I have had this come up a few times lately and wanted to see how to handle this. A few patients that had refunds coming to them (generally a small refund of $5 or $10), have stated not to bother sending it to them. Patients have said, "give it to a charity of your choice." Is this possible? If so, would I just write a letter to the patient (and keep a copy) detailing that they have a refund due to them but at their request we are donating to ABC Charity?