Two different things get reported under this heading, and it helps to separate them. Either a patient or appointment isn't visible in Stratus at all, or they're visible but nothing was verified automatically. Work through the checks below in order. If none of them explain it, we need example patients from you so we can trace it.
First: check your sync
Your sync badge tells you whether your practice software is talking to Stratus. On Patients it sits in the row of filters above the table; on Appointments it sits next to the page title. It reads something like Patients synced • 12 minutes ago.
Green, with a recent time. Your practice software is talking to us. Move on to the next check.
Sync failed, or a time hours or days old. Start with the obvious: is the office computer that runs your practice software turned on and awake? That's the most common cause by far, and Stratus cannot reach your data while that computer is off.
Connection failed. This means Stratus cannot reach your practice management software at all. Don't spend time troubleshooting this one yourself — message us straight away so we can get the connection restored.
You may also briefly see Syncing patients or Syncing appointments with a spinner — that's a sync in progress. Just wait for it to finish.
No badge at all. That usually means your office isn't connected to practice management software, which is expected if you add patients to Stratus by hand or by CSV upload. If your office is connected and the badge never appears, tell us.
Syncs run automatically every 5 minutes during the day, and pause overnight — roughly 6pm to 2am Pacific (9pm to 5am Eastern). Changes made in your practice software during that window sync in the early morning. There is also a Force Full Sync button directly to the right of the sync badge, and it is yours to use — but be clear about what it does: Force Full Sync tells the next scheduled sync to pull everything rather than only recent changes, so allow up to 5 minutes for it to kick in. It cannot repair a dropped connection. Click it, then check the badge again after a few minutes.
Second: check you're not filtered out of the view
Patients and appointments hide for boring reasons more often than broken ones.
On Appointments, you're looking at one day or one week at a time. Check the date at the top.
On Patients, there's a Filter by next appointment date range. If it's still set from earlier in your session, patients outside that range won't show. Clear it.
On Breakdowns, the status and eligibility filters narrow what you see. A breakdown that is still running shows as Queued, so if you haven't ticked Queued, it won't be in the list.
Cancelled appointments don't appear. If the appointment is cancelled in your practice software, it won't be in Stratus.
If you merged two patient records in your practice software, the old record goes away in Stratus too.
Third: why Autopilot skips a patient
Read this part closely, because when Autopilot skips a patient, it does it quietly. There's no error, no warning, nothing saying "we passed on this patient." It just doesn't happen, which is why it looks like something broke.
One thing to know first: Autopilot — Stratus verifying patients automatically before their appointments — is two separate things. Autopilot basic breakdowns run for every patient with an upcoming appointment, as long as they're turned on for your office — they are for most. Autopilot full breakdowns can additionally be limited to new patients only. A few of the reasons below apply to full breakdowns only — each one says so.
When an Autopilot breakdown didn't happen for a patient, one of the reasons below almost always explains it. Check them in order for the patient who was skipped:
Is Autopilot set to new patients only? (Full breakdowns only.) Check Settings, then the General tab, and find the Autopilot row. It will say either New patients only or All patients. On new-patients-only, returning patients don't get Autopilot full breakdowns — but if Autopilot basic breakdowns are turned on for your office (they are for most), returning patients still get those regardless of this setting. The setting isn't one you can change yourself — message us if it's set the wrong way for your office.
Is the appointment inside the window? Autopilot looks a set number of days ahead, and each kind has its own Days ahead setting in Settings › General, which you can change yourself: 2 to 14 days for Autopilot basic breakdowns, 7 to 14 days for Autopilot full breakdowns. Appointments further out than the window haven't come up yet.
Is it a weekday? Autopilot runs happen Monday to Friday only. An appointment booked Saturday for Monday morning may not be picked up until Monday.
Does the patient have an insurance on file, with a member ID? A blank member ID is an automatic skip.
Does that insurance identify the carrier? Either the insurance carrier name or the payer ID is enough. Only an insurance record missing both is skipped.
Does the patient have a date of birth? A missing date of birth means a skip.
If the patient isn't the subscriber, does the subscriber have a date of birth? Same rule, and this one gets missed constantly — a child's record looks complete while the parent's is missing a birthday.
Did the appointment come from your practice software? If your office is connected, only appointments that exist in your practice software and have synced across get picked up. One typed directly into Stratus won't be.
Does your account have at least one provider NPI? If there are no provider NPIs on the account at all, every patient is skipped. Check Settings, then the NPIs tab. If there are NPIs but no default, that's fine — we fall back to one of them.
Has this patient already had a breakdown recently? If the same patient and the same insurance were done within the last month, we don't repeat it automatically — even if the patient has several appointments coming up. Autopilot works off each patient's earliest upcoming appointment, and one verification covers them.
Is there an older breakdown still in progress? (Full breakdowns only.) A full breakdown that never finished, for the same patient and the same insurance, blocks new Autopilot full breakdowns with no time limit. Tell us if you see one sitting there for days.
Is it their secondary insurance you're expecting? Autopilot full breakdowns run on the primary plan only — a secondary full breakdown has to be requested by hand. Autopilot basic breakdowns cover both the primary and the secondary.
If the checklist comes up clean, send us examples
We need specific patients to trace this. A general report — "our patients aren't coming through" — doesn't give us anything to follow, and it slows down your answer.
If the patient or appointment is missing from Stratus entirely, or what you see in Stratus is outdated or not updating — a syncing problem — please send:
Two or three patient names, exactly as they're spelled in your practice software
The appointment date for each one
If it's outdated rather than missing: what Stratus shows versus what your practice software shows
What your sync badge said when you looked, and roughly when you looked
If the patient is in Stratus but no breakdown happened — an Autopilot problem — please send:
Two or three patient names
The appointment date for each one
The patient's insurance — the carrier name, and whether it's their primary or secondary plan
Whether you expected an Autopilot basic breakdown or an Autopilot full breakdown
Two or three real examples is enough. With those we can follow one patient the whole way through and tell you exactly where it stopped — and if it's a bug on our side, that's how we find it.
One more thing
If you need a patient done today, you don't have to wait for Autopilot. Open the patient, find their insurance, and click Basic Eligibility or Full Breakdown yourself. Those buttons are also on the patient's row in the Patients list, and they work whether or not Autopilot picked that patient up.