
| Prompt | Response | Req | Len |
|---|---|---|---|
| Batch Number | Type the code you want or click the magnifying glass to search a list of every 'unlocked' batch. | 17 | |
| Default Last Batch | If you want the last batch number (used by the current user, in the current database, for the current date) to default, select this check box. If you select this check box while in any function in the system that contains a Batch Number field and then you access a different function that contains a Batch Number field, the Batch Number field will automatically default the last batch number used. |
1 |

| Prompt | Response | Req | Len |
|---|---|---|---|
| Social Security No. | Informational only. Displays the Social Security Number stored in the patient's Name and Address record. | 12 | |
| Date of Birth | Informational only. Displays the patient's date of birth. | 10 | |
| Balance Due $ | Informational only. Displays the current account balance. | 10 | |
| Date of Last Visit | Informational only. Displays the date of the patient's most recent service. | 10 | |
| Last Payment Date | Informational only. Displays the date of the patient's most recent payment. | 10 | |
| Last Payment Amount $ | Informational only. Displays the amount of the patient's most recent payment. | 10 | |
| Internal Comment | Informational only. Displays the Internal Comment stored on the patient's Billing Information record. | 45 | |
| Accounting Date | Type the date you want or click the calendar icon to select a date. The default is the current system date. Future dates are not permitted. If you are using batches, the Accounting Date is set to the accounting date specified for the batch and cannot be changed. | 10 | |
| Refund Date | Type the date the refund is actually issued, or click the calendar icon to select a date. The default is the date entered as the Accounting Date. This is the date that prints on the patient's statement. | 10 | |
| Refund Amount $ | Type the refund amount (or credit balance write-off) as a positive number. | 10 | |
| Refund Code | Type the code you want or select it from the list. The list includes only adjustment codes from the Adjustment Code Table that are marked as refund codes. Even though a refund is a debit adjustment, CGM webPRACTICE needs to differentiate between a refund debit adjustment and a regular debit adjustment. | ![]() |
10 |
| Remarks | Optional. Enter additional information about the refund or write-off. Any information entered here overrides the description contained in the Adjustment Code Table. This remark is stored in the patient's history and prints on the patient's statement. | 40 | |
| Payee | Type the code you want or select the payee from the list to identify the party receiving the refund (for example, an insurance carrier). |
