If I don't do patient billing, I adjust it off too. But if I do their patient billing, and it's a provider who has repeat visits (mental health, chiro, etc) I ask the provider if they are refunding to the patient, or applying to future visits. If they are applying to future visits I adjust it out of the billing it is overpaid on (with a note as to what I'm doing) and apply the credit to the future billings.
Michele