Working with the Outbox
The Communications Outbox lists all outbound letters and notifications generated by the system — determination letters (including GoldCard Initiation and GoldCard Rejection for proactive GoldCard reviews), data request letters (including Excluded Brand Data Request, GoldCard Data Request for proactive GoldCard outreach, Therapy Interchange Data Request for interchange reviews, and Legacy Therapy Discontinuation Data Request for legacy therapy reviews), continuation notices, therapy interchange move-to-preferred notices, legacy therapy discontinuation notices, and more.
Navigating to the Outbox
From the left navigation, select Communications, then select the Outbox tab.
Reading the Outbox List
Each row in the outbox table represents one outbound communication. The columns are:
| Column | Description |
|---|---|
| Type | The communication type (e.g., Initiation, GoldCard Initiation, Rejection, GoldCard Rejection, Data Request, Excluded Brand Data Request, GoldCard Data Request, Therapy Interchange Data Request, Therapy Interchange Move to Preferred, Legacy Therapy Discontinuation Data Request, Legacy Therapy Discontinuation, Continuation, Discontinue) |
| Patient | The patient the communication is about |
| Guideline | The clinical guideline that triggered this communication |
| Recipient Type | Who the letter is addressed to (Prescriber, Patient, Pharmacy) |
| Status | The current delivery status (see below) |
| Mode | Whether delivery is Manual or Automatic |
| Created | The date and time the item was created |
A small orange warning icon next to the recipient type means the recipient identifier (NPI or fax number) is missing and the item cannot be sent until it is resolved.
Delivery Status Reference
| Status | Meaning |
|---|---|
| Pending | Documents have not yet been generated |
| Generated | Documents are ready; manual items await printing, automatic items will fax within ~20 minutes |
| Fax Queued | Fax is queued — status refreshes every few minutes |
| Fax Sending | Fax transmission is in progress |
| Fax Sent | Fax sent successfully |
| Fax Failed | Fax transmission failed |
| Delivery Queued | Electronic delivery is queued |
| Delivery Sending | Electronic delivery is in progress |
| Delivery Sent | Letter delivered successfully |
| Delivery Failed | Delivery failed |
| Sent | Documents have been printed or faxed |
| Failed | Failed to generate or send documents |
| Cancelled | This item was cancelled and will not be sent |
Filtering the Outbox
Several filters are available along the top of the outbox table:
- Mode — Filter by Manual (staff-initiated) or Automatic (system-initiated).
- Status — Choose a status from the dropdown to show only items in that state. The default view shows Any status (all items). Clear the Status filter to return to Any.
- Type — A multi-select dropdown lets you filter by one or more communication types (e.g., show only Rejection and Initiation letters).
- Missing Recipient — Toggle the Missing Recipient chip to show only items that cannot be sent because a recipient identifier is absent. This filter automatically switches the Status filter to Pending.
- Patient letters — Toggle the Patient letters chip to show only communications that have a patient-facing letter artifact attached.
- Business Unit — Appears when you have access to multiple business units; use it to scope the list to a specific unit.
Searching by patient name
Use the search box above the outbox table to find letters for a specific patient. Type part of the patient’s first or last name; the list updates to show matching outbound communications.
Search works together with the filters above the table. For example, you can set Mode to Manual, choose a Status, and still search by name — only rows that match both the filters and your search text appear. Clear the search box to return to the full filtered list.
Downloading and Printing Letters
For Manual / Generated items you can select one or more rows (up to 50) using the checkboxes on the left, then select Download & Print Selected in the upper right.
The system prepares a combined PDF for printing and opens it in your browser. After it opens, a confirmation dialog asks: Have you successfully printed all of your document(s)?
- Select Yes, Mark As Sent to record the items as sent and update their status.
- Select No, I Cancelled if you did not complete printing; the items remain in Generated status.
Marking Items as Sent Manually
If you have already sent items through another channel, you can mark them as sent without printing. Select the rows you want to update (up to 50), then select Mark Selected as Sent. The status of each selected item updates to Sent immediately.
Viewing a Communication’s Delivery Status
Select any row to open the Outbox Item Details page. This page shows:
- Status chip with a plain-language explanation (e.g., “Fax will be sent automatically within 20 minutes” for a Generated / Automatic item).
- Mode chip indicating whether the item is Manual or Automatic.
- Type and Template of the letter.
- Recipient Type and the resolved recipient name, fax number, or NPI.
- A live delivery status that polls automatically for in-flight statuses (Fax Queued, Fax Sending, Delivery Queued, Delivery Sending).
An excluded medication letter addressed to the pharmacy is handled the same way as other pharmacy determination letters: you send, print, and recover it the same way.
If the recipient identifier is missing, a yellow warning banner appears at the top of the details page with an Assign NPI button. Selecting this button lets you search for and assign the correct provider NPI so the letter can be sent.
Recovering Cancelled or Failed Items
If an outbox item shows Cancelled, Failed, Fax Failed, or Delivery Failed, you can regenerate the PDF from the details page using Regenerate PDF (when a recipient is assigned). For automatic prescriber or pharmacy items, use Send Fax or Retry Fax after regeneration to queue a new transmission. Patient and manual items are regenerated for staff download and print only.
You can also recover letters from the PA Workflow Timeline recipient tabs using Resend Letter or Regenerate Letter without opening the outbox details page.