The document types that arrive on a medical practice fax line
What each one is, who sends it, what has to happen to it, and the specific way each tends to go wrong.
- A typical practice fax line carries about eighteen recurring document types across six categories — referrals, imaging, insurance, prescriptions, records, and everything else.
- Filing a document is only half the job. Most of these need a task routed to a specific person; a document filed without a task is the most common way a fax is lost while appearing handled.
- The costly confusions are between pairs that look alike on a cover page: a consultation note versus a referral, and an imaging result versus an imaging authorization. Each pair goes to a different team.
- Roughly one fax in ten is unrecognised. Escalating those to a named person beats guessing.
- Patient matching should use name and date of birth. Name alone is the leading cause of a misfiled document.
This is a working reference, not a taxonomy exercise. It is drawn from a pain management practice in Rhode Island that receives about fifty faxes a day, where each of these arrives regularly enough to need its own rule.
Referrals and clinical documents
The highest-stakes category, because a referral sitting unprocessed is a patient not scheduled and revenue not booked.
Specialist referrals
Who sends it: A primary care office, another specialist, or an urgent care.
What has to happen: Identify the patient, create the chart if they are new, attach the referral, and route a task to whoever books that referral type.
How it goes wrong: The patient is new and gets created twice, or the referral is filed to a same-name patient with a different date of birth. Matching on name alone is the single most common cause of a misfiled referral.
Consultation notes
Who sends it: Another clinic, a therapy practice, or an EMR that faxes automatically (Clinicient and similar).
What has to happen: Match the patient, attach to the chart, task the provider who should read it.
How it goes wrong: Confused with a referral. A consultation note is a report on a patient already seen; a referral is a request to see them. They route to different people.
Discharge summaries
Who sends it: A hospital or skilled nursing facility.
What has to happen: Match, attach, create a follow-up task so post-discharge care is scheduled.
How it goes wrong: Filed without a task, so nobody books the follow-up inside the window.
Progress notes for signature
Who sends it: Another practice needing a signature from one of your providers.
What has to happen: Match, attach, task the specific provider — not the front desk.
How it goes wrong: Routed to admin staff who cannot sign, where it sits.
Imaging
Imaging splits into results coming back and authorizations going out. They look similar on a cover page and go to opposite teams.
Imaging reports
Who sends it: A radiology group.
What has to happen: Match, attach with a label naming the modality and body part, task the ordering provider.
How it goes wrong: Attached with a generic label, so the chart shows five documents called “Fax” and nobody can find the MRI.
Imaging authorization requests
Who sends it: An insurer, or your own outbound request coming back answered.
What has to happen: Extract the modality, attach, task the authorization staff.
How it goes wrong: Treated as a result and routed to the provider, so the authorization is never entered and the study gets denied.
Prior authorization requests
Who sends it: An insurer or a utilization management vendor.
What has to happen: Extract the request details, route to the insurance team with the deadline visible.
How it goes wrong: Missed deadline. These are the most time-sensitive documents on the line.
Insurance and authorization
This category is where money is lost quietly, because a document that is merely filed rather than acted on looks identical in the chart.
Insurance authorizations
Who sends it: The payer.
What has to happen: Extract the authorization number and the valid date range, attach, enter the authorization, update the patient flag, task billing.
How it goes wrong: Attached to the chart but never entered as an authorization. The visit happens, the claim is denied, and the document was there the whole time.
Balance confirmations
Who sends it: A law firm handling a personal-injury or workers-compensation case.
What has to happen: Identify the firm and the case, attach to the patient, task the designated staff member.
How it goes wrong: Routed as a records request. Different team, different deadline.
Insurance eligibility
Who sends it: The payer or a clearinghouse.
What has to happen: Match, attach, task billing.
How it goes wrong: Filed and forgotten while stale. Eligibility is a snapshot — coverage can end between the check and the visit.
Prescriptions
eRx and prescription documents
Who sends it: A pharmacy — refill requests, prior authorization for a drug, or transfer confirmations.
What has to happen: Match, attach, task the prescribing provider’s own assistant.
How it goes wrong: Sent to a generic queue instead of the prescriber’s assistant. Prescription documents are the clearest case for routing by provider rather than by document type.
Records and administrative
Low clinical stakes, high legal stakes. Several of these carry statutory response deadlines.
Records requests
Who sends it: Attorneys, insurers, disability examiners, other practices, or the patient.
What has to happen: Identify the requesting party and the date range, attach the request, task records staff, and keep an auditable trail of what was sent and when.
How it goes wrong: No audit trail. When the request is disputed months later, nobody can prove what left the building.
Medical questionnaires
Who sends it: Insurers, employers, disability programs.
What has to happen: Match, attach, task whoever completes them.
How it goes wrong: Sits in a pile because no single person owns them.
Lab and diagnostic results
Who sends it: A reference lab.
What has to happen: Match, attach, task the ordering provider.
How it goes wrong: Filed to the chart without a task, so an abnormal result is never seen.
Portal messages
Who sends it: Printed or forwarded from the patient portal.
What has to happen: Classify by intent and route to the person who can answer.
How it goes wrong: Routed by sender rather than by what is being asked.
Everything else
Roughly one fax in ten is none of the above. How a practice handles this category determines whether an automation is trustworthy.
Vendor and third-party communications
Who sends it: Suppliers, billing services, payers with general correspondence.
What has to happen: Classify and route to the correct internal team.
How it goes wrong: Treated as clinical and attached to a patient chart it has nothing to do with.
Absence and work accommodation forms
Who sends it: Employers, schools, disability programs.
What has to happen: Identify the provider, attach to the patient, task with the work restrictions visible.
How it goes wrong: Completed without the restrictions the provider actually documented.
Unrecognised documents
Who sends it: Anywhere.
What has to happen: Escalate immediately to a named person, with whatever was extracted and a suggested action — never a silent guess.
How it goes wrong: A system that classifies everything with false confidence. A wrong answer delivered confidently costs more than an honest escalation.
Last updated: September 2026
Zally handles every type on this page for practices running DrChrono — reading each fax, matching the patient, attaching it to the chart, and routing the task to the person who owns it.
