You can see in the logs if an email is sent. You should also check the Unsent Emails folder to make sure you don't have things sitting in there.
On every new BSV I build, one of the first things I do is:
1) make the SystemSettings BO intelligent
2) Copy in a Test Outgoing email notification
3) load SMTP credentials into SystemSettings
4) Put my email address in SystemSettings.EmailAddress
5) Copy in a process to send the test email notification to SystemSettings
6) Attach the process to a SystemSettings menu and execute the process
There are a number of free SMTP services you can use to test and make sure your BSV's email functionality is working properly, then you can move toward the Exchange connection.
We used to use Exchange & I just remember if was a total pain to get connected using "SendAs" functionality. Our network guy had to go into Exchange for specified users and turn on SendAs capability. Sounds like it should be easy, but it wasn't. I also remember the login process was tricky. Sorry I can't be more specific. Thankfully we moved to Gmail and I use Mandrill now for most SMTP processing. Very slick and easy!