Chat support at amazingcharts.com was able to answer the question. Copied and pasted, in case anyone else runs up against it.
"the above is definitely a bug. I checked our portal and saw that you were on this version - 12.3.1 has an issue specifically for ACPM users on that build, namely the issue you've been seeing with patient photos. They may appear to save correctly, and if you switch tabs they'll look fine, but if you close and open the chart for example it'll be removed. This should be fixed in the next major release, but let me check if we have a build in between that can resolve this"
"It seems there's no beta build that fixes this quite yet, only the slated version 12.4 that should be covering this issue later this quarter"
"rest assured it's a high priority bug we're looking to patch out. I'll reach out if I have any updates on the status of a build that fixes it"
If anyone else uses ACPM and has this issue, I hope this helps. Be sure to contact online support through the chat and get your office in the queue for the fix.
