In the Account Module, adjustments are used to create additional charges or reduce charges on a patient account. They are always attached to a single patient, provider, and clinic, and can be optionally attached to a procedure.

Adjustments are also used by the Billing/Finance Charges, Broken Appointments Automation, Discount Plan, and Sales Tax tool.

By default, Open Dental assigns adjustments to the patient's clinic and primary provider. If a procedure is attached to an adjustment, or the adjustment is added through the Procedure, the adjustment is assigned to the procedure's clinic and provider. To change the default clinic and provider assignment see the Account Module Preferences, Enforce Valid Adjustments.

To determine behavior and logic of adjustments, review other preferences in Account Module Preferences and Appointments Module Preferences. To customize adjustment types, see Definitions: Adj Types. Use the Daily Adjustments Report to report on custom types.

Add a Single Adjustment

Add single adjustments using Edit Adjustment. There are three ways to open this window:

Add the adjustment information and click OK to save.

Add Multiple Adjustments

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

  1. In the Account module, open the multiple adjustment window. There are two ways to open this window:
    • Click the Adjustment dropdown and select Add Multiple.
    • Highlight multiple procedures, right-click and select Add Adjustment.
  2. Date: Enter the adjustment date.
  3. Amount: Enter the adjustment amount per procedure. The amount will apply to each attached procedure. To apply a different fixed amount to each procedure, do one procedure at a time or update an individual adjustment once it has been added.
  4. Provider / Clinic: Verify the adjustment's provider and clinic assignment. By default adjustments will inherit the procedure's provider and clinic. To override the procedure provider and clinic, click [...] and select the provider and clinic.
    Note: If the Enforce Fully, Force Valid Adjustments Account Module Preference is enabled the provider or clinic cannot be changed here. Instead double click on the adjustment from the patient account (user must have the Setup security permission).
  5. Additions / Subtractions: Select the adjustment type.
  6. Note: Enter a note that will be added to the adjustment applied to all selected procedures.
  7. Available Procedures: Highlight the procedures to create adjustments for. To filter the procedures in the grid, select a different Credit Filter. The default credit filter depends on the Enforce Valid Adjustment set in Account Module Preferences.
    • Only allocated credits: Show all procedures that do not have enough attached credits (e.g. pay splits, adjustments) to cover the full cost of the procedure (e.g. procedures that have attached pay splits that only cover part of the cost).
    • Include all credits: Show all procedures that are not paid off using first in/first out logic. This logic applies when credits in a payment are not explicitly attached/allocated to procedures.
    • Exclude all credits: Show all procedures on this patient's account.
  8. Add Adjustments: Click to create an adjustment for each procedure. The grid title will change to Available Procedures with Adjustments and each adjustment will be listed below its attached procedure.
    • To edit one or more applied adjustments, highlight the adjustment, change the adjustment info and note, then click Update.
    • To delete one or more applied adjustments, highlight the adjustment and click Delete.
  9. Click OK to post the adjustments to the patient's account.
Note: If no procedures are selected and you click OK, a single adjustment will be created with the adjustment info.