Adjustments are used to create additional charges or reduce charges on a patient account.

In the Account Module, in the toolbar, click Adjustment.


Adjustments affect production (see Production and Income). They are also used by the Billing/Finance Charges, Late Charges, Broken Appointments Automation, Discount Plans, and Sales Tax tools. Adjustments can be attached to a procedure but are always attached to a single patient and assigned to a provider and can be assigned to a clinic.

To view a list of adjustments added in a date range, run the Daily Adjustments Report.

Adjustment Details

Enter the adjustment amount, type, etc. at the top of the window.

Entry Date: Read only. The date the adjustment was created.

Adjustment Date: Typically the same as the entry date. This is the date that appears on the account and most reports. Modifying this date could potentially change historical data.

(procedure date): The date of the procedure associated with the adjustment. Read only when a procedure is attached to the adjustment.

Amount: The amount of the adjustment.

Provider: Defaults to the patient's primary provider. Click the dropdown or [...] to select a different provider (only providers restricted to the user's clinic will show) or attach a procedure to inherit the procedure's provider.

Clinic: Defaults to the patient's assigned clinic. Click the dropdown to select a different clinic (only clinics restricted to the user will show) or attach a procedure to inherit the procedure's clinic.

Additions: List of adjustment types that add the adjustment amount to the patient's account balance.

Subtractions: List of adjustment types that subtract the adjustment amount from the patient's account balance (issues a credit of production).

  • To customize the list of adjustment types, see Definitions: Adj Types.
  • Additions and Subtractions only display types the user has access to. To edit available adjustment types for a user, edit the Adjustment Type Deny security permission. See Security section below.


Attach or detach this adjustment from a procedure. To set whether users are required to allocate an adjustment to a procedure, see Adjustments in Allocations Setup.

The clinic and provider of the adjustment must match the attached procedure. If the provider and clinic do not match, the procedure value will not be updated and the adjustment will be considered a separate charge when a payment is applied.

Attach: Select a completed procedure from the Select Procedure window. Subtraction adjustments will reduce the procedure fee and Addition adjustments will increase the fee.

Note: Procedures cannot be attached to adjustments that are attached to a patient payment or Payment Plan.

Detach: Remove the attached procedure from the adjustment.

Edit Anyway: Button is only visible if the adjustment is attached to a procedure and the Adjustment setting in Allocations Setup is set to Rigorous. Click to change the provider or clinic. Users must have the Setup security permission.

Note and Buttons

Add notes regarding the adjustment, save changes, or delete the adjustment at the bottom of the window.

Delete: Remove the adjustment from the patient's account. Adjustments attached to a payment or payment plan cannot be deleted.

Note: Enter any notes about the adjustment. These notes can be included on statements when the Show notes for adjustments preference is enabled. This text box supports Right-Click Options.

OK: Save changes made to this window. If a warning appears, see Negative Adjustments section below for additional information.

Cancel: Close the window without saving any changes.

Add Multiple Adjustments

To create multiple adjustments attached to multiple procedures at once, see Add Multiple Adjustments.

Negative Adjustments

The Negative Adjustments preference determines if users are able to create subtraction adjustments that exceed the estimated patient portion remaining. When the preference is set to Block, users will receive a message informing them an adjustment cannot be created.

Click OK on this message to return to the Edit Adjustment window and edit the adjustment as to not exceed the estimated patient portion remaining.

If the Negative Adjustment preference is set to Warn and the adjustment exceeds the estimated patient portion remaining, users receive an Overpaid Procedure Warning instead. Users can choose to Cancel the adjustment or click OK to proceed with creating the adjustment.


The following Permissions affect access to adjustments:

Adjustment Type Deny

In the User Groups tab of the Security window, select a user group to deny access to specific Adjustment Types (e.g., finance charge, professional discount, etc.)

  1. Check the Adjustment Type Deny permission
  2. The definition picker will pop up. Highlight the adjustment types to deny for the user group. To select multiple types, select Ctrl + click.
  3. Click OK.

Users in the selected user group do not have access to the selected Adjustment Types. When creating a new adjustment (or editing an existing adjustment), denied Adjustment Types are hidden in the Adjustment Type lists.

If a user is assigned to multiple User Groups, they are only denied access to specific Adjustment Types when all assigned User Groups are denied access.