The most likely scenario is that someone created the appointment for that record directly within Xchart instead of creating it by opening that appointment from within CareStack.
You can easily tell if it's linked by looking at the Case Summary page in your Xchart dashboard.
You should see text under the words "Case Summary" that says "Linked To CareStack"
If you do not see that text. The finalized document will not be put back into CareStack.
Two options for preventing the issue:
Xchart can disable your organization fromm creating unlinked appointments completely. If you are fully integrated to CareStack and want to remove the ability for people on your team from creating unlinked patients and appointments in Xchart we can turn this ability completely off for your account. If you'd like to do this, please contact [email protected] and request that this setting is changed on your account.
Train your team. To always make sure they're create new Xchart cases by clicking the "Open Surgery Details" link within CareStack.