ApprovalMax pushes only fully authorised Bills (i.e. all assigned Approvers have approved) to QuickBooks Online. Once a Bill has been fully approved, it'll bear the Approved watermark and have the approval audit report attached:
If a Bill/Purchase Order has not been fully approved (not all approvals have been collected), it won't be pushed to QuickBooks Online:
Users with the Administrator or Auditor role can use the reporting feature to show all Bills/Purchase Orders pending approval, and also see whose approval they are waiting for: