A signed encounter that does not push to the destination EHR almost always falls into one of three categories. The push fired and failed silently, the push never fired because of a setting, or the connection is in an error state and the queue is paused. Each has a different fix.
Step 1: check the External Apps panel
Open Settings, then Tools and AI, then External Apps. Look at the connection status for the EHR in question.
If the status is Active, the connection itself is healthy. Move to Step 2.
If the status is Error or Disconnected, the connection broke. Most common causes are a revoked OAuth token (someone changed the EHR admin password, or the Osmind or Kalix integration was uninstalled on the EHR side), or an expired API token (SimplePractice tokens have a finite lifetime that varies by account). Reconnect by clicking Reconnect and completing OAuth again, or by pasting a new API token. Once the connection is Active, the queued encounter will push automatically within a few minutes.
Step 2: open the encounter and check the push status
Open the encounter detail page (/sessions/view/<encounter-id>). Look for the EHR push status indicator in the
encounter metadata panel. Possible states:
- Not pushed: the encounter was signed but the push never fired. Usually a provider mapping issue (Step 3) or a push setting that excludes this encounter type.
- Pending: the push is queued and has not run yet. Wait two minutes and reload. If still pending after five minutes, contact support.
- Failed: the push ran and the destination EHR rejected the request. The error message in the indicator usually identifies the problem (missing required field, patient not found in destination EHR, provider mapping unresolved). Fix the underlying issue and click Retry.
- Pushed: the push succeeded. If the note is still missing in the destination EHR, the destination EHR has it but is rendering it somewhere unexpected. Check Step 4.
Step 3: verify provider mapping
The most common cause of Not pushed is an unmapped provider. If the encounter was signed by a provider who is not mapped in External Apps, the system has nowhere to route the note in the destination EHR.
Open Settings, External Apps, the EHR connection, and the Provider Mapping panel. Verify the signing provider has a mapped destination. If the provider is missing, map them and click Retry on the encounter.
Step 4: search the destination EHR
If Nextvisit shows Pushed but the note is not where you expect it in the destination EHR, the EHR placed it differently than you anticipated. Common patterns:
- Osmind and Kalix attach the note to the visit if a visit exists for that date and patient. If no visit exists, the note attaches to the patient record without a visit. Search for the patient and look at recent notes.
- SimplePractice places the note in the patient’s notes section, not the appointment if the appointment was not pre-created. Search the patient’s notes by date.
If the patient does not exist in the destination EHR (this happens with SimplePractice while two-way is in development), the push fails with a “patient not found” error. Create the patient in SimplePractice, then click Retry.
When to email support
Email hello@nextvisit.ai with the encounter ID, the EHR, the signing date, and a screenshot of the push status
indicator. Most cases resolve within a few hours during business days. The integrations team has direct access to the
push logs and can usually identify the cause within the first response.