There are several scenarios in which an office will credit a patient account. Usually negative Adjustment will account for the credit whether or not a refund occurs. Once an adjustment is put on an account, if there is a resulting negative balance, you can choose to either leave the account with a credit or refund actual payment by cash, check or credit card.

  1. Credit the Account

    A credit to the account means you remove a portion of the patient's balance by adding a negative adjustment. Credits occur for the following scenarios:

    • Warranty work: The patient has work redone at no additional charge. You will chart the replacement procedure at normal price, then add a negative adjustment. The balance stays the same.
    • Product return: The patient is returning a purchased product for a refund or just credit.
    • Courtesy credit: The patient is unhappy with work and wants a credit for part or all of the charge.
  2. (Optional) Refund

    If a patient ends up with a negative account balance after a negative adjustment is entered as shown above, the patient may decide to keep the credit on the account or you may process a refund (negative Payment Allocation). Refunds only apply to procedures or goods the patient has already paid for. You would be returning money to a patient with the original payment type.

    1. Start by crediting the account with a negative adjustment as above.
    2. If you decide to refund money, click Payment in the Account Module.
    3. Enter a negative amount in the amount field.
    4. Select the payment type.
    5. Allocate the refund to a procedure or unearned income type
    6. Click OK.

To process a return on a credit card, see Credit Card Return. ACH transactions cannot be refunded back to the original account.


Scenario 1: Your patient purchased a product that they want to return.

  1. Add a negative adjustment to the account to negate the original charge.
  2. Check the account balance. If there is a credit, choose to:
    1. Refund the balance by creating a negative patient payment in the correct amount.


    2. Leave the credit.

Scenario 2: Your patient received a filling that fell out, so it needs to be redone. This is called a warranty credit. You aren't going to return money to the patient, but you will add a negative adjustment to account for the warranty when you chart the replacement procedure.

  1. Chart the replacement procedure and mark it complete.
  2. Add a negative adjustment equal to the procedure fee amount.

Scenario 3: A patient has a crown break soon after treatment, but has since moved out of state. They already paid for the crown so their current account balance is $0.

  1. Enter a negative adjustment (Misc Neg Adjustment) for $800. This makes the patient balance -$800 and affects production amounts.
  2. Enter a negative payment for the refund amount and write them a check. This takes the balance back to $0 and affects the income amount.