Testing writes, per system

Your Open Dental sandbox takes every write the API makes, so you can test all of them there. Live practices run 15 systems, and not every system takes every write. Before you ship, know which writes work on each practice's system.

How to read the tables

Sent to the system means NexHealth queues the change for the practice's sync and it lands on the next cycle, usually within minutes. See How a write reaches the health record system.
NexHealth only means the API returns 2xx and the NexHealth record changes, but nothing reaches the system. The practice does not see it.
400 means the API rejects the call. Nothing changes.
To learn which system a practice runs, call GET /sync_status; each sync returns an emr object with a display_name. On v3.1.0 (beta), GET /locations/{id} returns it as ehr.

Appointments

Every PATCH /appointments write is confirmed the same way: when the command finishes, appointment_updated fires on success, or appointment_updated.failed, .timed_out or .incomplete otherwise, with previous_attributes showing the field you changed.

What you send	Sent to the system on	On the other systems	How you know it landed
`POST /appointments`	Every system, once the location has `insert_appt_client: true`	Held in NexHealth, never sent	`appointment_insertion`: `complete`, or `failed`, `timed_out` or `incomplete`. On `complete` the appointment's `foreign_id` is set.
`PATCH /appointments` with `cancelled: true`	athenahealth, Cloud9, Curve Hero, Denticon, Dentrix, Dentrix Ascend, Dentrix Enterprise, Dolphin, Eaglesoft, eClinicalWorks, ModMed, NextGen Office, Open Dental	NexHealth only	`appointment_updated`
`PATCH /appointments` with `confirmed: true`	Every system		`appointment_updated`
`PATCH /appointments` with `checkin_at`	Denticon, Dentrix, Dentrix Enterprise, Eaglesoft, ModMed, NextGen Office, Open Dental	NexHealth only	`appointment_updated`
`PATCH /appointments` with `start_time` and `end_time`, `operatory_id` or `note`	Denticon, Dentrix, Dentrix Enterprise, Eaglesoft, Open Dental	`400` `EMR does not support appointment update` for a time or note change. A change to `operatory_id` alone is accepted and stays in NexHealth.	`appointment_updated`

Two more rules on live practices:

PATCH /appointments works once the appointment has reached the system (foreign_id set). Before that, only cancelled: true is accepted, so you can free the slot when an insertion fails. Anything else returns 400 Cannot update appointment because it is not synced with the PMS and/or a live client.
A cancelled appointment or a scheduling block cannot be updated.

Patients

What you send	Sent to the system on	On the other systems	How you know it landed
`POST /patients`	Nothing is sent on v3.0.0. The patient is created in NexHealth and reaches the system when you book their first appointment.		`foreign_id` stays `null` until an appointment lands.
`POST /appointments` for a patient with no `foreign_id`	athenahealth, Cloud9, Denticon, Dentrix, Dentrix Ascend, Dentrix Enterprise, Eaglesoft, eClinicalWorks, ModMed, NextGen Office, Open Dental, OrthoTrac. The patient is created in the system as part of the booking.	Curve Hero, Dolphin and PracticeWorks cannot take a new patient from the API. Book with a patient the system already has.	`appointment_insertion`. The patient's `foreign_id` is set when it lands.
`PATCH /patients`	Nothing is sent on v3.0.0. NexHealth only.

On v3.1.0 (beta), POST /patients sends the patient straight to Denticon, Dentrix, Eaglesoft and Open Dental and fires patient_insertion; PATCH /patients sends the change and fires patient_update.

Payments and adjustments

What you send	Sent to the system on	On the other systems	How you know it landed
`POST /payments`	Dentrix, Dentrix Enterprise, Eaglesoft, Open Dental, where the practice has ledger sync	The API returns `202` on every system. On these the payment never reaches the ledger.	`payment_insertion`: `complete`, or `failed`, `timed_out` or `incomplete`
`POST /adjustments`	The same four	The same	`adjustment_insertion`, same suffixes

Both calls return 202 with an empty body. The record appears on GET /payments or GET /adjustments once the sync reads it back.

Documents

POST /patients/{id}/documents reaches the system only where document insertion is turned on for it: Curve Hero, Denticon, Dentrix, Dentrix Ascend, Dentrix Enterprise, Eaglesoft and Open Dental. For athenahealth, eClinicalWorks and OrthoTrac, ask developer support. Elsewhere the document stays in NexHealth. document_insertion fires with complete, or failed, timed_out or incomplete.

v3.1.0 (beta) only

Sandbox keys can call v3.1.0; production keys need access for your organization. See Versioning.

POST /insurance_plans, POST /insurance_coverages and DELETE /insurance_coverages/{id} are sent to Dentrix, Eaglesoft and Open Dental. Elsewhere the API accepts the call and the change stays in NexHealth. insurance_plan_insertion, insurance_coverage_insertion and insurance_coverage_deleted tell you when it landed.
POST /communication_logs is Open Dental only, turned on per organization. Other systems return 422.

What this means for your sandbox

Every row that names Open Dental works on your Open Dental sandbox, so you can test each write end to end there. The demo practice has no sync behind it: bookings are accepted and never land, and PATCH /appointments returns 400 for anything but a cancel. See Sandbox and test mode.