E-fax: Troubleshooting Guide & FAQ

This guide runs through the most common reasons for failed or pending E-faxes. 

The most common error reason for failed faxes is attempting to send non-supported file types. We recommend only sending PDF documents via fax. Word documents and other file formats (ie. PNG, JPG, excel, sheets, csv, etc).will likely not send or render properly and result in a failed fax. You can convert your document/file to a PDF and add it again to Healthie to successfully fax. 

Please review the troubleshooting guide below. If you are still having issues, please email hello@gethealthie.com for further troubleshooting. 


What format should I enter for a fax number?

The recommend format for entering a Fax Number is (xxx) xxx-xxxx, though you can use "-" instead of (). 

Error message "No Faxtone" 

This means that there is an issue with the recipient number, and they did not respond with an available fax tone, in order to fulfill your request. 

This can happen if the number you have entered is not a fax machine (for example if you try to send a fax to a phone number), or possibly if the number is not active / valid. 

Error message "Remote fax"

This means that a connection was established with the remote fax, but during the transmission of the fax the remote fax disconnected the call. The primary cause for this is generally a poor connection to the destination fax machine. 

We recommend re-trying to send this fax. If fax continues to fail, please reach out to the recipient and confirm that their fax line is enabled and active. 

Error message "Optional Content PDF files aren't supported and their pages cannot be safely extracted"

The PDF file you are trying to fax has layers/graphics incorporated that prevents the file from securely being uploaded & sent.These digital content layers are not compatible with a faxable format, which is why you are receiving the error. 
In this instance, please convert your PDF into a different format to fax this document, in order to "flatten" these layers. Here are two free tools to help you with this:

Error message "file encrypted"

Sometimes when uploading a document to e-Fax, you may receive an error message reading "file is encrypted". In order to unencrypt this file for upload:

  1. Right-click your file and open with Preview
  2. Click File (top navbar) > Export
  3. Select PDF as the format and uncheck encrypt

Error message "malformed PDF"

Healthie supports sending PDF file types. If you see the error message "malformed PDF file" it means that you are attempting to fax a file that is not a PDF. To remedy this, we recommend confirming that you are attempting to send a PDF file. 

We will update this post if it becomes possible to E-Fax a non-PDF file. 

Error message "can't modify frozen String..." 

Sometimes with documents that have multiple layers of information, content may not display as intended when uploaded to another platform. We suggest you try flattening the layers of the PDF and re-adding it to Healthie. 

Steps for flattening a PDF with Adobe can be found here: Printing complex PDF document using Acrobat

I have tried to send a fax multiple times, but it is not going through. What should I do?

The receiving fax line is likely busy. Please re-try sending this fax in a few minutes. You can press "Resend" next to the fax. 

You will get an e-mail if the document fails to send. At this point, when you receive this e-mail, the system has stopped trying to re-send the fax, so you will need to re-start the Sending an E-fax process

When I click on "View Fax" I only see the cover sheet. Was my entire fax sent? 

Yes, your entire fax was sent. The preview only shows the cover sheet. 

Is there a limit to how many documents or sheets I can fax at once?

There is no limit to the number of documents that can be faxed at once. There may be restrictions on the size of an individual faxed file, so if you are trying to fax a very large file, we recommend breaking the file into multiple faxes. Often times, these restrictions are set by the receiver. 

How do providers sending me an E-fax format their fax number for me?

Please have providers dial "1" before the area code. For example, 1-833-xxx-xxxx.   

I would like to E-fax an Intake Form. How can I do this?

Healthie supports E-faxing of charting notes and documents. If you'd like to E-Fax an intake form, you will need to download the form as a PDF, and then upload it as a Private Document, to E-fax the form.

Can I attach medical records to CMS-1500 forms?

At this time, we do not offer the capability to attach client medical records in the form of PDF or document to a CMS-1500 when submitting to Office Ally. To send a medical record to your client's insurance company, you can E-Fax the document to the insurance provider.

Can I fax Word documents?

We recommend only sending PDF documents via fax. Word documents and other file formats will likely not send or render properly. You can convert your Word document to a PDF and add it again to Healthie.

Depending on your device, here are a few ways you can convert your document to a PDF: 

  • Open the original document with Word or Pages and "Export" as a PDF (more resources for Microsoft and Apple users)
  • Open the document > Print > Choose "Save As" and adjust the file format to PDF 

The new PDF file can be added to your Healthie Documents library, or directly to your Client's Chart as a private document

Once re-added as a PDF, you can re-attempt to send via e-Fax.

How can my team member view and send faxes? 

To have the "Send Fax" feature available to the organization member, you will need the "Can view sent faxes from members in the organization" enabled for that member. This can be done in their member settings

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