Prescriber inbox do's and don'ts
A faxed lithium level looks like a refill request until you open the fax. Have a staff member sort the inbox by kind before clinic, abnormal lab results first.
Co-founder, JotPsych
Your first patient is at 8:00. You're opening the night's faxes one at a time.
Have staff sort the inbox by kind before clinic
Put lab results on top, abnormal results first
Give each kind one staff member
Letting your EHR send messages you never act on
Filing a fax before you match the patient
Leaving failed prescriptions for later
Suggested rules for the faxes, lab results, pharmacy requests, and EHR messages that reach a behavioral health prescriber overnight. Staff sort the items first, so the prescriber starts the day with the abnormal lab results.
Three do's
Have staff sort the inbox by kind before clinic.
Have a staff member open and sort each fax and pharmacy request. Use four kinds: lab results, refill and change requests from pharmacies, records from other clinicians, and forms from payers.
Pinnacle Medical Group, a primary care group in Northern Nevada, gets faxes from pharmacies, labs, and specialists. Pinnacle's chief executive, Chris King, said a fax "could be a stat lab," or "just a 90-day refill, but you don't know until you open the document."
Put lab results on top, abnormal results first.
Have your staff put any result the lab flags as abnormal at the top. Your patient's lithium level from the day before shouldn't wait behind a 90-day sertraline refill, records from a past psychiatrist, and a form from a payer. You read the lithium level first.
Fax, 2 pages, 6:42 AM
Fax, 1 page, 6:55 AM
Fax, 3 pages, 7:10 AM
Lithium level, drawn the day before
Refill request for sertraline, 90 days
Records from a past psychiatrist
An illustration of a behavioral health prescriber's inbox before clinic. The lithium level looks like the refill request until someone opens each fax.
Give each kind one staff member.
Use the roles your practice has. Your nurse opens lab results, your front desk files records from other clinicians, and your biller fills in forms from payers. Your medical assistant checks each pharmacy request against the last visit, the last lab, and the current dose, so the request reaches you with the chart already checked.
Three don'ts
Don't let your EHR send messages you never act on.
Ask whoever sets up your EHR to turn those messages off.
Physicians at one multispecialty practice got 243 inbox messages a week on average, and the EHR itself sent almost half, a 2019 Health Affairs study found. Physicians who got more than the average number of messages sent by the EHR itself had a 40 percent higher probability of burnout. Count the messages your EHR sends by itself.
Don't file a fax before you match the patient.
Check the name and date of birth on each fax against the chart. Then file the fax. At Pinnacle, a physician who finds the wrong document in a chart calls King right away.
Don't leave failed prescriptions for later.
Check for failed e-prescriptions before your first patient. Your staff can sort everything else in your inbox, but under DEA rules only a prescriber can sign the replacement for a failed controlled-substance e-prescription.
Connect your prescribing account, and JotRx, JotPsych's e-prescribing, adds a bell that lists each kind of prescribing work. Failed sends come first, and refill and change requests from pharmacies each get their own row.
Book 15 minutes- Chris King, chief executive officer of Pinnacle Medical Group, “Tight Margins, New Locations: How Two CEOs Are Growing With AI,” session B7, Medical Group Management Association (MGMA) 2026 Annual Conference, San Antonio, September 28, 2026.
- Pinnacle Medical Group, home page, read September 30, 2026.
- Ming Tai-Seale and colleagues, Health Affairs 38, no. 7 (2019): 1073 to 1078.
- DEA, 21 CFR part 1311, subpart C: section 1311.135(a), only the registrant may sign a controlled substance prescription; section 1311.170(b), a prescription that failed to reach the pharmacy may print for the practitioner's manual signature; read October 4, 2026.