending change already applied, so you can test your migration, or start using a new table, before the general availability date.
### Can I get a change earlier than its GA date?
Yes, in many cases. Once a change is built and verified, Elation can copy the affected tables into the [Early Release](/articles/hdb/early-release) channel while the change waits out its notice period. Request access through the Support Portal.
### Where do I raise a concern about an announced change?
Contact the [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - Change notice, and reference the date of the notice. If a change we have classified as a behavior change or as non-breaking would in fact break your integration, tell us during the notice window so we can partner on a solution. Depending on what the change touches, that might mean reworking how we deliver it, extending the notice period, or giving you the change in [Early Release](/articles/hdb/early-release) so you can adapt against it first.
***
## Related Articles
* [Hosted Database Release Notes](/articles/hdb/hdb-snowflake)
* [Early Release](/articles/hdb/early-release)
* [Subscribe to release feeds](/articles/subscribe-to-release-feeds)
* [What data is available?](/articles/hdb/where-can-i-see-what-data-is-available)
* [How to tell when my data was last refreshed](/articles/hdb/how-to-tell-when-my-data-was-last-refreshed)
* [Does my data refresh in real time?](/articles/hdb/does-my-data-refresh-in-realtime)
***
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Charge
Source: https://help.elationhealth.com/articles/hdb/charge
Query Elation Billing charge line items - the per-CPT lines on a claim, with their charges, adjustments, payments, and outstanding balance.
Elation Billing charge line items. Each row is one billable service line within a claim, carrying its financial lifecycle (charges, adjustments, payments, balance). Multiple charge lines roll up to a single `claim`, and the claim points back to an EHR-side `bill`.
The table schema can be found in our [HDB dbdocs reference](https://dbdocs.io/hosteddb_support/hosted_database_snowflake?view=charge).
**For reporting on but not limited to:**
* Per-CPT volume and revenue for a date range
* Outstanding balance per patient, payer, or claim
* Patient-responsibility vs. payer-responsibility splits via `balance_responsibility`
* Charges that have not yet been billed (`first_billed is null`)
* NDC-level drug-charge reporting
* Reconciling claim totals against the sum of their charge lines
The financial columns on `charge` (`total_charges`, `adjustments`, `payments`, `balance`) are the running totals stored on the line in Elation Billing - they reflect the latest state, not a transaction log. For the per-ERA adjustment history use [`era_matched_adjustment`](/articles/hdb/era-matched-adjustment).
## Charges for a date range
Returns every charge line with service date in a window, with the CPT and modifiers, units, charge totals, and current balance.
```sql sql theme={null}
select
ch.id as charge_id
, ch.claim_id
, ch.patient_id
, ch.practice_id
, ch.from_date
, ch.through_date
, ch.cpt
, ch.mod1
, ch.mod2
, ch.units
, ch.unit_charge
, ch.total_charges
, ch.adjustments
, ch.payments
, ch.balance
, ch.balance_responsibility
, ch.last_billed
, ch.last_billed_name
from charge ch
where ch.is_deleted = false
and ch.from_date between '2026-01-01' and '2026-03-31'
order by ch.from_date, ch.claim_id, ch.priority;
```
## Outstanding balances by responsibility
Aggregates remaining balance by who owes it. Useful for separating patient-AR from payer-AR snapshots.
```sql sql theme={null}
select
ch.practice_id
, ch.balance_responsibility
, count(*) as open_charges
, count(distinct ch.claim_id) as claims_with_balance
, count(distinct ch.patient_id) as patients_with_balance
, sum(ch.balance) as total_outstanding_balance
from charge ch
where ch.is_deleted = false
and ch.balance > 0
group by ch.practice_id, ch.balance_responsibility
order by ch.practice_id, total_outstanding_balance desc;
```
## Charges that have not yet been billed
Returns lines that exist in Elation Billing but have not been billed out to any payer. Useful as a "ready to submit" worklist for billers.
```sql sql theme={null}
select
ch.id as charge_id
, ch.claim_id
, ch.patient_id
, ch.practice_id
, ch.from_date
, ch.through_date
, ch.cpt
, ch.total_charges
, ch.line_note
, ch.created_timestamp
from charge ch
where ch.is_deleted = false
and ch.first_billed is null
order by ch.from_date;
```
## CPT volume and revenue
Rolls up CPT-level activity over a 90-day window: line counts, unique patients, billed totals, collected totals, and the running balance still on those lines.
```sql sql theme={null}
select
ch.cpt
, count(*) as line_count
, count(distinct ch.patient_id) as unique_patients
, sum(ch.units) as total_units
, sum(ch.total_charges) as total_billed
, sum(ch.payments) as total_collected
, sum(ch.adjustments) as total_adjusted
, sum(ch.balance) as total_outstanding
from charge ch
where ch.is_deleted = false
and ch.from_date >= dateadd(day, -90, current_date)
group by ch.cpt
order by total_billed desc;
```
## Reconcile a claim with its charge lines
Joins one claim to the sum of its charge lines so you can confirm the claim total matches what's actually billed line-by-line.
```sql sql theme={null}
select
c.id as claim_id
, c.local_id
, c.bill_id
, c.from_date as claim_from_date
, c.through_date as claim_through_date
, c.is_billed
, count(ch.id) as charge_lines
, sum(ch.total_charges) as sum_charges
, sum(ch.payments) as sum_payments
, sum(ch.adjustments) as sum_adjustments
, sum(ch.balance) as sum_balance
from claim c
left join charge ch
on ch.claim_id = c.id
and ch.is_deleted = false
where c.is_deleted = false
and c.id = 1234567890 -- Replace with actual claim ID
group by c.id, c.local_id, c.bill_id, c.from_date, c.through_date, c.is_billed;
```
## Drug-charge detail by NDC
Filters to charge lines that carry an NDC (the National Drug Code) and surfaces the structured NDC fields alongside the financial state.
```sql sql theme={null}
select
ch.id as charge_id
, ch.claim_id
, ch.patient_id
, ch.from_date
, ch.cpt
, ch.ndc
, ch.ndc_code
, ch.ndc_dosage
, ch.ndc_measure
, ch.units
, ch.total_charges
, ch.payments
, ch.balance
from charge ch
where ch.is_deleted = false
and ch.ndc_code is not null
and ch.from_date >= dateadd(day, -180, current_date)
order by ch.from_date desc;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Charge DX
Source: https://help.elationhealth.com/articles/hdb/charge-dx
Report on the diagnosis codes attached to each Elation Billing charge line.
One row per diagnosis code per Elation Billing charge line, ordered by `sequence_number`. This is the Elation Billing counterpart to `bill_item_dx` on the Elation EHR side.
There is no `id` column. Elation Billing holds no single key for these rows, so a row is identified by its charge, diagnosis code, and sequence together - all three parts are needed, because neither charge and sequence nor charge and code is unique on its own.
This table's columns and relationships are shown in the [Hosted Database schema](/articles/hdb/schema).
`dx` holds the ICD-10 code with the decimal point removed: `I10`, `E785` for E78.5, `Z0000` for Z00.00. This matches the format used by `bill_item_dx.dx`, so it does not join directly to `icd10.code` without reinstating the decimal point.
`sequence_number` sets the order the diagnosis codes appear in on the claim and starts at 1, though a small number of rows carry 0. `is_deleted` rolls up the parent charge, so the diagnosis lines of a deleted charge are flagged deleted too.
**For reporting on but not limited to:**
* Which diagnoses were billed, and how often
* The primary diagnosis on each charge line
* Diagnosis mix by practice or by CPT code
* Charge lines carrying more diagnosis codes than expected
* Reconciling billed diagnoses against the Elation EHR bill
## Diagnosis codes on each charge line
```sql sql theme={null}
select
c.id as charge_id
, pt.full_name
, c.cpt
, c.from_date
, cd.sequence_number
, cd.dx
from charge_dx cd
inner join charge c on c.id = cd.charge_id
left join patient pt on pt.id = c.patient_id
where not cd.is_deleted
order by c.id, cd.sequence_number;
```
## Most frequently billed diagnosis codes
```sql sql theme={null}
select
cd.dx
, count(*) as charge_line_count
, count(distinct cd.charge_id) as charge_count
from charge_dx cd
where not cd.is_deleted
and cd.dx is not null
group by cd.dx
order by charge_line_count desc;
```
## Primary diagnosis by practice
```sql sql theme={null}
select
p.name as practice_name
, cd.dx
, count(*) as charge_line_count
from charge_dx cd
left join practice p on p.id = cd.practice_id
where not cd.is_deleted
and cd.sequence_number = 1
group by p.name, cd.dx
order by p.name, charge_line_count desc;
```
## Charge lines carrying several diagnosis codes
```sql sql theme={null}
select
c.id as charge_id
, pt.full_name
, c.cpt
, count(*) as diagnosis_count
, listagg(cd.dx, ', ') within group (order by cd.sequence_number) as diagnoses
from charge_dx cd
inner join charge c on c.id = cd.charge_id
left join patient pt on pt.id = c.patient_id
where not cd.is_deleted
group by c.id, pt.full_name, c.cpt
having count(*) > 3
order by diagnosis_count desc;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Claim
Source: https://help.elationhealth.com/articles/hdb/claim
Query Elation Billing claims to see what was submitted to payers, the providers and authorizations attached, and the EHR-side bill each claim corresponds to.
An Elation Billing claim - the bill submitted to a payer for the services on a patient visit. Each claim links to its patient, practice, service location, and the EHR-side bill it corresponds to. Provider data is denormalized: for each of the five roles (rendering, referring, supervising, billing, ordering) the row carries the provider's name and NPI directly.
The table schema can be found in our [HDB dbdocs reference](https://dbdocs.io/hosteddb_support/hosted_database_snowflake?view=claim).
**For reporting on but not limited to:**
* All claims for a patient, practice, or date range
* Claims that have not yet been submitted to a payer (`is_billed = false`)
* Original vs. corrected vs. voided submissions via `icn_code`
* Per-provider claim volume by joining on the rendering or billing NPI
* Reconciling Elation Billing claims to EHR bills via `bill_id`
* The billing legal entity each claim was submitted under via `legal_entity_id`
* Whether a claim is on a biller worklist, and why, by joining `worklist` / `worklist_reason` on `claim_id`
* The notes billers left on a claim, and who wrote them, by joining [claim\_note](/articles/hdb/claim-note) on `claim_id`
* Drilling into a single claim by `id` or `local_id`
`claim.bill_id` links the Elation Billing claim back to the EHR-side `bill` table. It is empty when the claim has no matching bill in HDB - typically claims created directly in Elation Billing without an EHR bill, or claims whose EHR bill does not map into your Hosted Database.
## Claims for a date range
Pulls every claim with a service-date window, with payer-facing detail and the provider who rendered the service.
```sql sql theme={null}
select
c.id as claim_id
, c.local_id
, c.patient_id
, c.practice_id
, c.service_location_id
, c.location_code
, c.from_date
, c.through_date
, c.rendering_provider_name
, c.rendering_provider_npi
, c.billing_provider_name
, c.billing_provider_npi
, c.is_billed
, c.accept_assign
, c.claimmd_id
, c.icn
, c.icn_code
, c.co_pay_paid
from claim c
where c.is_deleted = false
and c.from_date between '2026-01-01' and '2026-03-31'
order by c.from_date, c.id;
```
## Unbilled claims
Returns claims that have not been submitted to a payer yet, oldest first. Useful for a "what's stuck in pre-submission" worklist.
```sql sql theme={null}
select
c.id as claim_id
, c.local_id
, c.patient_id
, c.practice_id
, c.from_date
, c.through_date
, c.rendering_provider_name
, c.billing_provider_name
, c.worklist
, c.narrative
, c.created_timestamp
, c.updated_timestamp
from claim c
where c.is_deleted = false
and c.is_billed = false
order by c.from_date;
```
## Corrected and voided submissions
Filters to claims that were resubmitted as corrections or voids. `icn_code` carries the resubmission type (1 = original, 7 = corrected, 8 = void); `icn` carries the payer's original control number that the resubmission references.
```sql sql theme={null}
select
c.id as claim_id
, c.local_id
, c.patient_id
, c.from_date
, c.through_date
, c.icn
, case c.icn_code
when 1 then 'original'
when 7 then 'corrected'
when 8 then 'void'
else 'other'
end as resubmission_type
, c.claimmd_id
, c.billing_provider_name
, c.updated_timestamp
from claim c
where c.is_deleted = false
and c.icn_code in (7, 8)
order by c.updated_timestamp desc;
```
## Claim volume per rendering provider
Aggregates claims and copay collected per rendering provider over the last 90 service days. Filters out deleted claims and rows with no rendering provider attached.
```sql sql theme={null}
select
c.rendering_provider_npi
, c.rendering_provider_name
, c.practice_id
, count(*) as claim_count
, count(distinct c.patient_id) as unique_patients
, sum(c.co_pay_paid) as total_copay_collected
, sum(iff(c.is_billed, 1, 0)) as claims_submitted
, sum(iff(c.is_billed, 0, 1)) as claims_pending
from claim c
where c.is_deleted = false
and c.rendering_provider_npi is not null
and c.from_date >= dateadd(day, -90, current_date)
group by c.rendering_provider_npi, c.rendering_provider_name, c.practice_id
order by claim_count desc;
```
## Reconcile a claim with its EHR bill
Joins a single claim to the EHR-side `bill` table to compare what the practice billed against what was submitted to the payer.
```sql sql theme={null}
select
c.id as claim_id
, c.local_id
, c.bill_id
, c.patient_id
, c.practice_id
, c.from_date as claim_from_date
, c.through_date as claim_through_date
, c.rendering_provider_name
, c.billing_provider_name
, c.is_billed
, c.claimmd_id
, b.id as ehr_bill_id
, b.billing_date as ehr_billing_date
, b.billing_status as ehr_billing_status
, b.notes as ehr_bill_notes
from claim c
left join bill b on b.id = c.bill_id
where c.is_deleted = false
and c.id = 1234567890; -- Replace with actual claim ID
```
## Claims billed against an authorization
Lists the claims attached to a specific prior authorization. The join also returns claim-level service dates so you can see when the authorization was actually used.
```sql sql theme={null}
select
a.id as authorization_id
, a.auth_num
, a.payer_name
, a.auth_units
, a.starts as auth_starts
, a.expires as auth_expires
, c.id as claim_id
, c.local_id
, c.from_date
, c.through_date
, c.rendering_provider_name
, c.is_billed
from authorization a
join claim c on c.authorization_id = a.id
where a.is_deleted = false
and a.id = 12345 -- Replace with actual authorization ID
order by c.from_date;
```
## Legal entity a claim was billed under
Joins each claim to the `legal_entity` that carries the tax id, NPI, and billing name it was submitted under.
```sql sql theme={null}
select
c.id as claim_id
, c.local_id
, c.patient_id
, c.from_date
, c.is_billed
, le.id as legal_entity_id
, le.name as legal_entity_name
, le.tin
, le.npi as legal_entity_npi
from claim c
left join legal_entity le on le.id = c.legal_entity_id
where c.is_deleted = false
and c.from_date >= dateadd(day, -90, current_date)
order by c.from_date, c.id;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Claim Note
Source: https://help.elationhealth.com/articles/hdb/claim-note
Query the notes billers leave on Elation Billing claims, including who wrote each note and when.
One row per note per claim - the trail of notes billers build up on an Elation Billing claim as they work it. Each row carries the note text, the Elation Billing user who wrote it, and when it was written. Every note is attributed to a user, so this table is the record of who touched a claim and what they said about it. Filter on `is_deleted = false` to exclude notes that have since been removed.
This table's columns and relationships are shown in the [Hosted Database schema](/articles/hdb/schema).
`claim_note.claim_id` is the Elation Billing claim id and joins to [claim](/articles/hdb/claim)`.id` - it is not an EHR `bill` id. `claim_note.elation_billing_user_id` joins to `elation_billing_user.id` and is an Elation Billing user identifier, not an Elation EHR user id.
**For reporting on but not limited to:**
* The full note history on a single claim, in the order it was written
* Which biller last touched a claim, and when
* Note volume per biller over a date range
* Notes flagged to count toward a patient's statement (`is_statement_note = true`)
* Auditing follow-up on denied or aging claims by pairing notes with claim status
## Note history for a claim
Returns every note on a single claim, oldest first, with the name and login of the biller who wrote it.
```sql sql theme={null}
select
n.id as claim_note_id
, n.created_timestamp
, concat(u.first_name, ' ', u.last_name) as author_name
, u.email as author_email
, n.is_statement_note
, n.note
from claim_note n
left join elation_billing_user u on u.id = n.elation_billing_user_id
where n.is_deleted = false
and n.claim_id = 1234567890 -- Replace with actual claim ID
order by n.created_timestamp;
```
## Claims by who last touched them
Returns the most recent note on each claim, so you can see which biller worked a claim last and how long ago.
```sql sql theme={null}
select
c.id as claim_id
, c.local_id
, c.from_date
, c.is_billed
, n.created_timestamp as last_note_timestamp
, concat(u.first_name, ' ', u.last_name) as last_author_name
, n.note as last_note
from claim c
inner join claim_note n on n.claim_id = c.id
left join elation_billing_user u on u.id = n.elation_billing_user_id
where c.is_deleted = false
and n.is_deleted = false
qualify row_number() over (partition by c.id order by n.created_timestamp desc) = 1
order by n.created_timestamp desc
limit 100;
```
## Note volume per biller
Ranks billers by how many claim notes they wrote over the last 90 days.
```sql sql theme={null}
select
concat(u.first_name, ' ', u.last_name) as author_name
, u.email as author_email
, count(*) as notes_written
, count(distinct n.claim_id) as distinct_claims
, max(n.created_timestamp) as most_recent_note
from claim_note n
left join elation_billing_user u on u.id = n.elation_billing_user_id
where n.is_deleted = false
and n.created_timestamp >= dateadd(day, -90, current_date)
group by u.first_name, u.last_name, u.email
order by notes_written desc;
```
## Statement notes for a patient
Returns only the notes flagged to count toward a patient's statement, across every claim for that patient.
```sql sql theme={null}
select
pat.first_name
, pat.last_name
, c.id as claim_id
, c.local_id
, n.created_timestamp
, concat(u.first_name, ' ', u.last_name) as author_name
, n.note
from claim_note n
inner join claim c on c.id = n.claim_id
left join patient pat on pat.id = c.patient_id
left join elation_billing_user u on u.id = n.elation_billing_user_id
where n.is_deleted = false
and n.is_statement_note = true
and c.patient_id = 1234567890 -- Replace with actual patient ID
order by n.created_timestamp desc;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Claim Queue
Source: https://help.elationhealth.com/articles/hdb/claim-queue
See which claims were queued for submission to the clearinghouse, when, and by which biller.
One row per claim queued for submission to the clearinghouse.
This table is mostly history, not a live worklist. Elation Billing removes a claim from its queue once the claim leaves it, so well over 99% of rows are completed work rather than pending work. **Any question about what is waiting to be submitted must filter on `is_deleted = false`** - a plain row count over the whole table will overstate pending work by several orders of magnitude.
Those completed rows are kept because they are the only record in the Hosted Database of which biller pushed a claim out the door and when. [claim](/articles/hdb/claim) carries no user, and no other Elation Billing table attributes a claim submission to a person.
This table's columns and relationships are shown in the [Hosted Database schema](/articles/hdb/schema).
A row that has left the queue records neither why it left nor when. `created_timestamp` is the only timestamp on this table, so the time a claim spent in the queue can be measured only for claims still in it. For when a claim was actually submitted, use [clearinghouse\_transaction](/articles/hdb/clearinghouse-transaction).
`is_submitted` identifies the rows Elation Billing confirmed it submitted electronically. Paper submissions are deliberately not counted - they leave the queue without the batch label `is_submitted` depends on, and cannot be told apart from a biller pulling the claim back - so `is_submitted = false` means not electronically confirmed, not necessarily unsubmitted. For the billing outcome itself use `clearinghouse_transaction` and `claim.is_billed`.
`status` has two values Elation Billing defines: `pending`, meaning queued and awaiting a biller marking it ready, and `ready`, meaning cleared for the next submission run. A third form, `batch-` followed by a timestamp, is an internal label applied while a group of claims is being submitted.
The same value means different things depending on `is_deleted`. On a row that has left the queue, `pending` means the claim was paper billed or pulled back by a biller, and a `batch-` label is the audit trail of the run that submitted it. On a row still in the queue, a `batch-` label should exist only momentarily, so a surviving one means that submission run did not finish and the claim is stranded.
`patient_insurance_id` is the insurance the claim was queued to be billed to, which is not necessarily the one it was last billed to. It is only meaningful on rows still in the queue.
**For reporting on but not limited to:**
* Which claims are waiting to be submitted right now
* Which biller queued a claim, and when
* How long the claims currently queued have been waiting
* Electronically confirmed submissions over time, by biller or practice
* Stranded claims left behind by an unfinished submission run
## Claims currently waiting to be submitted
```sql sql theme={null}
select
cq.created_timestamp
, pt.full_name
, cq.claim_id
, cq.status
, concat_ws(' ', u.first_name, u.last_name) as queued_by
, pi.carrier as insurance_to_bill
from claim_queue cq
left join claim c on c.id = cq.claim_id
left join patient pt on pt.id = c.patient_id
left join elation_billing_user u on u.id = cq.elation_billing_user_id
left join patient_insurance pi on pi.id = cq.patient_insurance_id
where not cq.is_deleted
order by cq.created_timestamp;
```
## Electronically confirmed submissions by biller
```sql sql theme={null}
select
concat_ws(' ', u.first_name, u.last_name) as biller
, u.email
, count(*) as claims_submitted
, min(cq.created_timestamp) as first_queued
, max(cq.created_timestamp) as last_queued
from claim_queue cq
left join elation_billing_user u on u.id = cq.elation_billing_user_id
where cq.is_submitted
group by u.first_name, u.last_name, u.email
order by claims_submitted desc;
```
## Stranded claims from an unfinished submission run
```sql sql theme={null}
select
cq.created_timestamp
, p.name as practice_name
, pt.full_name
, cq.claim_id
, cq.status
from claim_queue cq
left join claim c on c.id = cq.claim_id
left join patient pt on pt.id = c.patient_id
left join practice p on p.id = cq.practice_id
where not cq.is_deleted
and cq.status ilike 'batch-%'
order by cq.created_timestamp;
```
## Oldest claims still waiting in the queue
```sql sql theme={null}
select
p.name as practice_name
, pt.full_name
, cq.claim_id
, cq.status
, cq.created_timestamp
, datediff(day, cq.created_timestamp, current_date) as days_waiting
from claim_queue cq
left join claim c on c.id = cq.claim_id
left join patient pt on pt.id = c.patient_id
left join practice p on p.id = cq.practice_id
where not cq.is_deleted
order by cq.created_timestamp;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Clearinghouse transactions and messages
Source: https://help.elationhealth.com/articles/hdb/clearinghouse-transaction
Clearinghouse submission, response, and message records from Elation Billing - a claim's lifecycle through the clearinghouse and the detail returned at each step.
Two tables cover a claim's journey through the ClaimMD clearinghouse.
`clearinghouse_transaction` has one row per lifecycle event - submitted, acknowledged, accepted or rejected, ERA received, crossed over to another payer, and so on. `clearinghouse_message` has one row per message the clearinghouse returned within one of those events, so a single transaction usually has several messages.
Join them on `clearinghouse_message.clearinghouse_transaction_id = clearinghouse_transaction.id`. `clearinghouse_message` also carries `claim_id` and `practice_id` copied from its transaction, so you can filter messages by claim or practice without joining first.
These tables' columns and relationships are shown in the [Hosted Database schema](/articles/hdb/schema).
On `clearinghouse_transaction`, `type` is the normalized lifecycle category (for example `SUBMITTED`, `ACKNOWLEDGED`, `accepted`, `DENIED`, `REJECTED`, `ERA RECEIVED`, `CROSSOVER`). `status` is the detailed, human-readable message for the same event and often includes the payer name (for example, "Submitted to clearinghouse for \"). `claimmd_id` is the identifier assigned by the clearinghouse, not a Hosted Database key.
On `clearinghouse_message`, `message_subject` and `message` change meaning together. For a validation or scrubbing message, `message_subject` names the claim form field at fault (`diag_1`, `ins_number`, `prov_npi`) and `message` is readable text such as "Diagnosis code invalid \[R108]." For a message derived from an ERA, `message_subject` is instead a label (`Total Paid`, `ICN`, `Paid Date`) and `message` holds that label's value (`$83.00`, `01-27-2026`).
`message_code` tells the two apart. It is populated on messages the clearinghouse returned against a claim submission, and `null` on ERA-derived rows and on Elation Billing's own scrubbing status lines. Filter with `message_code is not null` for submission responses and `is null` for the rest.
Only messages the clearinghouse linked back to a transaction are included. The rest are mostly acknowledgments, plus payer denial reason lines that arrive with a remittance rather than a claim submission, and they cannot be attributed to a practice. For the acknowledgment lifecycle use `clearinghouse_transaction.type`. For denial reason analysis use [era\_matched\_adjustment](/articles/hdb/era-matched-adjustment), which carries the payer's adjustment and remark codes with the amounts and the claim they apply to.
**For reporting on but not limited to:**
* A claim's progress through the clearinghouse over time
* Submission, acceptance, rejection, and denial counts
* Transactions for a given claim or patient
* Tracing a transaction back to the clearinghouse via claimmd\_id
* Which claim form fields most often fail validation before submission
* ERA payment detail returned against a claim
* How many messages the clearinghouse returned per transaction
## Rejected and denied clearinghouse transactions
```sql sql theme={null}
select
t.created_timestamp
, p.full_name
, t.claim_id
, t.type
, t.status
from clearinghouse_transaction t
left join patient p on p.id = t.patient_id
where t.type in ('REJECTED', 'DENIED')
and not t.is_deleted
order by t.created_timestamp desc;
```
## Messages returned for rejected and denied claims
```sql sql theme={null}
select
t.created_timestamp
, p.full_name
, m.claim_id
, t.type
, m.message_code
, m.message_subject
, m.message
from clearinghouse_message m
inner join clearinghouse_transaction t on t.id = m.clearinghouse_transaction_id
left join patient p on p.id = t.patient_id
where t.type in ('REJECTED', 'DENIED')
and not m.is_deleted
order by t.created_timestamp desc, m.id;
```
## Claim form fields that most often fail validation
```sql sql theme={null}
select
m.message_subject
, count(*) as message_count
, count(distinct m.claim_id) as claim_count
from clearinghouse_message m
where m.message_code is not null
and m.message_subject is not null
and not m.is_deleted
group by m.message_subject
order by message_count desc;
```
*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \*
# Connecting to Patient Matching SFTP Service
Source: https://help.elationhealth.com/articles/hdb/connecting-to-patient-matching-sftp-service
This document will guide you through connecting to Elation’s Patient Matching service using [FileZilla](https://filezilla-project.org/) or [Cyberduck](https://cyberduck.io/).
## **Setup Requirements**
* **Host Address:** `patient-matching-data-transfer.elationemr.com`
* **Username:** Provided to you by Elation Health. Typically your email address.
* **Private Key**: This allows you to securely authenticate with the SFTP server.
### **Connecting with [Cyberduck](https://cyberduck.io/)**
Follow the steps below to connect to the data transfer service using Cyberduck.
1. Open Cyberduck
2. From the **File** menu, click **Open Connection**
![Cyberduck connection window showing FTP protocol selected, Server field active and empty, Port set to 21, with Username, Password, Anonymous Login, and SSH Private Key fields all empty.]()
3. In the connection window, fill in the fields as follows:
* **Protocol:** SFTP (SSH File Transfer Protocol)
* **Server:** patient-matching-data-transfer.elationemr.com
* **Port:** 22
* **Username:** Enter the username you received from Elation
* **Password:** Leave this field empty
* **SSH Private Key:** Click the field to select the file containing your private key
4. Following screenshot is an example of correctly filled-out connection window:
![Cyberduck connection window configured with SFTP protocol, server patient-matching-data-transfer.elationemr.com, port 22, username field active, SSH Private Key set to ~/.ssh/patient-matching.key, and Add to Keychain checked.]()
*The above screenshot was taken on macOS. If you’re using Windows, the file path may look slightly different. All other fields remain the same.*
5. Click Connect. Cyberduck will try to connect to the SFTP server.
6. When connecting for the first time, you may see a screen like the one below. This message appears because your computer has not connected to this server before and is verifying its identity. Select Always and click Allow to proceed with connecting to the SFTP server.
![Cyberduck "Unknown fingerprint" dialog showing the server's ssh-rsa key fingerprint, with "Always" checkbox and "Allow" button to trust and proceed.]()
7. Once connected, Cyberduck will display your upload folder, here is where you will add your .CSV file.
### **Connecting with [FileZilla](https://filezilla-project.org/)**
Follow the steps below to connect to the data transfer service using FileZilla.
1. Open FileZilla
2. From the File Menu, click Site Manager … to open the following window
![FileZilla Site Manager dialog with "My Sites" folder selected, empty connection fields, and General tab active. New site and Duplicate buttons are available.]()
*Site Manager in FileZilla (New Site Setup)*
3. Click on New site, and choose a name that you'll easily remember in the future
4. On the right-hand side, under General tab, fill in the fields as follows:
* **Protocol:** SFTP - SSH File Transfer Protocol
* **Host:** patient-matching-data-transfer.elationemr.com
* **Port:** 22 (Or leave this field empty)
* **Logon Type:** Key File (Set this option before filling out the fields below it, as it may reset them.)
* **User:** Enter the username you received from Elation
* **Key file:** Click the Browse button to select the file containing your private key
5. Following screenshot is an example of correctly filled-out connection window
![FileZilla Site Manager showing "Elation Patient Matching" site selected, with Protocol set to SFTP, Host as patient-matching-data-transfer.elationemr.com, Logon Type as Key file, User as user@example.com, and Key file path filled in.]()
*The above screenshot was taken on macOS. If you’re using Windows, the file path may look slightly different. All other fields remain the same.*
6. Click Connect, FileZilla will try to connect to the SFTP server.
7. When connecting for the first time, you may see a screen like the one below. This message appears because your computer has not connected to this server before and is verifying its identity. Select Always trust this host and click Allow to proceed with connecting to the SFTP server.
8. Once connected, FileZilla will display your upload folder, where you can drag-and-drop file. Your connection settings will be saved in FileZilla’s Site Manager for future use.
### **Uploading a File**
Once connected, simply drag-and-drop your file into your folder. The system will automatically pick up and import the file.
### Important: File name must be unique. Files with the same name will not be processed again.
# Managing Network Policies
Source: https://help.elationhealth.com/articles/hdb/create-network-policies
There is no UI interface to create a network policy for USERADMIN roles on a reader account. You must create, view, remove network polices via a worksheet.
Please check out the official snowflake documentation for more information [https://docs.snowflake.com/en/sql-reference/sql/create-network-policy](https://docs.snowflake.com/en/sql-reference/sql/create-network-policy)
You can follow the syntax guide located in the official[ Snowflake documentation](https://docs.snowflake.com/en/sql-reference/sql/create-network-policy)
```sql sql theme={null}
CREATE [ OR REPLACE ] NETWORK POLICY
[ ALLOWED_NETWORK_RULE_LIST = ( '' [ , '' , ... ] ) ]
[ BLOCKED_NETWORK_RULE_LIST = ( '' [ , '' , ... ] ) ]
[ ALLOWED_IP_LIST = ( [ '' ] [ , '' , ... ] ) ]
[ BLOCKED_IP_LIST = ( [ '' ] [ , '' , ... ] ) ]
[ COMMENT = '' ]
```
## Creating a Network Policy
**Step 1:** Create a new worksheet and lets view what existing Network Policies we have
```sql sql theme={null}
SHOW NETWORK POLICIES;
```
![Results tab selected showing SHOW NETWORK POLICIES query output with columns for created_on, name, comment, and IP list entries, displaying "Query produced no results"]()
**Step 2:** Lets start by creating a Network Policy with an `ALLOWED_IP_LIST`
```
CREATE NETWORK POLICY mypolicy2 ALLOWED_IP_LIST=('999.999.99.000','111.222.1.000');
```
**Step 3:** Now lets view your newly created Network Policy
Run the below command to view your Network Policies and which IP addresses are currently assigned
```sql sql theme={null}
DESC NETWORK POLICY ;
```
![DESC NETWORK POLICY results table showing ALLOWED_IP_LIST with values 54.244.77.231,111.222.1.000, confirming the policy was created successfully.]()
```sql sql theme={null}
ALTER NETWORK POLICY MYPOLICY2 SET BLOCKED_IP_LIST=('22.222.11.111');
```
Lets run DESC on the Network Policy name to verify our changes
```sql sql theme={null}
DESC NETWORK POLICY ;
```
## **Activating Your Network Policy**
Once your Network Policy is created reach out to [Elation Support Portal](/articles/support-portal-introduction) to setup additional permissions to allow you to activate your Network Policy
When Elation Health has completed the steps required to activate your Network Policy run the below command to activate your Network Policy
```
call database.schema_name.setNetworkPolicy('MYPOLICYNAMEEXAMPLE');
```
**Verifying your Network Policy is active**
To view your newly created Network Policy run the below command
```sql snowflake theme={null}
SHOW PARAMETERS LIKE 'network_policy' IN ACCOUNT;
```
![SHOW PARAMETERS result showing NETWORK_POLICY key with value MYPOLICY2 active at ACCOUNT level, confirming the network policy was successfully activated.]()
Or reach out to [Elation Support Portal](/articles/support-portal-introduction) for a representative to verify your Network Policy has been activated.
## **Switching between active Network Policies**
You can only have one active network policy at a time
```sql sql theme={null}
ALTER NETWORK POLICY MYPOLICY2 SET BLOCKED_IP_LIST=('22.222.11.111');
```
Lets run DESC on the Network Policy name to verify our changes
```sql sql theme={null}
DESC NETWORK POLICY ;
```
![DESC NETWORK POLICY results showing ALLOWED_IP_LIST with values 54.244.77.231,111.222.1.000 and BLOCKED_IP_LIST with value 22.222.11.111, confirming the ALTER command succeeded.]()
## **Updating an Existing Network Policy**
If you need to add additional IP addresses, remove IP addresses, or add in a new parameter you can use the ALTER statement.
For example: Lets use the ALTER statement to add a list of blocked IP addresses to our newly created Network Policy
```sql sql theme={null}
ALTER NETWORK POLICY MYPOLICY2 SET BLOCKED_IP_LIST=('22.222.11.111');
```
Lets run DESC on the Network Policy name to verify our changes
```sql sql theme={null}
DESC NETWORK POLICY ;
```
![DESC NETWORK POLICY results showing ALLOWED_IP_LIST with values 54.244.77.231,111.222.1.000 and BLOCKED_IP_LIST with value 22.222.11.111, confirming the ALTER command succeeded.]()
## **Removing a Network Policy**
Run the below command to remove a Network Policy
```sql sql theme={null}
DROP NETWORK POLICY IF EXISTS mypolicy2;
```
You can then run the bellow command to verify if it has been removed
```
SHOW NETWORK POLICIES;
```
# Creating a Custom Database
Source: https://help.elationhealth.com/articles/hdb/creating-a-custom-database
You can create custom tables in Snowflake which will allow you to aggregate data from your master database to analyze and run reports. For more information check out the Snowflake documentation [https://docs.snowflake.com/en/sql-reference/sql/create-table](https://docs.snowflake.com/en/sql-reference/sql/create-table)
**Step 1: Create your database**
1. On the left hand navigation bar click on **Data > Database.**
2. On the top right hand corner click on the **Blue Database button**
![Snowflake Databases page showing 3 existing databases, with "Data > Databases" selected in the left nav and the "+ Database" button highlighted in the top right corner.]()
**Step 2: Name your database and give it an optional comment**
![New Database dialog with Name field filled in as "MY_CUSTOM_DATABASE" and an optional Comment field partially showing appointment-related text, ready to click Create.]()
Click on the **Create button** once you are finished
**Step 3: Create a Schema**
1. Once the Database has been created you will see it on the left hand navigation along with your other database(s)
2. Click on the newly created Database then click on the blue Schema button on the top right hand side of the page.
3. Give your Schema a name and hit the create button
![MY_CUSTOM_DATABASE selected in the left nav, showing the Database Details tab with ACCOUNTADMIN ownership. The "+ Schema" button is highlighted in the top right corner.]()
![New Schema dialog in MY_CUSTOM_DATABASE, showing the Name field filled with "schema_name," an optional Comment field, unchecked Managed access, and the Create button.]()
**Step 4: Create your table**
1. Click on your newly created Schema
2. On the top right hand side corner of your screen click on the Blue Create button
3. Click on table then the appropriate option.
![SCHEMA_NAME selected in left nav under MY_CUSTOM_DATABASE, with the Create dropdown open showing Table, View, Stage, and other object type options.]()
For this example we will be choosing **Table** > As **Select**
This will take you to a new worksheet Pick your warehouse > Enter the criteria for you custom table > Click Create
![Snowflake worksheet showing USERADMIN role selected and SUPPORT_TESTING_WH warehouse selected (highlighted in red), with the Create Table button visible in the top right.]()
Enter the criteria for your new table and click Create Table
Make sure to reference your main hosted database and schema's full path
![SQL editor showing a CREATE TABLE AS SELECT statement for patient_id_to_appointmentas, with the SQL highlighted in red and the Create Table button highlighted in the top right corner.]()
You have successfully created a custom table
![Database object browser showing MY_CUSTOM_DATABASE > SCHEMA_NAME > Tables expanded, with PATIENT_ID_TO_APPOINTMENT table selected and highlighted inside a red callout box.]()
If you have any questions please contact [Elation Support Portal](/articles/support-portal-introduction)
# How often does my data refresh?
Source: https://help.elationhealth.com/articles/hdb/does-my-data-refresh-in-realtime
Your data refreshes once a day either at 1am PT or 5am PT. The data you are currently viewing will be from yesterdays actions in the EHR.
Please reach out to [Elation Support Portal](/articles/support-portal-introduction) if you would like to inquire about changing your refresh times. We currently only offer 1am PT or 5am PT.
# Early Release
Source: https://help.elationhealth.com/articles/hdb/early-release
Learn what the Hosted Database Early Release channel is, how to request access, and which changes are currently available early ahead of their General Availability date.
Early Release (ER) is an optional, separate Hosted Database channel. It carries changes that Elation has built and verified but has not yet rolled out to General Availability (GA), so you can query and test them before the GA date rather than waiting for it.
## What Early Release is
When a change to the Hosted Database is ready but is still inside its notice period, or is waiting on a scheduled release date, Elation can build a copy of the affected table with the change already applied and share it into your Hosted Database as an additional table. The GA table is untouched, so nothing you have in production changes.
That gives you two things:
* **Early access.** If you are waiting on a new table or column to unblock work on your side, you can start querying it now instead of at the GA date.
* **A place to test.** Every change is fully validated by Elation before it reaches Early Release, so the channel is not where a change gets its first exercise. It is there so you can confirm the change lands cleanly in your environment: point a test run at the Early Release table and see your own pipelines and queries handle it before the change reaches the table they read today.
Early Release is opt-in and is requested per practice. It is not enabled by default.
## Currently in Early Release
The table below lists every change available in the ER channel today, with its GA date where one has been set. A blank GA date means the date has not been fixed yet. Select **change notes** on a row to read what is changing and what to check on your side.
| Table affected | In ER since | Target GA date | |
| ----------------- | ----------- | -------------- | -------------------------------------------------------: |
| `lab_order_tests` | 08/14/2026 | 09/13/2026 | [change notes](#stable-row-identity-for-lab-order-tests) |
| `user` | 08/14/2026 | 09/13/2026 | [change notes](#provisioned-direct-addresses-on-users) |
### Stable row identity for lab order tests
**Query `lab_order_tests_early_release`.** Classified as a breaking change, so it carries 30 calendar days of notice before GA. Two things change.
**1. The unique key becomes stable.** `uq_lab_order_tests` today is derived from an identifier that Elation reissues every time a lab order is saved. Editing an order therefore leaves the old row in place and adds a new one, so the same test can appear against the same order several times. In the ER table the key identifies the pairing of an order and a test, so editing an order updates the row that is already there.
The `id` column still carries the underlying link identifier, and it still changes on every save. Use `uq_lab_order_tests` if you need to identify a row over time.
**2. Removed tests stay visible.** A test taken off an order currently disappears from the table. In the ER table it is retained and marked with a new `is_deleted` column. Add `where is_deleted = false` to see only the tests currently on an order.
**What to check on your side:**
* Anything that stores or joins on `uq_lab_order_tests` needs repointing, because the values change.
* Any query that counts rows in this table will return a different answer. Duplicates from edited orders go a