Check each link in the chain. The first one that is missing is the answer.
1. Is the location taking payments?
Settings → Billing → Payment methods → Patient payments: the location must read Taking payments. Any other state (Finish setup, Stripe reviewing, Payments off, Not connected) means no card can be charged. See Set up payments.
2. Is autopay on for the location?
Same page, Autopay: the location's switch must be on ("Charging cards on file when visits are completed"). It is off by default and disabled until step 1 is done.
3. Does the client have a card with autopay on?
Client → Billing tab → the Billing profile card shows the card (brand and last four) and Autopay: on. If it says no card, add one or ask the client to add it in the portal. If the card is there but autopay is off for this client, switch it on in Edit → Autopay. A recent decline is noted on the same card.
4. Was the appointment marked completed?
Autopay runs when the appointment's status becomes completed (from the editor, the hover card's Show, or the ended screen of a video visit). A visit left as confirmed or pending is never charged.
5. Did the visit produce a charge with a fee?
On the client's Billing tab, find the visit's charge:
- Draft: no fee could be found. Give the service a price under Settings → Services or the client a rate, then collect the balance by hand. See Set client fees and rates.
- Unpaid with a fee: the charge exists; the problem is in steps 1 to 3 or 6.
- Paid: it was charged. Look in the client's Payments tab for the payment and the Stripe receipt.
6. Is the client an insurance client?
Autopay charges the client's share: the copay for an insurance client, and nothing until a copay is entered on their billing profile. Self-pay and sliding-scale clients are charged the whole fee.
7. Was the card declined?
A decline leaves the charge open, notes the reason on the client's billing profile and portal, and sends the office a Payment failed notification. Have the client replace the card (staff or portal), then collect the balance. Card expiry updates from the card network arrive automatically; a card removed in Stripe turns autopay off.
Things that never autopay
- Practices connected to athenahealth.
- Cancellation and no-show fees when Charge the card on file right away is off on the policy; those sit on the balance.
- Group sessions for clients not marked attended.