Letter Builder
Web-based replacement for the legacy desktop Letter Builder. Full WYSIWYG word-processor with merge fields, plus an AI Letter Assistant that drafts complete letters from chart data. Click a card to jump to that section.
Letters Grid
Create Letter
Letter Details
AI Letter Assistant
Letters Grid
Setup → Clinical → Letters
Key Features
- Landing page for the Letter Builder under Setup → Clinical → Letters.
- Filter by name, category, active status, and document type before searching.
- Click any letter name to open it directly in the WYSIWYG editor.
- Inline search in the card header filters rows in real time — no Search button click needed.
- Duplicate copies an existing letter; Delete prompts for confirmation.
Field reference
Click to expandFilter bar5
NameInput
Type all or part of the letter name to narrow the list.
CategoryDropdown
Patient, Provider, Insurance, or Pharmacy.
StatusRadios
Active (default), Inactive, or All.
KindRadios
Label, Letter, or All document types.
SearchButton
Applies all filters and refreshes the table.
Table columns6
Letter NameLink
Click to open the letter in the editor.
DescriptionText
Internal team notes (never printed).
CategoryPill
Type of letter; the column header has a filter icon for inline filtering.
LabelYes / No
Whether this prints in label format.
SHORT_NAMEToken
Merge token used to reference this letter from automations.
ActionsIcons
Copy = duplicate; X = delete (asks to confirm).
Footer2
Result countText
"Showing 1 to N of M results".
Page controlsButtons
Previous, page numbers, Next, plus a Refresh icon.
Where to find it
Top nav → Setup → sidebar group Clinical → Letters.
Create Letter
2-step wizard · Setup → Clinical → Letters1
Details
Capture template metadata before writing. Only the letter name is required — everything else can be filled in later from the editor.
General5
Letter nameRequired
Display name in the grid and at the top of the editor. Example: "Return to Work Note".
CategoryDropdown
Patient, Provider, Insurance, or Pharmacy.
DescriptionTextarea
Optional internal notes for your team.
Profile GroupDropdown
Restricts who can see and use the letter.
Document typeDropdown
Letter = full page; Label = label format.
Toggles3
ActiveToggle
Visible in the grid when on; hidden when off (not deleted).
LabelToggle
Mirrors the Document type dropdown.
Clinical SummaryToggle
Auto-include this letter in clinical summary exports.
2
Build
A real WYSIWYG word-processor — documents look exactly as they will print on an 8.5 × 11 in page. Switch tabs to see each part of the editor in detail.
Floating text toolbar — full-width close-up
The toolbar floats as a pill at the top of the page. Toggle it open or closed with the Aa button in the top bar.
Text toolbar is hidden by default. Click the Aa button in the top bar to open the floating formatting toolbar (see the Text toolbar tab). Click Aa again to close it.
Top bar5
Back arrowAction
Saves and returns to the Letters grid.
Step indicator / TabsStepper
Shows Details → Build while creating; replaced by free-navigation tabs when editing.
Save statusIndicator
Shows Unsaved / Saving… / Saved with a cloud icon.
SaveButton
Manually persists the letter content and settings. When editing an existing letter the label is Update.
AaToggle
Opens or closes the floating text toolbar. The toolbar starts hidden — click here to reveal it.
Document area4
Page canvasEditable
Real 8.5 × 11 in page. Type anywhere; click outside to deselect.
Horizontal rulerDrag handles
Drag the left/right blue handles to set page margins. Default 1″ each side.
Vertical rulerDrag handles
Drag the top/bottom handles for top/bottom margins.
Word count + zoomStatus
Bottom bar shows live word count and a zoom slider (default 100%).
Group 1 — History2
Undo / RedoCtrl+Z / Ctrl+Y
Reverse and re-apply the last edits.
Group 2 — Font2
Font familyDropdown
Inter, Arial, Times New Roman, Calibri, Georgia, Verdana, Tahoma, Courier New.
Font sizeDropdown
8 pt – 72 pt.
Group 3 — Style6
Bold / Italic / Underline / StrikethroughCtrl+B/I/U
Standard text styling on the selection.
Text color · HighlightColor picker
Swatches under each icon show the current color.
Group 4 — Lists, indent & alignment8
Bulleted / numbered listButtons
Wrap the selection in a list.
Indent / outdentButtons
Shift the line in or out one level.
Align left / center / right / justifyButtons
Horizontal alignment of the current paragraph.
Group 5 — Object insert & tokens6
Insert tableGrid picker
Click the table icon to pick rows × cols visually.
Insert imageFile picker
Upload an image at the cursor.
Insert link / signatureButtons
Wrap a link or insert a signature image.
+ InsertPopover
One-stop insert menu (see next tab).
FieldsToken picker
Drops a merge token at the cursor (System, Smart, or Legacy User Field — see Letter Details for the three-tier field system).
Insert items6
ImageUpload
Upload an image from your device.
TableGrid picker
Pick rows × columns to insert a new table.
BarcodeInsert
Scannable code at the cursor — useful for lab and pharmacy letters.
LinkURL
Wraps the selected text in a hyperlink.
User FieldToken
Insert a custom merge token. Backward-compatible with legacy desktop user fields — these always prompt at letter generation.
Text from fileImport
Paste content from an external
.rtf, .docx, or .html file.Document5
New letterCtrl+N
Clear the editor and start fresh.
Import…Ctrl+O
Bring in content from
.rtf / .docx / .html.ExportCtrl+E
Save the current letter as
.docx or .pdf.DuplicateAction
Copy this letter and open the copy in a new editor.
PrintCtrl+P
Send to the browser print dialog.
View4
HeaderToggle
Show or hide the letterhead on every page.
FooterToggle
Show or hide the page footer.
Header on first page onlyToggle
Header prints on page 1 only.
Footer on first page onlyToggle
Footer prints on page 1 only.
Edit3
Select allCtrl+A
Selects all editor content.
FindCtrl+F
Open the find bar.
Toggle spell checkToggle
Browser-native spell checking on the body.
Page & danger2
Page Settings…Dialog
Page size and margins.
Delete letterDestructive
Permanently removes the letter (with confirmation).
Letter Details
Editing CONSULT11 · Setup → Clinical → LettersClicking an existing letter (here, CONSULT11) opens it in edit mode. The 2-step stepper from creation is replaced by free-navigation tabs — Details and Build — so you can switch back and forth at any time.
What you're looking at
- The Build tab shows the saved letter content — header, body, and footer.
- The body is pre-filled with the practice letterhead, patient/employer fields, and three duty options (Full / Modified / No Work).
- Every blue pill is a merge token — it resolves to real data when the letter is generated for a specific patient encounter.
- Header content (logo, address, phone, fax) auto-resolves from the encounter's location at generation time, not from a hard-coded snapshot.
Three-tier field system. Tokens render as styled pills inside the editor — never raw
{{variable}} names. Each token belongs to one of three tiers:
Field tiers3
System FieldsAuto-resolve
Always resolve automatically. Patient demographics, provider, encounter, practice/location, date/time. Examples seen here:
FIRST_NAME, LAST_NAME, DOB, LOCATION_ADDRESS1, LOCATION_TEL_NUM1, DateStamp.Smart FieldsAuto + fallback
Auto-resolve when the data exists; otherwise prompt the user. Referring provider, insurance, diagnosis, procedures, medications, allergies, vitals, progress notes, denial data, appeal data.
Legacy User FieldsAlways prompt
Always ask the user at generation time. Backward compatible with custom fields from the desktop Letter Builder. Examples here:
EMPLOYER_NAME, RETURN_TO_WORK_ON, TEMP_RESTRICTIONS_FROM.Delivery options3
PrintPDF
Standard browser print or save-as-PDF.
FaxDirect
Recipient fax auto-populates from the referring provider or payer directory.
Patient PortalSend
Push the letter to the patient's portal inbox.
Audit & storage2
Documents tabAuto-save
Letters save to the patient's Documents tab only on delivery — not on every keystroke.
Audit trailPer event
Every generation event is logged. Denial/appeal letters keep a bidirectional link between the document and the denial record.
Top bar3
Save statusIndicator
Cloud chip shows Unsaved / Saving… / Saved based on dirty state.
UpdateButton
Persists edits made on either the Build or Details tab. Replaces the create-flow Save button when editing an existing letter.
Settings (gear)Menu
Page setup, margins, and other letter-level options.
The Details tab
- Same metadata form as Step 1 — Details when creating, but pre-filled with the saved values.
- Edit the letter name, category, description, profile group, document type, or any toggle without leaving the editor.
- Changes commit when you hit Update in the top bar — the create-flow Save button is replaced by Update in edit mode.
Where it appears. When editing an existing letter the create-flow stepper is replaced by free-navigation tabs (Details / Build) so you can jump between metadata and content as you work.
General fields5
Letter nameRequired
Display name in the grid and at the top of the editor.
CategoryDropdown
Patient, Provider, Insurance, or Pharmacy.
DescriptionTextarea
Optional internal notes for your team.
Profile GroupDropdown
Restricts who can see and use the letter.
Document typeDropdown
Letter = full page; Label = label format.
Toggles3
ActiveToggle
Visible in the grid when on; hidden when off (not deleted).
LabelToggle
Mirrors the Document type dropdown.
Clinical SummaryToggle
Auto-include this letter in clinical summary exports.
Actions2
UpdateButton
Persists changes to the metadata and any unsaved edits in the Build tab. Replaces the create-flow Save button when editing an existing letter.
Back arrowAction
Returns to the Letters grid. Prompts to confirm if there are unsaved changes.
AI Letter Assistant
Sparkles FAB · Setup → Clinical → Letters
AI Letter Assistant
- The purple Sparkles FAB in the bottom-right of the editor opens the Letter Assistant chat panel.
- Pick a letter type (Referral, Appeal, Prior Auth, Work Excuse, etc.) and add a free-text prompt — the AI drafts a complete letter from chart and encounter data.
- Output is fully editable before delivery — the AI never sends or saves on its own.
- For Denial / Appeal letters, the AI auto-grounds appeal arguments in actual documented findings and pre-fills CARC/RARC, CPT, payer, and DOS from the denial record.
Five entry points. The AI can be triggered from anywhere a letter is needed — not just from the Letter Builder.
AI trigger entry points5
Letter EditorFAB
Sparkles button in the editor (shown here) — drafts directly into the current document.
Progress NoteInline
Generate a letter from the encounter's progress note context.
Demographics tabPatient-level
Trigger from the patient header for general letters (work excuse, return to school, etc.).
AI Assistant panelGlobal
Practice-wide assistant can request a letter draft as part of a broader workflow.
AI Denial / Appeal queueOne-click
From the denial action queue — generates an appeal letter with payer-specific arguments grounded in clinical notes.
Quick-prompt suggestions3
Return to workSuggestion
One-click to generate a back-to-work note grounded in the encounter.
School excuseSuggestion
Excuse note for school absences.
ReferralSuggestion
Referral letter pre-filled with diagnosis and reason.
Composer3
Free-text promptTextarea
Describe the letter in your own words. Enter to send, Shift + Enter for new line.
Attach contextTool
Pull in additional patient context (lab results, imaging, denial details).
Use templateTool
Start from an existing template, then ask the AI to revise or fill it.
Migration note
All existing desktop templates, system fields, user fields, categories, and progress-note letterhead assignments carry over. The desktop editor has a 90-day sunset.