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, and when does it charge?
Same page, Autopay & invoicing: the location's switch must be on. It is off by default and disabled until step 1 is done. The row says when it charges:
- "Charging cards on file each night for open invoices": go to step 3.
- "Charging cards on file when visits are completed": skip to step 4.
3. Nightly: is the visit on an invoice?
Nightly autopay charges open invoices, never visits on their own. On the client's Billing tab, look for an invoice billing the visit (or check Payments → Appointments, where the row shows its invoice).
- No invoice: turn on Daily invoicing on the same settings row. Each night it puts every client's visits from before today that aren't on an invoice yet onto one invoice, and autopay charges it that night. It only picks up visits from the day it was turned on; invoice older ones yourself (Create invoice on the Appointments tab).
- The invoice was voided: its visits aren't invoiced again by themselves. Create a new invoice for them.
- The visit or invoice is from today: nothing runs until tonight. The nightly run starts after midnight in the location's time zone (and finishes by 6am), when today's visits are invoiced and open invoices are charged.
Then check the invoice itself:
- A bank payment on it is still clearing: it is skipped until that settles.
- The client has an active payment plan: nightly autopay skips them, and the plan collects on its own schedule.
- Three declines in a row: nightly autopay stopped trying this invoice. Once the client saves a new card (step 5), it is tried again the next night. Or collect it yourself with Add payment.
4. On completion: was the appointment marked completed?
Autopay at completion 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. Does the client have a card with autopay on?
Client → Billing tab → the Billing profile card. Autopay should read On with the card (for example "On · Visa ending 4242"). If it reads Off · no card on file, add a card (Edit → Add card), ask the client to add one in the portal, or send them an add-card link from Settings → Billing → AutoPay clients. If the card is there but autopay reads Off, click Edit and turn the Autopay switch on. A recent decline shows on the same card as "Last autopay charge failed".
Settings → Billing → AutoPay clients shows the same for everyone at once: Needs a card lists clients who are enrolled but have no card.
6. 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 5 or 7. A Draft charge is never put on an invoice by daily invoicing either.
- Paid: it was charged, or it was already paid before the visit was completed (a copay taken at check-in counts toward the visit, and autopay only charges what is still open). Look in the client's Payments tab for the payment.
7. 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.
8. Was the card declined?
A decline leaves the amount open, notes the reason on the client's billing profile and portal, and sends the office a Payment failed notification. The client gets an email (and a text where they allow it) saying the payment didn't go through. If their bank asked them to confirm the payment (3-D Secure), nothing was charged and they are asked to pay it themselves in the portal. Have the client replace the card (staff, portal or an add-card link), then collect the balance; on a nightly location, invoices stopped after declines are tried again the next night. Card expiry updates from the card network arrive automatically; a card removed in Stripe turns autopay off.
9. Is Stripe still confirming it?
If Stripe didn't answer in time (a timeout, or a payment still processing), FrontDesk doesn't treat it as a decline and doesn't charge again. The payment appears in the client's Payments tab once Stripe confirms it went through. Check there before collecting the visit another way.
A payment plan installment wasn't charged
Payment plans charge the same card on file. Open the client's plan card and read the note under Next payment:
- Not charged: card payments aren't connected for this location. The location's Stripe connection is off or needs attention (step 1). The installment waits, and it doesn't count as a missed payment for the client. Once you reconnect Stripe under Settings → Billing → Payment methods, it's charged automatically. The office is told once.
- Autopay is off for this client or There's no card on file: nothing is charged automatically. Turn autopay back on or save a card, or use Record payment when the client pays.
- Declined, with the number of attempts: the card was refused. It's retried automatically in a few days while the plan is active, or you can click Charge card once the client has a new card.
- Confirming: Stripe hasn't confirmed the charge yet. It settles by itself, so don't charge it again.
Things that never autopay
- Practices connected to athenahealth.
- Accounts that have been closed, or archived by FrontDesk support: no client's card is charged.
- Cancellation and no-show fees when Charge the card on file right away is off on the policy; those sit on the balance.
- Clients in a group session who are marked no-show or cancelled. If you mark one back as there after the session is completed, they're billed then, and autopay runs for them.
- Visits that are cancelled, no-shows, or rescheduled.